Feature Guide-Match Merge

RelayClinical Service Feature Guide
Patient Record Match/Merge
Release 15.8
August 2015
Health Connections Brought to Life ™
Table of Contents
Overview ..................................................................................................................................................................3
Merge Proxy Privilege ..........................................................................................................................................3
What’s Inside ......................................................................................................................................................4
How Can We Help? .............................................................................................................................................4
Navigating Match Merge Workflows ............................................................................................................................5
Basic Record Review ...........................................................................................................................................5
Patient Record Manager.......................................................................................................................................7
Search Your Entire Network .................................................................................................................................8
Search Filters ................................................................................................................................................8
Search Results ..............................................................................................................................................9
Resolve Duplicate Patient Identifiers ......................................................................................................................... 11
Add New Patient ............................................................................................................................................... 11
Accept Patient ................................................................................................................................................... 12
Edit Patient ID ............................................................................................................................................ 13
Merge Records ............................................................................................................................................ 13
Find Duplicates ....................................................................................................................................................... 15
Enable Resolve Potential Patient Duplicates Reminders .............................................................................................. 17
Resolving Duplicates in Patient Record Manager ........................................................................................................ 18
Creating Patient Relationships .................................................................................................................................. 20
Add Provider – RelayClinical Record .................................................................................................................... 20
Add Relationship – Search Your Entire Network ................................................................................................... 21
Appendix A: Patient Match Merge – Frequently Asked Questions ................................................................................ 24
Appendix B: Patient Demographic Matching Process .................................................................................................. 27
© 1999-2015 RelayHealth and its affiliates. All rights reserved.
2
Overview
To help users manage potential patient duplicate records, the RelayClinical service provides multiple patient matching
workflows throughout the service. These workflows allow users to resolve potential demographic and identifier
duplicates and resolve provisional (temporary) patient records that may be created as a result of an HL7 ADT (Add,
Update, Merge), inbound C-CDA, or clinical results transactions. These workflows surface potential duplicates for review
and surface resolution options appropriate to the workflow (e.g., merge patient records, create new patient record,
correct patient identifiers, etc.).
Workflows that surface potential duplicates include:

Add a Patient

Accept a Patient

Find Duplicates (accessed from the Actions dropdown in a patient’s RelayClinical Record)

Resolve Patient Record (Results Manager)

Create Patient Relationship (Add Provider link and Search Your Entire Network)
In addition to duplicates management, this Feature Guide describes how users can establish new provider-patient
relationships from within the RelayClinical Record. This guide also describes how users in affiliations that share patient
records can use the Search Your Entire Network feature to search for and establish new relationships.
Merge Proxy Privilege
To use the service’s patient merge workflows, you must have the Merge Proxy privilege enabled for your account. Users
who have Practice Administrator privileges may adjust user privileges in the Settings area of the service and may assign
Merge Proxy privileges to themselves or to other practice users.
NOTE: If you merge records in error (merge records that should not be merged), this action could
potentially expose your organization to a HIPAA violation. If you suspect that records have been merged
incorrectly, contact RelayHealth Support immediately at 1-866-RELAY-ME to reverse the merge.
3
What’s Inside
This Feature Guide provides an overview of the RelayClinical service Patient Match Merge workflows. In this Guide, you’ll
find:

A brief navigational overview

Instructions for all users that identify the steps you’ll take to:
o
Manage patient identifier duplicates
o
Resolve patient duplicate records
o
Locate patient records in affiliated entities.

Instructions that describe how to enable the Patient Duplicates/Provisionals Reminder on your Home page

Instructions that describe how to resolve duplicates in the Patient Record Manager

Instructions that describe how to create a patient relationship in Search Your Entire Network
Additionally, this document includes the following supplemental information:

Appendix A: Patient Match Merge FAQs
Note:
The Results Manager application provides a unique patient record resolution workflow that requires users to resolve
potential duplicate records before managing tasks in the queue associated with this application. Please refer to the
Results Manager Feature Guide for detailed information about resolving patient records in this service area.
How Can We Help?
RelayHealth is ready to support you every step of the way as you use the service. You can request assistance, propose
suggestions, or submit comments by any of the following methods:

Use the ‘Contact Us’ link at the bottom of your Home page to send a secure message directly to our RelayHealth
Support organization. You can also call our toll-free number and speak to one of our Support representatives
from 4:30 am to 5:00 pm Pacific Standard Time. Call 1-866-RELAY-ME (1-866-735-2963) and select option 1.

