Mary Ellen Ford
RVHIMA Spring 2015
Contents

 EMPI – What is it?
 EMPI – First Things First
 EMPI—Why’s it matter?
 EMPI—How does it impact your work?
 EMPI—Air out your dirty data
 EMPI—Last thoughts
 Questions
EMPI – What is it?

 EMPI stands for Enterprise Master Patient Index
 Aka Patient Demographics
EMPI – What is it?

 Patient First Name
 Patient Middle
Name/Initial
 Patient Last Name
 Patient DOB
 Patient Sex
 Patient SSN
 Patient Address
 Patient Email Address
 Patient Race
 Patient Marital Status
 Patient Ethnicity
 Patient Language
 Patient Status
(alive/deceased)
 Date of Death
 Whoa…that’s a lot!
EMPI – First Things First

 Patient demographics used to be entered on index
cards (think Dewey Decimal System)…
EMPI – First Things First

 Mary Ellen’s story from paper MPI clean up days
EMPI – First Things First

 It’s been an evolution
 CardsFacility master patient indexEnterprise
master patient indexEHRHIE
EMPI – First Things First

 Now that data and more is collected electronically in
our HIS (health information systems)
EMPI – First Things First

http://campus.ahima.org/audio/2009/RB072109.pdf
EMPI – Why’s it matter?

 Quality care for patients
 Financial Health for the organization
 Referential Integrity—Key to the info—unique ID
EMPI – Why’s it matter?

 Healthcare personnel working with partial information
on the patient in their care
 Errors create enormous waste and additional expense
 Inability of authorized clinicians to access vital patient
records in the event of an emergency
 Increased number of tests being re-run because the
original results cannot be located
 Risks of negative drug interactions because physicians do
not know a patient’s current conditions or medications
 Delays critical diagnosis
 Exposes patients to unnecessary invasive procedures
Source: 2005 Connecting for Health Report, Markle Foundation
EMPI – Why’s it matter?

 Risk of clinical error
 Opens up potential for confidentiality breaches
 Cost of litigation
EMPI – Why’s it matter?

 Causes of duplicates
 Discrepancies in patient name, DOB, address, SSN,
IDs and other unique patient attributes
 Undefined or inadequate processes in registration and
MPI maintenance for addressing duplicate resolution
 Multiple information systems and databases
 Prior data conversions
 Poor system integration, or absence of integration
EMPI – Why’s it matter?

 Issues
 Intra System Duplicates (multiple MRNs for same patient
exist within the same system)
 Cross Over Duplicates (multiple MRNs for same patient
exist across systems)
 Overlays (1 MRN-multiple patients)
EMPI – Why’s it matter?

 It’s in the numbers!
 As of 2009, an average
hospital MPI had
around 500,000+
patient records
 HIEs had around 1M150M records
 Average duplicate rate
was 10%
EMPI – Why’s it matter?

 Duplicate Rate Calculation:
Total # of individual duplicate patient records x 100/
Total # of patient records in the MPI
= Duplicate Rate (%)
 The total number of individual duplicate records is the
count of the “extra” or duplicate patient records.
Therefore, if 50 patients each had two records, the
number of duplicate records would be 50 (representing
each of the “extra” or duplicate records). If 90 patients
had two records and 10 patients had three records, this
number would be 90 + (10*2) = 110 because 10 of these
patients had 2 extra or duplicate records. –AHIMA
EMPI—How does it impact
your work?

 Coding an account where the clinician documented
medical history of current patient on someone else’s
record—OMG! I mean OIG!
 Releasing patient record for continuity of patient
care and the receiving facility points out that the
records contain mixed information on father and son
(Jr & Sr)
 Registration created a duplicate record instead of the
original one with all the patient’s history, providers
do not have the pre-op info available for day of
surgery—call comes into HIM to fix it!
EMPI—Air out dirty data

 Average duplicate rate was 10% as of 2009
 Best practice duplicate rate is recommended to stay
below 5%
 Where does your organization stand relative to
industry benchmarks?
EMPI—Last Thoughts

 EMPI is the foundation for everything that happens
in healthcare
 Be the broom and clean up the dirty data—it could
be your record/your data or your family’s
 Be an advocate for your organization’s data integrity
and encourage proactive practices at registration and
in your organization’s MPI management
Questions
