by Shawn FrazierElectronic health records (EHR) have been implemented in nearly all healthcare facilities today. According to The Office of the National Coordinator for Health Information Technology, “As of 2015, nearly 9 in 10 (87%) of office-based physicians had adopted any EHR, over 3 in 4 (78%) had adopted a certified EHR and over half (54%) adopted a 'Basic EHR'.” While EHRs have helped organizations make significant strides with care coordination, enhanced privacy and security of data, and increased efficiency of care, they still leave room for error, specifically the creation of duplicate health records. A duplicate patient record occurs when one patient is associated with more than one record.
According to a study in Perspectives in Health Information Management, there are four main data-related reasons for duplicate records:
- Lack of data standardization
- Changing demographic data
- Lack of multiple matching demographic data points
- Default values
A Patient Identification and Matching Final Report prepared for the Office of the National Coordinator for Health Information Technology noted that, “The patient matching challenge can be quantified many different ways: the percent of records that are matched, duplicate record rates, false positive rates, false negative rates, sensitivity, and specificity. While an error rate of less than eight percent is the industry-recognized standard, many organizations exceed this rate. Studies have found that duplicate record rates in health care databases can be high. One study evaluated 112 MPIs and found a mean duplication rate of eight percent, with a quarter of the indexes having duplicate record rates of more than ten percent.” No matter what the duplicate record rate, they can cause significant problems.
An article in HIT Consultant noted that, “Missing or incorrect information in duplicate medical records can cause severe injuries, illness and even death. Duplicate medical records and overlays also lead to reimbursement losses, administrative inefficiencies, resource drains, liability concerns, and perhaps most significantly, compromised care delivery and threats to patient safety.” Furthermore, according to an NCBI article, “Duplicate records are associated with a higher risk of missing important laboratory results when compared with non-duplicated records. This risk is not merely the result of misallocation of laboratory reports, and may result from a change in clinical workflow. “
Having a duplicate record may result in patients not being diagnosed in a timely manner, if at all, or in some cases, the wrong patient may be given medication or therapy. For example, if a patient has screening labs to test for diabetes and the blood glucose level is elevated but the test result goes into the wrong medical record, that particular patient’s diagnosis is delayed. If the test resulted in another patient being wrongly diagnosed as having diabetes, they could undergo costly referrals for diabetes education and management, and even begin medication for a problem they do not have, causing the patient physical, mental and financial stress. Similarly, a patient with an abnormal mammogram result that does not make it to the correct record could lose valuable time if a cancer diagnosis is missed simply because of the result being sent to the wrong patient, and the patient who is incorrectly identified as having an abnormal mammogram could undergo unnecessary worry and costly, invasive diagnostic testing. One may wonder how such errors can occur, but a Journal of Medical Biochemistry article found that in one area of Texas, “2488 patients were named Maria Garcia in the Hospital District, and 231 of these (9.3%) also shared the same date of birth.” Fortunately, with the advent of an enterprise master patient index (EMPI), organizations may be able to avoid these critical mistakes and match patients correctly, even if there are multiple patients with the same name.
Utilizing an EMPI helps an organization prevent the creation of duplicate medical records. An EMPI allows healthcare organizations to identify and match patient records stored across multiple IT systems to prevent duplicate data and ensures all patient records are accurate, complete and up-to-date. While no system is perfect, or able to ensure a 0% duplicate records rate, an effectively implemented EMPI system results in clean, high-quality patient data and presents a ‘golden view’ of each patient that is both comprehensive and accurate.
An EMPI is exactly what’s needed to manage the recent explosion of healthcare data and the need to continually exchange information between all members of the patient’s care team. VisionWare partners with our clients to streamline the data integration process and provide clean, accurate information, so that organizations can be assured they are treating the right patient –every time.
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