THE TRANSITION FROM PAPER TO ELECTRONIC MPI
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THE TRANSITION FROM PAPER TO ELECTRONIC MPI
A master patient index (MPI) can be defined as an index of patients that are already known with one organization using single identifiers on their medical records. Electronic data in the healthcare industry boast a lot of advantages when compared to their paper records counterparts. The move to convert paper records to electronic records is a massive undertaking by healthcare leadership. The process of conversion of paper records of patients into electronic data is challenging but can be manageable when one knows what to expect (McFarlane et al., 2016, 163). One of the advantages of the HER system is that it saves a lot of time. The time would have otherwise been used in assessments of the paper records. The MPI will fill the gap of an electronic build-in knowledge that supports the current regulations in the healthcare industry. The EHR system to be used will be user friendly and easy to learn by the hospital staff. The other important aspect of being looked at is the consistency of the care and assessment management that the MPI system offers to the hospital. This paper focuses on the project conversation strategy and will see the transitioning healthcare paper records to an electronic master patient index (MPI).
Deployment of MPI
The MPI can be deployed in the form of passive or active mode. It makes use of existing Health Level Seven Messages (International). Additional data is required and defined precisely during selecting a vendor and implementing the project (Le et al., 2019, 122). Using the MPI’s active modeMPI will mean that the application will be at the front end of the scheduling or registration process. At this point, the identification of the patient is undertaken by employing the MPI software. The software requires integration between the legacy systems and the MPI.
The user of the MPI will be able to identify the patient from a repository of data and at a specific point in the patient identification pathway. The user then goes ahead and drops to the facility level scheduling or registration system.
The use of a passive mode of the MPI, on the other hand, will not affect the scheduling and registration pathway directly. The identification of the patients in the MPI in this mode is made behind the scenes. It is also done instead at the back of the registration function. However, there will be an establishment of thresholds. The limits would be in a manner that an individual is linked automatically to the existing data. When the limit of identification is not met, then the data for registration is held for later resolution in a work queue.
Many of the transitioning organizations make a move to launch MPI software is a passive mode at an earlier stage and then move to the active mode later on. The budget, initial goals, and timelines will determine the mode of deployment of the MPI software applications.
The two, passive and active methods of deploying the MPI applications should provide a leeway of identifying individuals of interest and whose records are linked in the application software. The identification should be at an organization and enterprise-level for both deployment methods. For the process to facilitate initial duplicate identification, deployment, in this case, will involve the loading of all the available databases. Before the MPI is launched, the identification of new patients’ procedures and policies must be reviewed and formulated.
Data Elements
Correct identification of the data elements used in the MPI is essential. The MPI forms a database that holds and maintains specific identifiers for each of the hospital patients seen. While transitioning from paper to electronic data, it will be critical to link the clinical information of the patients of interest visits after visits. The core elements of the MPI need to be clearly defined and of standard quality. After creating the correct definitions of these elements that are core in identificationpatient , it forms a basis with which algorithms match, produce error reports, and measure quality. It also forms the basis of staff training initiatives in the organization.
Many organizations are not sure how much information the patients can include in the MPI. With the current healthcare industry, there is no clear direction on the amount of data to be put in the MPI software (Lintz, 2018, 17). Regardless of the constraint, the elements selected for the MPI should readily and accurately identify patients through algorithm matches created. It should identify the patients with a single identifier and also enhance a longitudinal health record system. With the data elements, the clinical linkages should be facilitated to support patients’ access to health information.
Errors identified through a review of the MPI software may prompt for collection of new data elements from the paper records in this case. If the data is missing from the legacy system conversions, the registrar’s ability to select the correct patient will be hindered (González et al., 2019, 25). Maintaining the integrity of the patients’ data will mean ensuring that the data duplicates are corrected, and the other issues that affect the MPI software solved with efficacy.
The hospital will be required to come up with standard definitions of the data elements selected in the MPI software. The standards used to capture the patients’ demographic data should be able to enhance the staff’s accountability for accuracy and not the applications used in the MPI software. The efficiency of the identification process of patients in the MPI will be heightened by sticking to the formal organizational workflows and procedures by the hospital leadership and staff.
Algorithms for duplicate identification
While feeding the data on clinical records for patients, double entries may be a possibility. The hospital, therefore, needs to identify the duplicate patients’ records to improve the credibility and integrity of the data elements used (Wiedemann, 2010, 6). Mathematical formulas and algorithms may be used in combining the weights of the data elements used to identify the duplicates in the MPI data entries. The mathematical methods and the algorithm used ought to be sophisticated enough and powerful with high levels of accuracy. The organization should pick an algorithm from the three, deterministic, rule-based, and probabilistic algorithms. Most of the organizations make use of a deterministic algorithm on the data set of name, social security number (SSN), sex, and date of birth.
