Developing a Strategy to Win the War on Duplicates

This monthly column will discuss all the components of quality clinical documentation with a comprehensive approach to cover all areas of the healthcare industry.

By Robin E. Gates, RHIA

Duplicate records remain one of healthcare’s most vexing—and costly—problems. Consider that the average master patient index (MPI) system has a duplicate rate of between 8 percent and 12 percent—the equivalent of 80,000 to 120,000 duplicate records for a hospital system serving 1 million patients. Each pair of duplicate records costs the facility approximately $96 to resolve. (Some say the average rate is even higher, with Black Book Market Research putting it at 18 percent in its 2018 Mid-Year EHR Consumer Satisfaction Report.)

On top of that, there are significant clinical costs associated with duplicates. At one major pediatric facility, clinical care was negatively affected in 4 percent of cases involving confirmed duplicate records. The most common issues were treatment delays, duplicate tests due to lack of access to previous results, and surgical delays because of a lack of access to patient history and physical reports—all of which added approximately $1,100 to the cost of care for each impacted patient.

All of this is happening despite efforts to address the issue at national and individual facility levels—and despite well-established best practices designed to prevent the creation of duplicates. In fact, not only are duplicate records an intractable challenge, but their impact has grown exponentially with the proliferation of health information exchange. Now, a single duplicate can quickly contaminate the systems at the originating hospital and any facility on the receiving end.

As the duplicate rate climbs, so too does the level of resources required to keep systems clean. For most hospitals, dedicating the staff required to identify and reconcile duplicates before they are able to run amok within the EMPI and other systems is a luxury that is simply out of reach.

It’s time to consider a new strategy.

Faced with the prospect of paying for repeated cleanups or getting swamped with duplicates, some hospitals are seeking out support services that leverage both technology and expertise to provide ongoing EMPI monitoring and management. These services are charged with the task to identify, validate, and reconcile duplicate records before they can infiltrate and contaminate downstream and outside systems, maintaining the integrity of the EMPI without draining internal resources.

For some providers, outsourcing MPI maintenance could indeed be an effective solution. For example, a radiology center with about 1 million records flowing through its MPI each year reporteds a duplicate rate well below 1 percent after outsourcing its MPI support services. And duplicates that do make their way in are typically identified and resolved within one day.

In short, outsourcing ongoing MPI maintenance has the potential to reduce costs and increase productivity within the health information management department. What’s more, outsourcing can help reduce the clinical costs and patient safety issues incurred due to duplicate records, helping ensure quality of care and a stronger bottom line.

What is your facility’s current approach for dealing with duplicate records? Have you considered outsourcing? Let us know in the comments below.

Robin E. Gates, RHIA, ([email protected]) is vice president sales for Just Associates.

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