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  • 1.  Merging of duplicate patient charts

    Posted 09-20-2022 09:25 AM
    Hello everyone. I am hoping that someone will have some guidance for me. I work in a local health department. In our clinic we serve patients that will sometimes not have a social (or tell us they do not have one). Our registration system requires a social to be entered, so a "pseudo" social is created. If that patient does not show up for their appointment, their information remains in our system, but they do not get a chart number. If they do show up, they will get a chart created and chart number.

    Our problems occur when the patient comes back for a second visit, and provides us with different information and what ends up happening is we do not think they are in the system and they get a whole new profile and chart.

    We then, at some point, discover that we have multiple charts on a person and multiple chart numbers. We want to merge these charts because we will be going to an EHR system soon. Yep, still paper charting, joys of public health. We feel it is a risk to patient care to have more than one chart out there and more than one profile because we will not have the whole clinical picture of the patient.

    I am looking for any policies you all may have, or point me to any regulatory guidance. I have one supervisor who does not want to do this, she just wants to put a note in the registration system, and two other supervisors who want to merge the charts. We cannot totally remove the registration profile, but we can "zero" it out so that it is obvious to not use it.

    I am in favor of merging charts so that we can reduce risk in the future to patient care.

    Thank you for any advice and guidance!


    Katrina Drake
    Compliance & Facilities Officer
    Lexington-Fayette County Health Department
    SCCE Membership

  • 2.  RE: Merging of duplicate patient charts

    Posted 09-20-2022 09:35 AM

    This is actually much more common than most people may think...especially as more and more EHR providers become more affordable and accessible to providers.

    My addition to the discussion...which I hope you get many replies is this.  I don't think there is necessarily a right or wrong choice on next steps.  I often suggest to people that ultimately it will likely come down to what will work easiest in terms of:

    - Resources to get the merge done
    - Timeframes or deadlines for each step of the process you decide upon
    - How the merge you decide upon complements your work processes moving forward
    - Phased approach where you do a subset o charts to actually see how the merging works and then expanding after making necessary adjustments

    As is the case with many long standing processes...moving from one environment you have operated in for some time (paper...perhaps for years) another environment ( going to take time.  However, sometimes taking time is the one area where people seem to have the least tolerance or patience and consequently that is where you often will hear the most  _________________ (enter whatever word you like that essentially also means "complaints")

    Good luck!

    Posted: 7:30 AM AZ time

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