The registration function as a critical dependency in a lifetime clinical record (LCR)

Area of Science:

• Health Informatics
• Clinical Information Systems
• Patient Data Management

Background:

• Migration to Regenstrief Clinical Information System (RCIS) required robust patient identification processes.
• Existing systems (Unity, SMS) needed integration with the new Carebase system.
• Accurate assignment and verification of medical record numbers (MRNs) are critical for patient data integrity.

Purpose of the Study:

• To describe the development and implementation of improved patient registration processes.
• To address challenges in patient identification and MRN assignment during system migration.
• To reduce data fragmentation and errors caused by inaccurate registration.

Main Methods:

• Re-engineering the registration process, including down-time procedures.
• Implementing a separate, highly available Local Control Registry (LCR) for data access.
• Developing and issuing patient registration data cards (Carecards).
• Comprehensive education and training for registration and admitting personnel.
• Establishing a near real-time exception monitoring system.

Main Results:

• Initial implementation generated ~300 exceptions daily due to registration errors.
• Post-re-engineering, exceptions fell to less than one per week.
• Improved down-time procedures minimized the need for temporary "down-time numbers."
• Patient data cards facilitated rapid verification of registration data.
• Ongoing implementation of an imaging system for patient photographs aims to further enhance security.

Conclusions:

• Systematic re-engineering of the patient registration process is essential for clinical information system success.
• Effective training and continuous monitoring are crucial for maintaining data accuracy.
• Innovative solutions, like a stable LCR and patient data cards, can mitigate registration challenges.
• Reducing registration errors significantly improves data integrity and system interoperability.