1.1 BACKGROUND OF THE STUDY
Positive patient identification is the foundation of effective healthcare. It considers the right care to be conveyed to every patient in light of his or her individual needs. Recently, ECRI Institute analysts found that patient identification issues were common in healthcare, and these mistakes have critical patient wellbeing and financial implication. According to Michael (2012), 7 to 10 percent of patients are misidentified amid therapeutic record seeks. Besides, around 6 percent of those patients experience the ill effects of generally preventable unfavorable occasions, for example, wrong-side surgery or off base systems performed, medication errors, radiation exposures, blood transfusion responses, radiology blunders, or research facility blunders. (Michael, 2012).
When a patient walks through the door of the emergency room, if the correct medical chart with the correct patient information is not accessed, there can be serious repercussions. Diagnosis and treatment is a complex process. Even seemingly minor inaccuracies can lead to big mistakes, because caregivers are basing many high-risk/high-reward treatments on that information. Data, such as past medical history or medication and allergy lists, can be easily omitted or inaccurately listed if a patient is not identified properly.
Patient misidentification commonly occurs when a staff member begins a new patient chart and certain imperative information is missing. When this happens without a physician’s knowledge, it could seriously impact a patient’s health. For example, if a patient has a severe allergy to IV contrast but the patient’s medical chart does not note this, he or she could experience a life-threatening allergic reaction when the physician orders a CT scan with IV contrast. (Bártlová et al., 2015)
Another common danger is inaccurate medication lists. Consider anticoagulants, for example. These are important and potentially life-saving medications that can prevent strokes or heart attacks. But if a caregiver is unaware that a patient is taking anticoagulants, they may prescribe another, seemingly unrelated medication (antibiotics for treatment of a minor infection, for example) that could interact with the anticoagulant therapy and cause life-threatening hemorrhaging. (Sean, 2016)
The availability of an accurate past medical history is another crucial piece of a patient medical record. When a physician evaluates a patient’s signs and symptoms but does not have access to their complete medical history (or even worse, accidentally viewing another patient’s medical history due to improper patient identification upon registration), there is a chance of misdiagnosis and mistreatment, which can lead to potentially serious medical consequences. If a patient has a history of stomach ulcers and their doctor starts them on aspirin or ibuprofen, they could have a massive, life-threatening GI bleed. If a patient has a history of blood clots in the leg and starts hormone therapy, they are at an increased risk of developing more clotting, including a pulmonary embolism (a blood clot in the lungs) that could be life threatening. (Sean, 2016)
Even in this day and age of technology, clerical errors play a significant role in patient misidentification. Patients may have multiple duplicate charts throughout a healthcare organization due to simple typographical errors, name misspellings, inaccurate birthdates, language barriers, misinterpretations, misunderstandings, and communication errors between hospital staff, patients, outside caregivers, and family members. And remember, sometimes patients may be confused and unable to provide accurate information due to delirium, shock, dementia, psychosis, intoxication, or drug overdoses or they may even intentionally give inaccurate information for purposes of fraud.
Particularly in emergency situations with fast-paced triage, acutely ill patients, and oftentimes overcrowded environments, it can be difficult for hospital registrars to obtain accurate information and correctly identify the patient presenting for care. In these cases, in order to get the patient registered as quickly as possible, the registrar, rather than struggling for a prolonged time (precious moments when someone is in respiratory distress or bleeding profusely, believe me), may choose to just create a new chart rather than delay registration or risk picking the wrong patient’s chart and creating an overlay chart (one that has two different patients’ information tangled together in one chart). This, of course, results in a chart that includes none of the patient’s history and leads to all of the problems described above, compounding the situation further. (Bártlová et al., 2015 and Sean, 2016)
It’s important to remember that, in addition to the effect on patient safety, misidentification of patients also has a large financial effect. For example, if a doctor doesn’t know a patient has had a test in the past, he or she may order another CT scan, exposing the patient to unnecessary radiation, risk, and costs for both the patient and the healthcare system. Excessive and duplicate studies are a major problem in the practice of medicine, and without accurate patient identification, it is difficult to properly assess exactly who has had which studies and who needs a new test. Hospitals spend large amounts of money per year in human resources and information technology to sift through patient records after the fact and try to merge duplicate charts and separate out overlay charts. Furthermore, intentional patient misidentification (fraud) and unintentional incorrect patient identifiers lead to major financial losses for hospitals and the healthcare system as a whole, in part due to patient harm, liability and adverse events, inefficiencies in billing, and insurance claims denials. (Bártlová et al., 2015 and Sean, 2016)
1.2 STATEMENT OF THE PROBLEM
Misidentification of patients is a common problem that many hospitals face on the daily basis. Patient misidentification is one of the leading causes of medical errors and medical malpractice in hospitals and it has been recognized as a serious risk to patient safety.
