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Topic: Correct duplicate numbers before embarking on an EHR transition

HIM Connection, September 9, 2008

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Correcting duplicate numbers should be an ongoing effort, but this task becomes increasingly important in facilities that are migrating toward an EHR. "Data integrity is critical to the success of [information technology] initiatives," says Stacie Durkin, MBA, RNC, RHIA, president and CEO of Durkin & Associates in Kansas City, MO. "If the quality of the data isn’t the best it can be, it can affect the functionality of the application."

Durkin says facilities in the process of EHR implementation should take the following steps during the rollout process:

• Assess your duplicate management process. First, determine the number of duplicate medical record numbers. Next, consider your typical approach upon discovery of a duplicate-has your facility adopted policies and procedures to address the problem? Does your registration staff adhere to a standard data capture process to help prevent the occurrence of duplicates? Some systems don't allow users to correct patient identity until after discharge; knowing your system's capability in this regard and the ability to determine how many duplicates exist is essential.
• Determine how much time is necessary for MPI cleanup. Every facility's experience will be unique, Durkin says. A facility with 1.2 million records and a duplicate rate of 30%-360,000 potential duplicates-needs to review most of them to determine identity. Experienced staff members typically require approximately two minutes per duplicate pair when external resources, such as a paper record or electronic system, are not necessary for data verification. Inexperienced staff members might require five to seven minutes per duplicate pair.
• Establish your cleanup timeline. Facilities should perform MPI cleanup as close to EHR implementation as possible, Durkin says. Duplicate reports are a snapshot in time, and the potential for duplicate creation during the cleanup exists, she says. Generate a daily report to identify new duplicates as your go-live date approaches.
• Consider staffing needs. Determining the number of staff members necessary for MPI cleanup is challenging. Validation is time-consuming, and significant follow-up and research might be necessary. "If you have to have this cleaned up in two months and you have 50,000 duplicates, can your staff of one or two clean them up?" Durkin says. Some hospitals employ an MPI analyst to correct and research duplicate numbers. This individual typically is on call 24/7, particularly for emergency room/trauma situations in which urgency increases the likelihood of duplicate numbers and thereby potentially affects patient care.

Editor's note: This article was adapted from the September issue of Medical Records Briefing. For more information, visit www.hcpro.com/content/217080.cfm.

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