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Report: Medical Record Mix-ups Are A Common Problem


Medical records are a vital part of a patient's identity in the health care system. But what if they get mixed up with somebody else's, along with their treatments and exams? A new report by the ECRI Institute says that such patient mix-ups are actually quite common.

Dr. Hardeep Singh is a patient safety researcher at the Michael E. DeBakey VA Medical Center and the Baylor College of Medicine. He advised on this report. And he joins us now from the studios of WFYI in Indianapolis.

Thanks so much for being with us.

HARDEEP SINGH: Thank you so much for having me Scott.

SIMON: How common are these mix-ups?

SINGH: So the report by the ECRI Institute doesn't say exactly how common they are. But remember, they looked at 7,000 or more reports from 180 or more hospitals.

SIMON: Can you give us an example of a kind of mix-up that stays in your mind?

SINGH: Yeah. So, you know, one of the ones that ECRI talked about was when a patient who has a nasogastric tube and was not supposed to be eating was brought in a meal tray for somebody else. And the patient tried to eat it and aspirated. And there's another patient who was short of breath but got a cardiac clearance for another patient. And, you know, the outcomes were not good.

SIMON: Every time I've been in a hospital, which has been too much in recent years, they ask your date of birth. Isn't that supposed to prevent this kind of mix-up from happening?

SINGH: Yeah, absolutely. So, you know, one of the things we need to be doing is making this standardized. I've talked to many people. They say, well, he never even checked what my, you know, date of birth said. I think we need to go to more of a standardized approach in order to do that.

SIMON: Is there any kind of technological solution to this - I don't know - thumbprint, iris scan or something?

SINGH: We have electronic health records, which are supposed to make this easier. But remember, anytime you introduce technology within sort of a complex health care system, you know, it can also have unintended consequences.

So never before would I be sitting on a patient's, you know, medical record with three different electronic health record screens open, trying to work between, you know, different patients sitting in an emergency room. So with new technologies come this additional complexity that we need to sort of be thinking about.

But we can also use technology to, you know, warn providers when they're entering orders, for instance. If I'm supposed to be in Mr. James Smith and entering a complex chemotherapy order, for instance, I'd get an alert saying, are you sure?

Because there was another, you know, Mr. James Smith on the same ward in the hospital. Are you sure you're entering orders on the right Mr. James Smith, you know, for instance?

SIMON: Anything a patient can do to protect him or herself?

SINGH: With electronic health records has come in a layer of additional transparency for the health care system where patients can access more information electronically than they could ever do before.

So, you know, there are programs where you can actually look into the medical record to see, hey, by the way, I didn't have my spleen taken out. What note is this? This note is not mine (laughter). So - and then, you know, approach the system and say, you know, that note that is in my record from, you know, February 2 of, you know, 2014 is not really mine. It's somebody else's.

So I think when you have an additional, new layer of patient activation where they're not only asking questions on some of these, you know, complicated procedures to make sure that you're the person who's supposed to be getting that - but also be more proactive into looking at your medical records to see, is there some information you can catch proactively to, you know, report back?

SIMON: Dr. Hardeep Singh, thanks very much for being with us.

SINGH: Well, thank you so much for having me. Transcript provided by NPR, Copyright NPR.