Speak with your RelayHealth Territory Director or Deployment Specialist. These RelayHealth professionals
welcome your suggestions and comments about the service, your experiences with system use, and any
concerns you may have.
4
Navigating Match Merge Workflows
Basic Record Review
The most common screen you’ll use when matching and merging patient records is the Possible Duplicate Records
Found screen. This screen allows you to review detail of the potential duplicates, and presents known information in a
simple format. You can also click the Details link next to any record to review additional information associated with the
record. The details displayed may help you to decide whether to match records.
You’ll see the screen below if the service detects a potential duplicate in any of the following workflows:

Add a Patient

Accept a Patient

Find Duplicates (accessed from the Actions dropdown in a patient’s RelayClinical Record)

Resolve Patient Record (Results Manager)

Create Patient Relationship (Add Provider link and Search Your Entire Network)
To provide context to the information displayed, the screen also specifies the workflow in which the service identified the
potential duplicate (e.g., Patient Information from Clinical Result, from RelayRecord, etc.).
In general, selecting a checkbox to the left of a record on this screen enables the Confirm Record Match action button.
Similarly, unchecking the boxes will disable the Confirm Record Match action button. If the checkbox is inactive (grayed
out), you do not have Merge Proxy privileges enabled for your account. Please contact your Practice Administrator.
Note that the “Match Score” column may be configured to be hidden if your organization chooses to do so. For
more information, please contact your RelayHealth Deployment Specialist.
5
Another common screen you’ll use with merging records presents you with demographic details of the potential
matching records. For most workflows, you’ll have the option of selecting radio buttons to identify the demographic
elements you want to include in the surviving record.
Rows with different values are highlighted in yellow and have no pre-selected radio button. Rows with the same values
have no radio buttons and no highlighting except for editable Registry IDs (patient identifiers). When none of the
potential matching records has a patient identifier value, the Merge Patient Data pop-in will include one editable, radioselectable field.
In workflows to resolve duplicate patient identifiers, the demographic elements will not be selectable but display to
provide you with additional information. In resolving patient identifiers, the only selectable/editable fields will be the
identifier fields.
6
Patient Record Manager
The Patient Record Manager’s Duplicate Tasks tab provides a convenient, queue-based interface that allows you to
select individual records from the queue to manage. By default, Patients Duplicates Manager displays potential
duplicates from the entire patient panel in the queue on the left. To view potential duplicates from Results, Provisional,
or Other workflows, use the dropdown option above the queue, to select these views.
In the queue, the service
highlights the record currently
displayed. As you move through
the queue and resolve records, the
service places a green check next
to resolved records and advances
to the next record automatically.
Note the action buttons displayed
below the records: Create New
Patient, Confirm Record Match,
and No Patient Matches. The
Create… and Confirm… action
buttons toggle between enabled
and disabled depending upon
whether you’ve selected a record
by clicking the checkbox to the left
of the patient name. The No
Patient Matches action button is
enabled only if the service is
unable to identify a potential
matching record.
If the checkbox to the left of the patient name is inactive (grayed out), you do not have Merge Proxy privileges enabled
for your account. Please contact your Practice Administrator.
Note that the Patient Record Manager displays patient Social Security Number (SSN) only if your organization has been
enabled for display of this data. Additionally, SSN displays only to users who have Merge Proxy privileges enabled for
their accounts.
The Merge History tab allows you to view a list of completed merge tasks. Use the filters provided at the top of the
page to search by Patient, Practice, and/or Time Frame. You can also print the list using the link at the left of the screen
and/or adjust the number of records displayed per page using the dropdown to the right.
7
Search Your Entire Network
Users in organizations that are part of an affiliation that
allows for sharing patient records have the option to search
for patient records within the configured affiliation structure.
Not sure if this applies to your organization? Just look for
the ‘Search Your Entire Network’ link to the right of any
patient search field (e.g., on the Patients tab, the Global
Patient Search field, in any compose patient message
workflow). The link appears only if your organization is in an
affiliation configured to share patient records.
Search Filters
The Search Your Entire Network screen provides simple search filters, and RelayHealth offers two configurations for
search elements. In the default configuration, you may search for a record in affiliated entities by entering the patient’s
first and last name (or initials) or enter the patient identifier. You can optionally enter the patient’s middle name, date of
birth, and/or gender to refine the list further; however, these data elements are not used as primary search options.
In the alternate configuration, you may search for a record in affiliated entities by entering the Patient Identifier, Last
Name, and Date of Birth. All search fields are mandatory.
If you are a member of multiple affiliations and at least one of your direct (first level) affiliations has the second search
filter configuration described above, mandatory use of Patient Identifier, Last Name, and Date of Birth will apply for all
of your network searches. This is expected behavior. The second configuration is the more conservative of the two
options and is intended to minimize incidence of malicious or accidental access to patient health records.
8
Search Results
Search Your Entire Network search results, if any, include potential matching patient records from outside your
immediate practice and outside your immediate (first level) affiliation. If you access Search Your Entire Network from
any area other than the patient’s RelayClinical Record (e.g., global navigation bar search field, search from Patients tab,
search from messaging workflows, etc.), results display as below. Click the Details link to view additional demographic,
provider/practice relationship, and clinical data (if available). To link to a single patient record, click the patient name to
access the confirmation workflow.
If you accessed the Search Your Entire Network workflow from within the patient’s RelayClinical Record, by clicking the
Notifications Module or using the Search Your Entire Network Actions dropdown link, patient context is established, and
search results offer additional workflows if applicable. For instance, you may link to multiple records. If you have Merge
Proxy privileges enabled for your account, you may also merge patient records.
When patient context is established (i.e., Search Your Entire Network accessed from a patient’s RelayClinical Record),
the following logic applies to matching / linking options:

