Read the scenario and address the questions.

In this case, more is bad

Before automation, a hospital’s master data about patients consisted of type written 3 × 5 cards, each containing individual patient demographic data, medical record number, and patient admission and discharge dates. These master data composed the hospital’s MPI.

Large rotary style machines called cardveyors housed thousands of MPI cards. Cards were filed in strict alphabetical order by patients’ last names. To ensure there were no misfiles, cards created for new patients were filed in the cardveyor and tagged. Each tagged card was audited at the end of each day by a file clerk to make sure it was correctly filed. In many cases, if errors were not caught using this method, a misfiled card may never be located among the thousands of cards in the cardveyor.

Because cards were hand filed, potential duplicate cards identifying the same patient were identified by filing clerks. Usually, clerks identified these when they filed a new card in the MPI for a new patient admission. In cases of potential duplicate cards, clerks would compare patient demographic data and make a decision whether a duplicate had been created.

In the manual system, patient master data were not easily accessible throughout the hospital to those that needed it. For example, the admitting office would have to phone the medical record department to determine if a new admission had an existing medical record number. Or, the billing office had to call the medical record department to verify dates of admission and discharge of patients.

Patient master data are easily accessible throughout the enterprise in today’s automated MPIs. However, duplicate records in the MPI remain a problem. Statistics indicate that in some MPIs, the duplicate record rate reaches upward of twenty percent with the average duplication rate between nine and eleven percent.

[Side note: I remember using carveyors to look up MRNs and pulling charts. I think I’ve dated myself.]

Discussion Questions

1. Why do duplication rates for master data such as the MPI remain so high today?
2. What adverse impact do high duplication rates have?
3. In manual systems, audits were performed daily to decrease duplication rates. How are automated MPIs audited today?