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 CardsFacility master patient indexEnterprise master patient indexEHRHIE 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
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