When the user accesses the Search Your Entire Network workflow from the patient’s RelayClinical Record, the
service displays the “source” patient’s demographics above the search results. The “source” patient’s
demographics are not editable and are displayed only for matching purposes.
9

The service enables Merge Records and Link to Patient action buttons only after the user selects the provider
from the “Select Provider” dropdown and checks the consents and authorizations certification checkbox.
Otherwise, these action buttons are inactive.

If the user does not have Merge Proxy privileges enabled for his or her account, the Merge Records button does
not display, and the user will view only the Link to Patient action button.

When merging patient accounts, the user will have the ability to select the demographic data elements that will
be reflected in the surviving account. If a patient identifier is required, the service will display it on the data
element selection screen as well. The user can select one or more existing patient identifiers, or add a new
patient identifier, as necessary.

Users are prevented from merging multiple Online patient records, and the Merge Records button will be
deactivated if the user selects two Online records from the search results.

o
If the "source" patient is Online, the user may merge only Offline records.
o
If the "source" patient is Offline, the user will be able to merge a maximum of one Online record with
the Offline record.
o
If the user selects multiple Online records from the search results list, the service will allow the user to
Link to Patient only.
Users may link to multiple patient records (Online and/or Offline) from the Search Your Entire Network search
results.
o
Once the user selects the record(s), the user will choose a provider to link them to as well as add any
identifier (if applicable). This will establish a relationship with the provider for those patients.
o
If multiple patients are selected, those records will be merged into one and linked to the provider
chosen.
10
Resolve Duplicate Patient Identifiers
You can manage potential duplicate patient identifiers in the Add New Patient and Accept Patient workflows. Follow the
instructions below to resolve potential duplicates. Note that if do not have Merge Proxy privileges enabled for your
account, you will not be able to use the Link option noted below, and you will need to proceed without merging the two
records.
Add New Patient
In the Add New Patient workflow, you may assign patient identifiers if your organization requires them. If you assign an
identifier previously assigned to another patient record, the service displays an alert. The service also displays the Name
and Date of Birth from the conflicting record. To resolve the error, follow the instructions below:
1. Enter a different value in the identifier field and click Next.
2. The service creates the new offline patient record and displays the patient’s RelayClinical Record.
OR
1. Review the name and date of birth from the conflicting record. Click the Details link to review additional
details from the conflicting record.
2. If the record is a match for the New Patient record, click Link.
11
Accept Patient
If your practice is configured to display and/or require patient identifiers, you will enter an identifier when accepting new
patients in a ‘Patient Request to Use RelayHealth’ message response workflow. When accepting patients into your
RelayClinical practice, the service performs an identifier match search and raises an alert for conflicting records. To
resolve the alert, you will have the choice to merge the records (if you have Merge Proxy privileges AND the records are
in online and offline status), or you may change one of the identifiers. Follow the instructions below to resolve the alerts.
1. Navigate to the inbox where Patient
Request to Use RelayHealth messages
route for your practice.
2. In the inbox, click the message title
(Patient Request to Use RelayHealth).
3. Enter the patient identifier in the identifier
field. The field name is configurable and
may be labeled Patient ID, MRN, HNE,
etc.
4. If appropriate, select the patient facing
Branding from the drop-down options.
5. Click Accept.
6. The service displays the records that have the same identifier assigned. If the records are a match, click Merge
Records. If the records are not a match, click Edit Patient IDs. Note that the service will not allow you to
merge two online patient records. If both records displayed are labeled ‘Online Patient,’ you must select Edit
Patient IDs to resolve the conflict.
12
Edit Patient ID
7. If you selected Edit Patient IDs, the service refreshes
