By Alejandro Sangiovanni, Western Regional Manager, NextGate
Twitter: @NextGate
Healthcare’s heavy reliance on clipboards, signatures, and plastic ID cards can cause significant frustrations for patients and providers including incorrect patient matching, medical errors, repeated services, and poor communication. Today’s consumers demand convenience. The rise in urgent care clinics over traditional doctor offices continues to grow. Consumers want access to care on their terms. This includes walk-in appointments, neighboring locations, and 24-hour availability. Today, patients flock to their neighborhood urgent care clinic or pharmacy to receive tests, flu shots and COVID vaccinations.
The rise of healthcare retailization is here.
The retailization of healthcare took a big leap in 2018 when CVS made a $69 billion deal to purchase Aetna, the nation’s third-largest health insurer. CVS manages prescriptions for over 75 million Americans and more than 70 percent of the U.S. populations live within three miles of a CVS pharmacy.
The ripple effect of changing how millions of Americans receive medical care services is causing other retail giants, like Target and Walmart, to jump into healthcare too.
Both urgent care centers and retail clinics have continued to grow nationally as patients look for affordability and convenience, creating competition with traditional hospital and physician practice services. Today, urgent care clinics serve 89 million visits each year. According to a 2019 benchmarking survey from The Urgent Care Association, the number of urgent care clinics has rose steadily since 2013, from 6,000 to 9,000.
At the end of 2017, there were an estimated 2,800 medical clinics in retail space in the United States, according to Accenture. Between 2015 and 2017 the number of healthcare tenants in retail locations grew by 47 percent and is expected to double by 2022.
Further, a 2017 PULSE survey finds younger Americans are much more likely to use urgent care clinics than a doctor’s office, and are less likely to have a relationship with a primary care physician.
As retail health clinics evolve and become increasingly more mainstream, embracing innovations in digital identity will be paramount.
Digital identity has been used in other sectors including banking and retail but has yet to be widely adopted in healthcare. That’s because health IT applications used to manage, match and share patient data and demographics electronically are highly fragmented. Despite federally mandated requirements to push IT vendors into the 21st century, interoperability remains an elusive goal. Proprietary EHR systems fail to communicate or integrate data with other systems in the continuum, creating information sharing barriers, patient misidentification and significant frustrations for physicians and consumers alike.
Health plans also face issues trying to identity patients and share data with providers for billing, eligibility and claims reimbursement. A recent Gartner report on payer interoperability and clinical data integration finds that while 48 percent of health plans are ingesting digital charts from provider EHR systems, just 14% of them are receiving data that aligns with the HL7 exchange standard.
Stopping identity fraud, waste, and abuse (FWA) will grow even more important for providers, retail health clinics and payers as opioid abuse continues to climb. Spiked by the pandemic, drug overdoses accounted for more than 81,000 deaths in the United States in the 12 months ending in May 2020—the highest number of annual overdose deaths ever recorded—according to the Centers for Disease Control and Prevention (CDC).
Accurate patient identification to recognize individuals with the highest likelihood of FWA, while eliminating false positives, can help the industry eliminate abuse of the system. Capturing demographic data can also support high-quality analytics to spot developing patterns and trends in prescription drug abuse.
Without consistently and correctly matching individuals to their health data, patients and care providers will continue to suffer the consequences. Each year, as many as 440,000 Americans die from preventable medical errors, now the third leading cause of death in the country.
As healthcare becomes consumer-driven, it is equally critical to consider use of other identification mechanisms to ensure that patient demographic information is accurate and up-to-date. Use of personal smartphones, for example, to streamline registration and allow patients to play an active role in managing and updating their data can help to improve patient matching efforts at key stages where data errors often occur: during enrollment and at registration.
With digital identity, payers, providers and retail health clinics can meet the demands of today’s tech-savvy consumers by allowing them to be the single source of truth of their identity. Using their mobile device, everything from patient registration to health assessments and questionnaires, can be automated on-demand using digital credentials for fast, contact-less care. Digital health credentials run the gamut from driver’s licenses, insurance cards and vaccination records, all of which are issued by organizations that verify the authenticity of the information.
Equipped with privacy and security protocols already built their smartphone, consumers determine what information they share, with whom, and for what purpose. Identity can be verified in real time—allowing patients to skip the check-in process, avoid redundant paper-based forms, and expedite care delivery. Further, use of digital identity solutions can achieve 100% patient identification accuracy to support the industry’s long-standing patient matching issue to ensure the right data about the right patient at the right time.
Use of verified digital credentials can fundamentally change how consumers interact with health systems, retail clinics, pharmacies, and insurance companies with a convenient approach to identity that protects privacy while improving the patient experience.
For far too long, patients have been left out the conversation when it comes to healthcare digitization. Retail clinics have already recognized this new generation of patients where proximity and accessibility are king. As consumers continue to demand conveniences that resemble Amazon or Google, embracing digital identity solutions will give patients the user-friendly experience they expect and empower them to become engaged participants in their health.
This article was originally published on the NextGate Blog and is republished here with permission.