Defining The Duplicate Medical Record Problem
The Velocity Interoperability Blog and Velocity Interoperability Podcast are sponsored by Velocity Health Informatics. Velocity provides both data quality and data integration as a service offerings to ensure that healthcare providers access the correct patient record with the right data for each patient they serve.
What is a duplicate medical record?
Duplicate medical records are two or more medical records for the same individual. Many times, the records are not exact duplicates and each record only contains a percentage of the patient’s medical record history.
How are duplicate medical records created?
Duplicates can be created in several ways. One of the most common source of duplicates is errors made during the patient registration process. There are many variations of duplicates created by registration errors. One common issue is in the ER when a patient can’t be identified because they are not conscious.
Many times duplicates are created due to demographic changes for the patient. Registrars have difficulty finding a patient that has moved or changed their last name so they create a new record for that person.
Many organizations that have large number of duplicates discover that they need to provide more training to their registration staff. Other organizations find that the “matching algorithms” in their EMR need to be improved.
Additionally, many have pointed the lack of a National Patient Identifier as a key cause for duplicate medical records.
How big is the problem? What does the data show?
The American Health Information Management Association (AHIMA) recently completed a study that included a survey of providers on duplicate medical records. The most alarming stat from the study is that 45% of respondents said “I do not know” what their duplicate rate is.
The reminder of respondents reported the following duplicate rates:
- 18 % of Respondents – < 1% Duplicate Rate
- 19 % of Respondents – 1-3% Duplicate Rate
- 9 % of Respondents – 4-5% Duplicate Rate
- 3 % of Respondents – 6-8% Duplicate Rate
- 6% of Respondents – >8% Duplicate Rate
Click here for more information on the AHIMA study.
What problems are created by duplicate records?
The worst problems created by duplicate records are increased patient risk created due to a lack of all clinical information on a patient. For example, the record that a physician is accessing may not included allergies, medications, blood type, family history or pre-existing conditions that are vital information to their current encounter. This can lead a provider to order duplicate tests, ineffective treatments or otherwise harm patients.
Duplicate records create significant issues when trying to integrate systems and data with other providers and also when trying to implement new system at a provider. In those cases, data migration are significantly more complicated the higher the duplicate medical record rate is.
Can duplicates be fixed? How?
Having a “clean master patient index” and a clean set of medical records is vital to enabling technology. Many facilities have a tool or services that identify all duplicates and then work them down. Further, “best practice” organizations have an ongoing daily process of identifying and fixing duplicates via a combination of tools, processes and sometimes, external services.
How can duplicates be prevented?
Implementing unique patient identification technology solutions will certainly help. We will investigate different solutions in a future post. Organizations should implement Information Governance to implement standard policies for data collection and management. Organizations should also have a plan to monitor and continuously optimize patient matching.
And finally, continuous education is key to reducing/eliminating duplicate medical records.
Why is the duplicate medical record problem not as simple as described in the Questions and Answers above?
The Q & A above assume a patient in the context of a single Electronic Medical Record system for a single healthcare provider. The reality is that any patient that has ever been treated by two or more healthcare providers (doctors and or hospitals/systems) that do not use the same Electronic Medical Record system has duplicate medical records, (at least) one in each provider that has treated the patient’s EMR. IMO the great flaw of ARRA/Meaningful Use is that it did not include #interoperability as a requirement and now after we’ve spent well over $40B for all providers to implement EMR’s, we created a duplicated medical record problem that may never be able to be “fixed” and we left patients in a state where they have to cobble together their total medical record by assembling what is stored in the EMR systems of all providers that they have ever seen.
Get expert insight on the Duplicate Medical Record issue in our interview with Leigh Williams: Duplicate Medical Records: The Unintended Consequence of Implementing EMRs.
Join the Conversation
Please jump in and participate as your input will only improve our chances of success. The fine folks at Velocity are interested in exploring and improving our current states of medical record data quality and interoperability and this post is the first of many posts and (coming soon) podcasts reporting on current status and solutions. PLEASE bookmark this site and provide your input and feedback on a regular basis!
The Velocity Interoperability Blog and Velocity Interoperability Podcast are sponsored by Velocity Health Informatics. Velocity provides both data quality and data integration as a service offerings to ensure that healthcare providers access the correct patient record with the right data for each patient they serve.
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