the pop-in display and the Patient ID fields will be
editable. Change one of the IDs and click Save.
8. When you’ve edited and saved the identifier(s), the
service will confirm that the patient acceptance is
complete. Select a standard or custom confirmation
message to send to the patient.
Merge Records
7. If you selected Merge Records, the service displays the potential duplicates. Select one (or more) checkboxes, to
the left of the patient name, to identify the record(s) to merge into the Patient ID Match record.
8. Click Merge Records.
13
9. Select the demographic elements you want to include in the surviving record. Demographic values that do not
match will be highlighted in yellow. You must select a radio button for all highlighted lines before the service will
enable the Merge Records and Add Additionl Info action buttons. Click Merge Records to merge the records
immediately. Click Add Additional Info to add additional detail to the patient record (e.g., insurance,
guarantor, email, phone, etc.). On the Patient Information screen, click Save.
10. When you’ve completed the merge, the service will confirm that the patient acceptance is complete. Select a
standard or custom confirmation message to send to the patient.
14
Find Duplicates
The RelayClinical Record’s Chart Summary Notifications module performs a duplicate record search automatically each
time you access an individual patient’s RelayClinical Record. If the service identifies a potential duplicate within your
practice’s patient population, the Notifications module displays a numerical link next to the Duplicate Record Matches
label. If your organization is part of an affiliation that is configured to share patient records, you’ll also see a Network
Record Matches label in the Notifications module.
Additionally, the RelayClinical Record’s Action’s dropdown, displayed at the upper right above the navigation tabs,
includes Find Duplicates and Search Your Entire Network options. The Find Duplicates action and the Duplicate Record
Matches navigation link in the Notifications module launch the same resolution workflow. Similarly, the Search Your
Entire Network action in the dropdown and the Notification module’s Network Record Matches link launch the same
workflow.
To resolve the potential duplicate records, follow the instructions below.
1. Click the link in the Notifications module or select the Find Duplicates option from the Actions dropdown.
2. The service displays the potential duplicates. Click the Details links to review additional data from the individual
records. This additional information may help you to determine if the records should be merged.
3. If the records should be merged, click the checkbox(es) to the left of the patient name(s) and click Merge
Records. Note, if the checkbox is disabled, you do not have Merge Proxy rights. Please contact your Practice
Administrator.
15
4. Select the demographic elements you want to include in the surviving record, and click Merge Records to
merge the records immediately and return to the RelayClinical Record. Click Add Additional Info to add
additional detail to the patient record (e.g., insurance, guarantor, email, phone, etc.). On the Patient
Information screen, click Save to commit the merge and return to the RelayClinical Record.
Where values do not match in the Merge Patient Data screen, the service highlights the lines in yellow. You
must select a value for all highlighted lines before the service enables the Merge Records or Add Additional
Info action buttons.
16
Enable Resolve Potential Patient Duplicates Reminders
The RelayClinical service allows you to optionally display a reminder on your Home page for potential patient
duplicate/provisional records. This is a convenient and highly visible way to monitor potential duplicates and those
records that may have been received into your practice that do not have the required data to create a complete record
(i.e., provisional records).
When enabled, the duplicate reminder displays on your Home page only when the service identifies records that require
intervention. To enable the reminder, follow the instructions below.
1. From Home page, click the Edit View link.
This link displays to the far right of the At a
Glance, All Inboxes, and Scheduled tabs.
2. On the Edit Home Page Settings page, under the Reminders section, place a checkmark next to Resolve
Potential Patient Duplicates. Click Save.
If potential duplicate records exist, click the Resolve Patient Records – Duplicates/Provisionals reminder on
your home page to launch the Patient Record Manager.
17
Resolving Duplicates in Patient Record Manager
