Who Benefits ?
Community outreach is the first critical step to gaining trust within the homeless community. The trust previously experienced by homeless patients who have had successful outcomes will serve as a working conduit for change.
Hospital social workers provide a tremendous amount of benefit to homeless patients and help organize entire networks of care for them. The trust they establish with these patients makes a difference in their lives, not just medically speaking but also through the improvement of social conditions which can offer life altering benefits. "Providing improved conditions and empowering individuals with arriving at their own informed decision to seek care are the two most proven ways of obtaining trust among the homeless."*
Outreach teams consisting of one hospital social worker and one homeless patient** would educate and thereby reduce fear within the overall population. Giving high-functioning homeless patients who have begun to live success stories a means to give back to their community and build trust will positively affect their own health and the health of countless individuals over time.
This solution will allow the homeless to retain the anonymity they desire, while also enabling them to receive better, more efficient care. Since the database will be monitored and contained by a third party service provider, homeless individuals will be able to trust that their personal information will only be accessible to their doctors, nurses, social worker, and pharmacy. No other organizations (ex. the police or other governmental agency) would have access to their files.
* Shelley Cooper - The Primo Center for Women and Children - Chicago holistic homeless center
** patient would gain employment experience and personal compensation per outreach event
Homeless individuals benefit through gaining
trust and anonymity
How doctors and nurses will benefit
Linking a fingerprint to a patient's file, allows Emergency Rooms to accrue an accurate record of medical history, capture critical allergy information, and discover pre-existing conditions which are critical to emergent care. In turn, hospital staff become better informed, allowing for greater accuracy of diagnosis, an ability to build upon previous knowledge, track improvement or decline and provide personalized care.
Housing this database through a third party provider fills the essential need for inter-operability of patient records from hospital to hospital.
The extreme accuracy of fingerprint scanning will remove the rampant patient identification errors threatening homeless patient care. Avoiding the creation of duplicate patient records will improve each incident of care and positively affect the overriding cost associated with each visit.
Reliably identifying patients and connecting them to their history is essential to circumstances of emergent care. Neither a homeless patient's inability to communicate nor their desire to retain anonymous will make them less likely to receive equality of care in the ER.
How hospitals and taxpayers will benefit
Hospitals receive federal funding which helps them cover the high cost associated with treating homeless individuals. The amount of funding a hospital is awarded is based upon demographic data collected over time: such as race, age, ailment, and inability to pay. When a patient is treated under multiple identities, the data determining federal funding is exponentially skewed and this inaccurate burden trickles down to the taxpayer. For example, if a single patient enters the ER 5 times in one year and each visit results in a new chart, that patient will be counted as 5 separate individuals, thereby costing the hospital and taxpayers 5 times as much. This multiplicity of charting is common and the burden becomes exponentially enormous even in the course of one year.
Investing in trust over time through outreach and education, a hospital would facilitate a highly affordable and reliable means of identification through the practice of a secure, bio-metric fingerprinting system. A patient would retain the anonymity of their given name and their fingerprint need only be associated to their medical record number. This same number would be referenced at free standing pharmacies for identity cross reference where a patient could scan to receive their paid medication.
When the number of people who need assistance with paying for care ceases to be inflated through skewed data, taxpayers will fall under reduced financial burden. Likewise, the speed and accuracy of patient registry through ERs would free up critical time for healthcare workers to provide care to more patients overall.
Additionally, the interoperability of hospital software systems is awfully unreliable - even among the hospitals in Chicago who see homeless patients with overlap. Interfaces of hospitals within the same county, state and country should be completely understood and have the ability to work with one another in implementation without restriction. This is currently not the case. In fact, there are five or six different electronic medical record systems that are most commonly used and none of them interface reliably. Instead, they require doctors to feel suspicion and to make dangerous interpretations. A third year medical student working between Rush and Stroger hospitals in Chicago states, "one of the most frustrating aspects I've come across in the hospital system is trying to get health records from other hospitals. The different databases I encounter are unable to communicate with one another which makes it nearly impossible to obtain an accurate, full medical history when patients have received care from multiple hospitals."* Fingerprinting would serve as a National Patient Identifier for homeless patients, not only between hospital systems but with the critical inclusion of pharmacy systems as well.
* Conor Flavin - third year medical student, Rush and Stroger hospitals