Studies in Success: Peninsula Regional Medical

Relying on a Social Security Number Presents Risks

Successful Conversion to a MRN Requires Thorough Planning

 

Peninsula Regional Medical Center

Is a 366 bed Joint Commission-accredited tertiary care facility that is located in the center of the Delmarva Peninsula in Salisbury, Maryland. Their decision to convert from using Social Security numbers to a unique MRN was driven by a need to better protect their patient's identities.

Challenge: 

To mitigate the risk of privacy and security breaches, while working to better protect its patient population from identity theft and fraud, Peninsula Regional Medical Center (PRMC) in Salisbury, Md., determined it was time to transition away from the use of Social Security numbers to a unique, system generated medical record number (MRN), while working to avoid any interference with patient care or disrupting business processes and systems.

Solution: 

To complete the transition as cost-effectively and efficiently as possible, Peninsula first established a multi-disciplinary oversight committee capable of taking a very holistic view of the project to ensure equal representation of all interests. The organization then retained Just Associates (JA) to utilize their expertise in patient identification management and the electronic linking of patient records to design and manage the conversion and help PRMC avoid complications.

Result: 

Just Associates' data conversion planning, mapping, interface testing and data integration services provided significant value in keeping the project moving forward, allowing PRMC to successfully convert the MRN in over 25 applications with minimal disruption to clinical systems and departments.

Peninsula Regional Medical Center is a 366 bed Joint Commission-accredited tertiary care facility that is located in the center of the Delmarva Peninsula in Salisbury, Maryland. Their decision to convert from using Social Security numbers to a unique MRN was driven by a need to better protect their patient's identities.

Because of PRMC's high repeat admission rate, where patient records rarely became inactive, it was critical that the conversion to a new MRN be done in a manner that would have minimal impact on patient care and business processes. Further, there was concern over the conversion project's effect on more than 25 different information systems in place at PRMC, including registration, clinical, ancillary and financial systems. 

Just Associates' first order of business was conducting a comprehensive evaluation and assessment of the interface engine that supported the patient identifier. The patient identifier was used in multiple ways throughout the system, from surgical schedules to care plans and discharge instructions. Because of its broad use, the potential for workflow disruptions were significant. The goal was to develop a comprehensive understanding of how a patient identification number is used across the Peninsula system, including:

• How that identifier was entered into the registration system and how it was sent through to all downstream clinical, ancillary and financial systems
• Whether the downstream systems utilized the MRN within their database as a primary record key 
• How the systems read inbound message transactions and utilized the MRN to match to existing records in the database to determine whether the transaction should add a new record or update an existing record
• Additionally, every point-to-point interface needed to be evaluated and its accuracy validated

The project involved extensive interviews with the integration team and members of each department that utilized those systems that would be impacted by the patient identifier. By understanding at a very granular level how the patient identifier was used, JA was able to develop a workflow process that traced the movement of patient identification numbers from entry point (registration) through exit point (discharge) and every possible format in which that number would reside (paper files, clinical systems , etc.). This information allowed JA to rank impacted systems according to specific risk levels, leading to specific recommendations of how best to approach the conversion within each system. 

To facilitate the conversion, Just Associates and PRMC also:

• Designed and ran software scripts to automate the MRN conversion, effectively reducing IT staff workload and additional staffing costs
• Developed scenarios for error trapping, identifying potential failure points so the conversion process could move forward smoothly and with minimal disruption
• Developed and ran test scripts to confirm conversion accuracy, saving costs and raising confidence in the process Took an "outside the box" approach to minimizing workloads in clinical and ancillary departments which saved staff time and costs

In addition to ensuring that the migration to a new medical record numbering system was conducted in an efficient and cost-effective manner, PRMC gained a better understanding of how data and information flows through the entire organization, which will be invaluable as the facility migrates to a new information system.

“We engaged Just Associates to assist PRMC with a large data conversion project. This project involved over 25 downstream systems. JA’s unique combination of database, interface, clinical and business process knowledge enabled us to completely understand potential failure points in the conversion. They communicated effectively getting all project team members to collaborate and they were highly successful at keeping us on task.”

Ray Adkins, Chief Information Officer
Peninsula Regional Medical Center