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Although duplicate medical record numbers (MRNs) certainly are problematic, registering a patient on another person’s MRN is dangerous.
“This is particularly true with the implementation of EMRs as this can lead to medical decisions that are based on a different patient’s history,” says Shannon Haager, director of patient access services at The Ohio State University Wexner Medical Center in Columbus.
For this reason, Haager says, “We are much more uncompromising about the selection of a wrong MRN than with the creation of a duplicate.”
If, after using several search techniques, registrars aren’t absolutely positive their patient matches an existing MRN, they create a new record.
“The most common reason for this is two people with the same name and other data points are not validated,” Haager says.
A registrar assumes he or she has the correct “Tabitha Jorgenson” because only one comes up in the system, for instance.
“But it’s a brand new patient, raising doubt,” Haager notes.
Researchers found that 98.81% of individuals were uniquely identified using first name, last name, and date of birth while examining a database of more than 85 million individuals.1 However unlikely, it’s still possible to misidentify patients, even with those identifiers.
“We have several sets — at least five that I know of — where two people have the same name and date of birth,” Haager says.
Haager finds that talking with staff about what happens when the wrong MRN is used — “specifically, how dangerous it can be — is the most effective tool for reducing misspellings.”
Protocols to stop duplicate medical records were put into place recently at the centralized scheduling department at The Ohio State University Wexner Medical Center.
“We work directly with patients to verify multiple pieces of information,” explains patient access director Brooke Bellamy. This confirms whether it’s an existing patient in the system, or if a new account needs to be created.
“We have also standardized our registration process,” Bellamy adds. “We are confirming and collecting accurate data for patients for every appointment we schedule.”
Patient access quickly and easily identify any records that could match the patient, so a duplicate record isn’t created. The current processes still rely on the information given by patients, though.
“This allows for errors to be made,” Bellamy acknowledges.
Patients don’t always feel comfortable giving or confirming their Social Security numbers, one of the few pieces of information that does not change, over the phone. Patient names, aliases, addresses, and phone numbers often change.
“It leaves room for errors resulting in duplicate records,” Bellamy notes.