Recent studies have shown that an increasing number of medical errors are primarily caused by adverse drug events which are caused directly or indirectly by incorrect patient identification. In recognition of the increasing threat to patient safety, it is important for hospitals to prevent these medical errors from happening by adopting a suitable patient identification system that can improve upon current safety procedures.
In a nutshell patient misidentification causes the following problem:
i. Medication errors, blood transfusion errors,
ii. Testing errors,
iii. Wrong person procedures,
iv. Discharge of infants to the wrong families,
v. Phlebotomy and surgical interventions.
Patient misidentification is a widely reported problem in medical literature. For example, the National Patient Safety Agency quoted this problem as a “significant risk in the NHS” (Thomas and Evans, 2009).
1.3 AIM AND OBJECTIVES OF THE STUDY
The aim of this project work is to develop and implement biometrics based system for patient identification that will improve on the manual method of identifying a patient. The objective of the project is to develop a system that should be able to:
i. Reduce or possibly eliminate Patient misidentification in hospitals
ii. To increase accuracy of patient identification system
iii. Transform the manual process of patient identification to a computerized system through an improved method.
iv. Provide guidance for doctor and nurses accurately identification of patient related issues.
v. Eliminate paper costs, and provide all the reports for patient on demand.
vi. To reduce the risk of patient misidentification.
1.4. SIGNIFICANCE OF THE STUDY
The fingerprint based patient identification system will be of great benefit as it identifies patients accurately and retrieves their correct medical record. Also the biometric identification will create a one-to-one link between patients’ identities and their medical records. The biometric patient identification solution will enable healthcare providers to improve patient safety. By positively identifying patients, physicians ensure that the right care is provided to the right patient. Smoother, more accurate recordkeeping also increases revenue cycle efficiency by reducing duplicate medical records, overlays, and insurance fraud; enhances patient satisfaction by accelerating the patient check-in processes; reduces the risk of identity theft posed by conventional patient identifiers; and seamlessly integrates with existing electronic medical record (EMR) solution.
1.5 SCOPE OF THE STUDY
Since the topic of patient misidentification is very broad, this thesis concentrates on the technical aspects of the design, implementation, and evaluation of a patient identification system – while providing only references for further reading concerning the medical background of this topic. Therefore, the information in this thesis is of technical nature and aimed at readers with a background in medical informatics or IT managers working in healthcare institutions.
This project is to produce a working prototype, including both hardware and software as the proof of concept system. The prototype will need to demonstrate:
i. Identifying a patient using biometrics with a high degree of confidence.
ii. Code the software required for data mining techniques to match the patterns with known patterns. In addition, the proof of concept will include Web portal to show results to an operator such as a healthcare professional.
iii. Using the biometric system to confirm a patient’s’ identification. This includes writing software that prompts patient to scan their vein patterns, and confirms a patient’s identity via the use of biometrics
1.6 METHODOLOGY OF THE STUDY
According to Ndunagu, (2004) he defined Methodology as a way of thinking about and studying social reality”. “Potter in 1996 defined methodology as strategies that lay out the means for achieving the goals of research”. They all defined methods as procedures and techniques used to reach the study’s goal. “Potter in 1996 sums up the inter-relationship and differences by stating: “Methodologies are the blue prints; methods are the tools”. The research methodology used helps to ensure that a thorough study of the present system is effectively carried out, thus helping the project research team to completely understand the modus operandi of the present existing system so as to know how the new system should be structured and the functionalities needed in it to address the seemingly, existing problems discovered. This helps to know if there should be a total over hailing of the existing system or if only improvements should be made. Hence, after duly considering the above reasons, out of the whole software engineering standard for transforming ideas into an inference Engine which includes prototyping, experts’ system methodology and usability Engineering methodology, this work will adopt the steps of structured system analysis and design methodology (SSDM). SSDM is a methodology used in the analysis of design stages of system development. The step includes:
i Problem identification
ii System design
iii System implementation and maintenance.
The proposed system in its all whole is intended to totally take out the issue of the current system. The proposed system as a stand-alone application would empower the identification of patient using fingerprint biometric. The propose system is very easy to use and viable. It takes care of the issue of multifaceted nature by building a basic stand-alone application that can be effectively be utilized and comprehended by users at the hospital. The proposed system is intended to appear as the current system; the main change is in the stage that is from a manual one to an automated platform that is using patient fingerprint for identification. The reason is that new systems are better worked around a current system, so the administration can abstain from investing part of energy in manually identifying patient(s) that with the use of card numbers. The bedrock of this system is it utilizes fingerprint biometrics, and an all-around organized database, this database is intended for each table to go about as different patient record keeping. The excellence about the proposed system is that any information that should be entered with the database naturally shares assets with the information entered.