Duplicate Medical Record Numbers
I worked in a busy emergency room in patient registration and admissions for 15 years. I have seen my
share of duplicate medical record numbers. I recall hearing one of my new co-workers who had created
a new medical record for a patient questioning what the big deal was. I explained to hear the fatality it
could entail by creating a duplicate medical record number for an established patient. The health
history that is housed in the EHR, allergies, past medical history and current medications are not
available to the physician, nurse who is responsible for treating the patient. If the patient is critical, the
physician is not able to interview the patient to obtain pertinent medical history. It also happened to me
once. A patient was brought in by Emergency Medical Service and the Emt gave me the wrong spelling
of the patient’s name and date of birth. A social security number could not be obtained and the patient
was not able to verify any information due to Dementia.
AMIA, ‘American Medical Informatics Association‘, posted an article explaining the fatality it can
cause to create a duplicate medical record number. Duplicate MRN are often created in error by clerical
staff. Registration staff may only transpose a number or use a nick name for a patient. Critical information
can be missed or is not listed, it can result in superfluous testing which can cause an increase in health
care cost. It is an enormous burden on health care organization, not only the liability, but also the hidden
costs to fix mistakenly duplicates. While an exact dollar amount is difficult to pinpoint, the estimated cost
is approximately $ 50.00 per duplicate.
It is not clear if the implementation of EHR is posing a more complex problem creating duplicates or if it is
easier to fix the error. Some Health Care Facilities formed committees, Data Integrity Steering
Committee, Data Systems Workgroup, and Performance Management and Improvement to oversee and
hopefully decrease the amount of duplicate mrn’s. Some facilities reported that their effort to reduce
duplicate mrn’s consisted of alerting supervisors and employees. One organization reported more
training is provided for employees.
Training and awareness of the impact of duplicate medical records is in my eyes the most important
part. It is not stressed enough during a training period that is can cause fatal errors in patient care,
hidden costs as well as delay in insurance pay due to denials.