MASTER PATIENT IDENTITY

MASTER PATIENT IDENTITY

Kaplan University

HS415

MASTER PATIENT IDENTITY

​The meaning of MPI is master patient identity, which is an electronic database storage that holds all medical the information for the patient.  Unfortunately, anything electronic can be tampered with because it runs on a network.  Which mean the MPI infrastructure is at risk of a security breach.  Another form of MPI errors is staff misconduct.   When it comes to healthcare, staff misconduct is taken extremely seriously. There are a few issues that falls under this category: Obtaining a medial license fraudulently, performing any medical service under any type of alcohol or drug influence, falsifying medical records, or last but not limited to refusing to provide professional service due to a patient’s race, creed, color, age, gender, or ethnic background. Meaning, if a patient speak Spanish, and even a little bit of English, a Spanish interpreter is required if you aren’t bilingual.  Data entry is a common human error that can lead to further MPI mistakes.  Listening to the patient is key.  Always verify the correct spelling of the patient’s name and address. Confirm their date of birth, contact number, social security, and their insurance information, all at the time of patient registration to minimize patient duplication. During triage, listen to the patient’s chief complaint to reduce the number of unnecessary medical exams.  If able, access their medical history to provide quality care and to gain a better and faster understanding of their current medical visit to decide if this is a pre-existing condition currently being treated or is this a new diagnosis.  When it cones to billing, verifying all of their insurance information is key as well, because some patient’s has more than one medical insurance policy and the billing department needs to know who and how to bill the insurance companies accordingly. In the scenario below I will point out all the errors that can be found when it comes to patient identity, staff misconduct and language access, data entry errors, and insurance verification errors.

Shalom Memorial Case Scenario

Patient Information:

Daniel Rodriguez-Hernandez SR, 69

DOB: 8/11/1948 SSN: 111-22-3345

ADDR: 2343 Welcome St. Pensacola, FL 32504

INS: MEDICARE – 111-22-3345A & BCBS-FL – ID# – XMHA343299812 Group# – 99999

CHF CMPLT: Sharp pain in right leg due to a fall outside of a store.

​Daniel has been rushed into the ER of Shalom Memorial due to a bad fall that happened outside of Dollar General. Accompanying him is his son Daniel Jr. He is being registered and triaged at the same time.  The clerk is getting his information. Daniel is here on vacation. Only Daniel Jr. speaks perfect English but not Daniel Sr. Against better judgment and policy, he never spoke with the patient Daniel Sr. and only obtained minimum information from Daniel Jr.  Here is his patient data entry log:

​The patient’s name is Daniel Hernandez. He’s 69 and speaks English.  His date of birth is 8/11/1948.  His 2343 Welcome Way, Pensacola, FL 32504.  He has a sharp leg pain in his right leg due to a slip and fall at the store of Dollar Store.  He has Medicare Blue and his insurance cards are scanned into the system.  I gave him a referral to Avectus to get his claim billed to Dollar Store.  Most of the information came from his son Jr.  He was transferred to room 33.

​ A CMA came in the room to trying to speak to Daniel Sr., but found out that he couldn’t speak English, so like the register clerk, he spoke with his son instead of getting a Spanish interpreter.  He did however clarified the nature of the accident and corrected his address from 2343 Welcome Way to Welcome St. Due to the area of the pain, the CMA ordered a CT Scan of the back and some medications.   Daniel Sr. was discharged and given a prescription.  Everything was written in English and he couldn’t read what he was signing.  Daniel Jr. didn’t translate any information to Daniel Sr. he explained that he was going to once they went home.

​The errors made in registration were many.  He never confirmed the correct spelling of the address that neither the clerk nor the CMA corrects the patient’s last name.  The correct last name for Daniel Sr. is Rodriguez-Hernandez. The other mistake is that he paraphrased the nature of the accident and got the location of the accident wrong.  Always be specific and detailed in describing what happened and never abbreviate, because there’s a Dollar Store and a Dollar General.  Daniel Jr. told them specifically where it happened.  For HIPAA purposes, that must be verified, billing can know who to send the claim to.  Last but not least, neither the clerk nor the CMA made the wise decision to request a Spanish interpreter for Daniel S, nor have all the medical documents in Spanish..  That is in direct violation of language access policy and they both chose not to provide quality care. If the patient speaks little to no English, all documentation has to be in the language they speak, unless requested otherwise. Fortunately, the CMA get the corrected nature of the accident, but he never should have requested Daniel Sr. to have such an expensive test when an X-ray of the right leg to check to see if it was broken would’ve sufficed.  Now he will get 2 deductible or copay bills that Medicare won’t cover. And most importantly, the insurance type is wrong.  Daniel has 2 insurances, not one. Medicare Blue is a combination of Medicare & BCBS as supplement plan, but Daniel has traditional Medicare plan Part A/B and a supplement plan from FL-BCBS like AARP.

​These errors lead to serious consequences.  The 1st offence, you get a verbal warning and 3 months refresher training. The 2ndoffence, you get a write up, 6 months refresher training and shadowed for 3 months.  The 3rd offence, its automatic grounds for terminations of employment.  All these rules are in the handbook they sign and every mistake is stored in their history records.

Reference:

ALUAŞ, M. (2016). Ethical and Legal Considerations of Healthcare Informatics. Applied Medical Informatics, 38(3), 91-98.

Haenke Just, B., Marc, D., Munns, M., & Sandefer, R. (2016). Why Patient Matching Is a Challenge: Research on Master Patient Index (MPI) Data Discrepancies in Key Identifying Fields. Perspectives In Health Information Management, 1-20.

Cheri, W. (2013). Patient Safety and Healthcare Quality: The Case for Language Access. International Journal Of Health Policy And Management, Vol 1, Iss 4, Pp 251-253 (2013), (4), 251.