In fiscal year 2013, Yale-New Haven Hospital discharged more than 80,500 inpatients and handled nearly 950,000 outpatient encounters.
That's a lot of medical records.
With so many records, issues are bound to arise, including duplicate medical records, erroneous data changes, unidentified patients, alias patients and patient identity theft.
Yale New Haven Health System's Patient Identity Team is responsible for resolving these and other issues to ensure each patient has one record in Epic that contains the correct patient name, date of birth and other identity information. The team also works with clinicians to ensure information on medical history, tests and treatments is in the correct patient record. The 10-member team, part of Health Information Management (HIM), operates 24/7 and serves Yale-New Haven, Bridgeport and Greenwich hospitals and the system's growing number of ambulatory facilities.
"It is critical that each patient be assigned one unique medical record number to ensure patient safety and continuity of care," said Maria Michelangelo, master patient index manager and manager of the Patient Identity Team. "Having one unique medical record number is also key to providing high-quality care and helping providers operate more efficiently."
Safety is a particular concern with duplicate records, which can occur for various reasons. One common scenario: A woman who used her maiden name during a previous hospital visit returns years later under her married name. Since starting in October 2012, the Patient Identity Team has eliminated thousands of duplicate records, said member Towanna Duncan, data integrity specialist.
"By eliminating duplicates we're making sure clinical staff don't chart in one record while the patient's medical history is in another," she said.
Among the Patient Identity Team's biggest challenges is making corrections to medical record documentation with current patients and communicating those changes to the patients' care team members and other departments so all information is in sync.
Team members also get calls from clinicians who discover problems with identity information in records, said Arisia Artis, HIM registrar and team member.
"We need to fix the problem immediately to be sure the correct patient information is in the right place," she said. "We want to be sure the patient is receiving the right tests or procedures."
By maintaining accurate records, the team helps ensure that the health system receives reimbursement for care from government and private payers. The team also works with other departments to investigate identity theft and insurance fraud cases — for example, if a patient falsely uses the name of a Medicare-covered relative.
Dealing with current records and concerns is a big enough job, but the team has also been transferring information from old paper records and electronic records from previous computer systems into Epic.
"We're dealing with about 4.5 million patient records right now," Michelangelo said. "It's a lot of work, but it's rewarding because we know we're helping both the patients and the people taking care of them."
Employees who have questions or concerns about duplicate medical records or patient accounts, chart corrections or any other data integrity issues should call the Patient Identity Team, 688-2240.