Abstract
PurposeTo reduce patient and procedure identification errors by human interactions in radiotherapy delivery and surgery, a Biometric Automated Patient and Procedure Identification System (BAPPIS) was developed. BAPPIS is a patient identification and treatment procedure verification system using fingerprints.MethodsThe system was developed using C++, the Microsoft Foundation Class Library, the Oracle database system, and a fingerprint scanner. To register a patient, the BAPPIS system requires three steps: capturing a photograph using a web camera for photo identification, taking at least two fingerprints, and recording other specific patient information including name, date of birth, allergies, etc. To identify a patient, the BAPPIS reads a fingerprint, identifies the patient, verifies with a second fingerprint to confirm when multiple patients have same fingerprint features, and connects to the patient’s record in electronic medical record (EMR) systems. To validate the system, 143 and 21 patients ranging from 36 to 98 years of ages were recruited from radiotherapy and breast surgery, respectively. The registration process for surgery patients includes an additional module, which has a 3D patient model. A surgeon could mark ‘O’ on the model and save a snap shot of patient in the preparation room. In the surgery room, a webcam displayed the patient’s real-time image next to the 3D model. This may prevent a possible surgical mistake.Results1,271 (96.9%) of 1,311 fingerprints were verified by BAPPIS using patients’ 2nd fingerprints from 143 patients as the system designed. A false positive recognition was not reported. The 96.9% completion ratio is because the operator did not verify with another fingerprint after identifying the first fingerprint. The reason may be due to lack of training at the beginning of the study.ConclusionWe successfully demonstrated the use of BAPPIS to correctly identify and recall patient’s record in EMR. BAPPIS may significantly reduce errors by limiting the number of non-automated steps.
Highlights
Patient identification and procedure verification are well-known problems in the medical industry
The Joint Commission goes on to point out that wrong site surgery data collected by other organizations suggested a significant amount of under-reporting to the Joint Commission
BAPPIS identified 1,311 fingerprints from 143 patients prior to treatment as a graph created in Figure 6. 1,271 fingerprints were verified with the system
Summary
Patient identification and procedure verification are well-known problems in the medical industry. Accreditation by the Joint Commission demands accuracy of patient identification by using at least two patient identifiers [1]. The most popular identifier, wristbands, is proving to have an unacceptable error rate. These misidentifications can lead to a medical misadministration and falls under the category of a ‘sentinel event’. The sentinel report update in December 2001 from the Joint Commission analyzed 126 incidents for root causes and determined 76% involved surgery on the wrong body part or site; 13% involved surgery on the wrong patient; and 11% involved the wrong surgical procedure.
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