Data Integrity
The data to be transferred from paper records of patients will only have integrity if they are accurate, complete, and with consistency. An MPI that contains only a single file for each patient is considered clean (McFarlane et al., 2016, 165). Inaccurate information contained in the MPI can be transmitted into the HIE. Reviewing the duplicates will produce information on the sources of errors. The hospital staff needs to be aware of such errors to avoid their occurrence at the level of data entry. A communication channel should be established to report the identified errors and correct them accordingly.
MPI Error Rate
The errors contained in the MPI software applications may create problems such as billing errors, unnecessary duplicate tests, and legal exposure in the healthcare industry. The availability of many duplicates in the MPI system creates an unnecessary workload that reduces the MPI system’s efficiency. Therefore, the organization should prioritize the maintenance of the MPI software applications (Zhao, 2018, 192). The move will significantly reduce the error rate in the MPI system. The error rate needs to be calculated to keep track of the efficiency of the MPI system. The processes which may affect the quality of the date include decentralized MPI registration, lack of staff training, difficulty in registering specimens from the laboratory, among other constraints.
Data Ownership
The issue of ownership of data is an essential one and should be addressed earlier in planning and before rolling out the MPI software application. The hospital needs to define who will be mandated to change information and at which level (Lintz, 2018, 46). Data on patients is subject to cybercrimes and needs to be protected at all costs. Changes to specific information of patients will pose significant challenges to the hospital that participate in HIEs.
Corporate and Enterprise Identifiers
The assignment of identifiers that is enterprise is inherent in e-MPI development. The enterprise identifiers are not widely in use in the healthcare of patients but are commonly used in the systems that are downstream. The enterprise identifiers serve as the behind the scenes link to the MPI software identification of persons at the corporate level. Using a corporate identifier will enhance the linkage between the clinical data of patients and facilitate identification efficiently.
MPI Maintenance
A highly efficient and error-free MPI software application needs constant maintenance. It includes oversight, correction of errors in the MPI system, and evaluation of the system in question (Oleg & Kuttalingam, 2016, 67). The maintenance of the MPI should be left in the hands of a highly qualified professional to ensure the high credibility of the dataset. The individuals given the responsibility to maintain the MPI should be provided with the necessary tools and be highly trained in the area. The procedures used in maintenance should also be supervised for credibility, and integrity issues in maintenance should improve the person’s search abilities to reduce errors in the future. The professionals also need to have participated in the registration process to enhance the process of identification improvement. It also includes running an overview of the workflow of registration, the obstacles that are frequently encountered
In conclusion, the project conversion strategy on the transitioning of the health care record keeping and identification of patients from paper to MPI is not an easy. The hospital staff should be adequately trained before beginning to use electronic identification patients to minimize errors. The methods applied in the transition is subject to adjustments depending on the initial plans for the project. The MPI policies should also be outlined and adhered to by the MPI system users to protect information on the patients. Management of MPI should, therefore, be a critical activity for the organization in question. The process requires a person with a variety of skills and technical know-how with experience. Opportunities for individuals who can demonstrate a vast knowledge in the management of information in technology in the healthcare industry.
References
González, C.B., Bordoni, M.V.G., Stieben, A., and Baum, A.J., 2019. Strategies in the implementation of standards for patient identification on legacy software in the Health System of Buenos Aires City. Electronic Journal of SADIO (EJS), 18(2), pp.21-38.
Le, H.P., Hackel, S., Guenther, A., Goldschmidt, R., Daoud, M. and Deserno, T.M., 2019, April. International Standard Accident Number: A Master Case Index Linking Accident & Emergency with Medical Data. In EFMI-STC (pp. 120-124).
Lintz, J., 2018. A Qualitative Study of Master Patient Index (MPI) Record Challenges from Health Information Management Professionals’ Perspectives. Perspectives in Health Information Management.
McFarlane, T.D., Dixon, B.E., and Grannis, S.J., 2016. Client registries: identifying and linking patients. In Health Information Exchange (pp. 163-182). Academic Press.
Oleg, BESS, and Kuttalingam, V., 4medica Inc, 2016. Systems and methods for managing a master patient index, including duplicate record detection. US Patent 9,262,584.
Wiedemann, L.A., 2010. Fundamentals for Building a Master Patient Index/Enterprise Master Patient Index (Updated). Journal of AHIMA.
Zhao, J., 2018. Identification of Master Patient Index (MPI) Record Challenges from Healthcare Professionals’ Perspectives. Central Michigan University.