Patient Demographics: How Can It Improve the Effectiveness of Healthcare Management

Demographic information of patients is collected by health care providers for a variety of reasons. The most common reasons are to send medical bills, contact them for claim issues, bill payments, etc.

The type of demographic data that is collected varies depending on the healthcare provider and their jurisdiction but can include items such as age, sex, country of origin, marital status, and income. In recent years, state and local government entities have made a concerted effort to increase the focus on understanding and collecting data related to patient demographics. When it comes to improving healthcare, understanding patients’ demographics is a critical first step. As most nations’ demographics continue to change, it is essential that medical industries have accurate patient data.

This is the first bit of information that should be gathered from the date of birth to the insurance carrier that your patient is associated with. The information in medical billing files is also accommodating when there’s a derailment in the payment process.

Whether your medical billing management is handled in-house or you have handed it over to a medical billing company, you have to remain updated about the often overlooked detail – patient demographics.

Why does patient demographic matter?

Why does patient demographic matter

It is important to update and gather demographic information of the existing patient as you do for the newly admitted patient. Suppose your existing patient has changed his phone number then contacting him on phone calls will be fruitless. If they changed their association with the insurance, claiming bills to the old insurance company will deny your claims, which will eventually drain your efforts and claims will be denied. Besides, the payment process will be delayed and will take additional efforts to update and remake bills on the current insurance account, submit claims, and then wait for their approval.

For this, effective measures have to be taken when you need to ask for updated information from your patients. Although, the supply asking ‘Has anything changed in your information?’ may not work every time.  Your patient may not realize what information you have, he may not realize what address or phone number you have on their file. The system should be efficiently maintained in a way that anybody in the office can access them whenever they need the patient demographics. Creating a standard patient demographic collection process will save time and cost of expensive future denials as well.

Collecting Patient demographics to update the existing information

The easiest and best way to collect the updated information for your patients is to gather the updated information every time a patient visits for an appointment. Possibly, most of the information remains the same, but you still need to confirm and gather it accordingly. Depending on the practice and jurisdiction, the information may include;

Collecting Patient demographics to update the existing information

Address confirmations;

  • Is ‘Abc, 123, xyz’ still your address?
  • If not, can you confirm your current address?

Phone number

  • Please update/confirm your contact number for work and home
  •  Do you use a cellphone? Please mention your number for a quick call when needed.

Employer Information

  • Do you still work at ‘ABC company’ located in ‘XYZ’?
  • Is Mr. John still your employer?

Insurance information

  • Is your primary insurance company still covering you for the same premium?
  • Would you mind providing/updating the insurance company information?
  • Do you have any secondary insurance companies?
  • Your data shows that you have switched your job, have you updated employer information in your file
  • Please provide contact information and concerned authorities from your new work and the insurance company.

Workers’ compensation

  • Today’s visit is due to an injury you got from a workplace or met with an accident?

The information above can be taken through the medical application that you use for patients, on a form when they visit, or designate a front desk officer to gather updates through communication.

One of the standard regulations carries the Quality Improvement Strategy Program (QIS) which is monitored by the Centers for Medicare & Medicaid Services (CMS). The QIS program has been designed to motivate staff to gather updated patient information for a better outcome. In addition, the CMS website has also confirmed that following QIS for collecting patient data is one of the best practices.

Your practice may also need to follow the state demographic regulation for updating or gathering patient data. For instance, in Massachusetts, the state obligates the practices to get the race and ethnicity information, ER stays, and observation units for inpatients.

The exact language that the state law that obligates practices to gather the information says;

“[A] recommended data collection tool has been developed … to standardize efforts across hospitals.”

Setting up EMR for data intake

Setting up EMR for data intake

Once you gather all the information about patient demographics and the state-required data, you need an authentic place where you can store it. Practices are shifting rapidly on the software and electronic medical record (EMR) platforms to reach out to the required information quickly.

These platforms help the practices to secure data by applying digital security measures and is more convenient to get the required results in just a few clicks and creates great opportunities compared to physical storage.

Additionally, they also provide streamlined access practices and departments when it comes to data sharing to other facilities, especially for billing and financing claims.

However, despite the credibility and the convenience, the EMR process provides, not every practice uses the technology to ease its burden. According to Centers for Diseases Control and Prevention (CDC) data, 14.1% of physicians working privately (office-based) do not use the EMR system. Besides, the good news is that it is available at the hospital facilities, and the other 86.9% are office-based practitioners.

EMR systems can make a practice of minimizing their work in updating patient information. As the system is connected to many other platforms so it prompts you whenever the changes are made in the patient’s information at any medium.