“If a person gives five different names over a five-month period, we are still able to get the correct patient medical record to the treating provider, regardless of the patient’s name,” says Kandy Swanson, BayCare Health System.


When patients present for care at BayCare Health System, a 14-hospital system serving Tampa and central Florida, they rest a hand briefly on a scanner that detects the unique vein patterns on their hands. Those palm vein images are used to identify patients quickly and accurately, streamlining patient check-in, eliminating medical-record mix-ups, and improving patient safety.

Using biometric technology for identification is working well for patients, clinicians, and the registration staff, says Kandy Swanson, BayCare’s director of admitting and registration.

The technology makes use of the fact that people’s palm vein structures are much more unique than their fingerprints. Using invisible infrared light, a palm scanner detects blood flowing through patients’ veins and creates digital signatures that are stored in the health system’s computer.

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“If a patient came to one our facilities 15 years ago when she was single, and she comes to another facility today married and with a different name, we are able to link her to all her medical records using the palm vein image,” Swanson says.

Biometrics to the Rescue

Historically, BayCare used patients’ Social Security numbers as the unique data points for patient identification. In 2008, system leaders started searching for an alternative because they knew patients preferred not to share their Social Security numbers.

“We were hearing from our patients that they were concerned about identify theft, and patients were quite vocal about not wanting to give out their Social Security numbers,” Swanson says.

About the same time, BayCare was launching an electronic health record (EHR) system, which allows staff to access patients’ medical records as soon as they are registered. “It’s paramount that we have the patient identified correctly so we get the correct medical record to the treating physician as soon as possible,” she says.

Matching medical records with patients correctly is a challenge for most health systems, in part because they have so many duplicate records. A 2013 study prepared for the Office of the National Coordinator for Health Information Technology reported an analysis of 112 master patient indexes that found a mean duplication rate of 8 percent, while a separate analysis of 11 patient indexes found duplication rates ranging from 7-39 percent.

In a presentation at HIMSS16, Raymond Aller, MD, director of informatics at the University of Southern California, said many health systems underestimate the problem of duplicate records. He cited one hospital that found 69,807 cases in which two or more patients shared the same last name, first name, and date of birth. That hospital had records for 2,488 patients named Maria Garcia—and 231 of the records had the same date of birth.

Another challenge in matching the right record to the right patient reflects the fact that some patients present false identification when they register. For example, uninsured patients may borrow someone’s insurance card to gain access to care, and some patients seek care under an assumed identity for various reasons. Biometric technology helps front-desk staff sort those situations out.

“If a person gives five different names over a five-month period, we are still able to get the correct patient medical record to the treating provider, regardless of the patient’s name,” Swanson says. “That is a huge win because patients are going to get the care they need, regardless of who they say they are.”

Benefits of Palm Vein Technology

Shortly after introducing the palm vein scans, BayCare took the additional step of inserting patient photographs into their medical records. “We call it the ‘gold standard’ of patient identification,” Swanson says.

In addition to its top benefit—the ability to accurately match patient to medical record—the biometric patient-ID process offers several advantages for the health system.

Streamlined registration. “We are saving time on every visit because we don’t have to ask for a driver’s license or a Social Security number and explain why we need that information again even though the patient has been here before,” Swanson says.

Patient satisfaction. Because front-desk staff no longer ask patients for forms of identification, their concerns about identify theft are alleviated. Moreover, patient photographs offer greater privacy in waiting rooms. Instead of calling out patients’ names, nurses or technologists who will room patients use the photographs to find patients in waiting rooms. “They can go right over to the patient and say, ‘Please come with me,’” Swanson says. “It’s more personalized and more private.”

Early ID for clinicians. Treating clinicians like being able to view the photographs of patients they will be seeing before they enter the exam room.

Biometric Technology Implementation

BayCare’s registration leaders and information services staff worked together to integrate the biometric technology with the EHR and registration systems. The new patient-ID process was rolled out to all hospitals, outpatient centers, and ancillary services facilities over a two-month period.

Before the new process was launched in its facilities, BayCare participated in more than 50 health fairs and other community events to educate patients about its plans to use biometric images. “We knew that it would seem very different,” Swanson says. “We started introducing the concept so people could start talking about it, and when patients came into the healthcare system, they likely would have heard about the new technology out in the public.”

During those community events, BayCare staff highlighted the following advantages of the new technology for patients.

  • Accurate identification, eliminating the possibility that imposters could use patients’ insurance benefits
  • Faster check-in
  • Confidence that all BayCare medical records would be merged together and linked to patients’ palm vein image
  • No need to produce ID documents at medical appointments or in the emergency department
  • Accurate identification, eliminating the possibility that imposters could use patients’ insurance benefits
  • Faster check-in
  • Confidence that all BayCare medical records would be merged together and linked to patients’ palm vein image
  • No need to produce ID documents at medical appointments or in the emergency department

On patients’ first visits to BayCare facilities, registration staff ask for legal identification such as driver’s licenses or state ID cards. Patients place their hands on scanning devices and, in less than four seconds, palm vein images are recorded and matched to patients’ identification.

“We scan that information into our EHR, and forever after, that image will be associated with that patient at the time of registration,” Swanson says. “It doesn’t matter which facility you visit; we will recognize you.”

Photo ID. About a year after the biometric identification launched, BayCare added photo identification. Each registrar’s workstation is equipped with a webcam that allows patient photographs to be taken quickly. Registrars tell patients that photographs are being inserted into their medical records as a patient-safety measure, and patients readily accept it, Swanson says.

Kiosk registration. In a subsequent phase of the initiative, BayCare introduced patient registration kiosks in its outpatient facilities, hospitals, and emergency departments. Each kiosk is equipped with palm scanning devices. “Patients can quickly register themselves,” Swanson says. “That has been embraced wholeheartedly by our patients.”

Improved Patient Identification

Patients who are wary of biometric or photo IDs have the option of using their Social Security numbers as their unique identifier, but few choose that. In the eight years since the system was introduced, more than 1.2 million patients have enrolled.

“There were only a handful of people either at the fairs or when we went live initially that said, ‘No, this is not for me,’” Swanson says.

The use of palm vein technology for patient identification has allowed BayCare to streamline its registration processes, reduce the problems associated with duplicate medical records and medical identity theft, and improve patient safety.

Lola Butcher is a freelance writer and editor based in Missouri..

Interviewed for this article:

Kandy Swanson 
is director of admitting and registration, BayCare Health System, Tampa, Fla.

Publication Date: Thursday, February 09, 2017