Photo Credit: Iodrakon
Physicians should employ strategies to avoid duplicate and overlay medical records, which can have detrimental impacts on patient healthcare.
Unfortunately, medical records are not always accurate, and errors like patient misidentification or identity duplication occur. OB/GYN, CEO, and co-founder of healthcare software solutions company 4medica, Oleg Bess, MD, notes how jarring it can be to encounter an electronic health record (EHR) that suddenly appears cloned or fused with someone else’s profile. While Dr. Bess feels confident in his knowledge of each patient, such errors could cause perilous and irreversible issues in everything, from clinical labs to insurance carriers to treatment from other clinicians.
According to Dr. Bess, problems like poor data management, insufficient data maintenance, inadequately run patient registration processes, and deficient EHRs all lead to low-quality patient data, which pervades the US healthcare system. Despite technology advances, Dr. Bess points out that most laboratories still rely on paper requisitions and manually entering patient demographics. This, in turn, creates a situation geared toward typing errors and a challenging clinical decision-making environment. In Dr. Bess’s opinion, duplicate records are often the result of overburdened data-entry workers not taking the time to search for the correct patient record, opting to create a new identity instead. Also, the situation gets compounded by incomplete patient records with potentially changing data like addresses, phone numbers, employers, or insurance carriers. As a result, healthcare systems contain duplicate records and, perhaps more unnerving, overlays—situations in which data from different patients is combined or completely switched.
A discouraging medical record duplication rate of 10% is, according to Dr. Bess, typical for healthcare organizations, but some have duplication rates that reach 30%. One example cited by the Healthcare Financial Management Association points out a Texas hospital where 22% of patient records were duplicates. Former health information management director at the Children’s Medical Center Dallas, Katherine Lust, added that of those duplicate records, clinical care was impacted in 4% of cases, with delayed emergency department treatments and surgeries, as well as superfluously ordered tests. While duplicate records are cause for concern, overlays are more urgent, as one patient’s chart has a completely different person’s information in it. As a result, physicians refer to the wrong medical information when choosing treatment plans for these patients, which Dr. Bess notes can have devastating patient outcomes and may lead to serious litigation.
If a patient’s record is established thoroughly and accurately from the get-go, their chances of misidentification or duplication will decrease. Dr. Bess believes that this begins with a patient’s primary care physician (PCP), who can take measures such as ensuring that patient registration forms employ many identifiers, like full names with middle initials, birthdates, social security numbers, etc. Doing so from the start will help prevent the creation of duplicate records due to previously unrecorded data. Dr. Bess also recommends that PCPs routinely check test results, insurance information, and other patient data for accuracy.
According to Dr. Bess, the ultimate answer to solving this issue is a National Patient Identifier system. In the interim, healthcare organizations and physicians would be best served to educate themselves on how to use new technologies to avoid duplicates and overlays.