The Patient Record Manager provides a convenient, queue-based area to manage potential duplicate records and
provisional records that may have been created in the service based on interoperability flows (Results, ADTs, etc.). To
merge duplicate/provisional records in this area of the service, you must have Merge Proxy enabled for your account.
Please contact your Practice Administrator.
1.
On the Patients tab, click Patient
Duplicates Manager on the vertical
navigation panel. If you have the
Resolve Potential Patient Duplicates
Reminder enabled, you can access this
area by clicking Resolve Patient
Records – Duplicates/Provisionals
on your Home page.
2.
Select a potential duplicate from the
queue on the left.
3.
The first record displayed indicates
potential patient duplicate information.
One (or more) records display below
the potential duplicate. Click the Details
links in the potential duplicates to
review additional information about the
record(s).
4.
You have several choices to resolve the record:
A) If the records should be merged, place a checkmark next to one (or more) duplicate records. Click Confirm
Record Match.
B) After reviewing the potential matches, you may decide to create a new patient record immediately based on
the data presented at the top of the form. If this is appropriate for your workflow, click Create New
Patient, and complete the required fields in the Update Patient Record form to create the new record.
C) If the service did not identify any potential matches, click No Patient Matches. Selecting this action
removes the record from the
Patients Record Manager
queue.
5.
In this scenario, we will Confirm Record
Match. The service presents a list of
patient data elements. Use the radio
buttons to select the data elements that
should prevail in the final, merged
record. Values that do not match will
be highlighted in yellow. All yellowhighlighted lines must be resolved
before moving forward.
18
6.
To merge the records immediately and return to the task queue, click Merge Records. If you have data that you
want to include in the merged record (e.g., health plan data, patient consents, etc.), click Add Additional Info.
Enter the additional data in the record and click Save to commit the merge and return to the task queue.
Patient Record Manager displays. The queue has been updated with green checkmark on the merged record. If there
are other potential duplicates in the queue, Patient Record Manager auto-advances to the next set of records for
resolution.
19
Creating Patient Relationships
The RelayClinical service provides two workflows that allow providers and staff members to create patient relationships
independent of a patient-initiated or referral related requests. These workflows are:
1. Add Provider Relationship in the RelayClinical Record
2. Add Relationship in Search Your Entire Network
Note that Search Your Entire Network is a configured option that allows affiliated entities to share patient records. The
Search Your Entire Network link displays only if your organization has been configured for searching and sharing of
patient records.
To add new patient-provider relationships, follow the instructions below.
Add Provider – RelayClinical Record
1. Access the patient’s RelayClinical Record using the Global Patient Search, the Patients tab, or the Recent
Patients list.
2. The patient’s RelayClinical Record display defaults to the Chart tab Summary view. Use the Actions dropdown to
select the Add Provider Link.
3. On the Create Patient Relationship screen, use the Provider dropdown list to select a provider from your
practice that you want to associate with this patient. You can optionally click the Details link to review
additional detail in the patient record (e.g., Providers, Practices, clinical data, etc.).
4. Click Confirm. Online patients receive notification of the new relationship automatically.
20
Add Relationship – Search Your Entire Network
RelayClinical service users in organizations that are part of an affiliation that allows for sharing patient records can
search for patient records in affiliated entities and establish new patient relationships with just a few simple steps.
Follow the instructions below to add new relationships.
Patient Search Fields Method
1. Click the Search Your Entire Network link
to the right of any patient search field in the
service (e.g., on the Patient tab, in the Global
Patient Search field, in any compose patient
message workflow, etc.). Note, this workflow
does not include “patient context,” which is established only if you access Search Your Entire Network from the
patient’s RelayClinical Record. See “RelayClinical Record Method” below for alternate workflow steps.
2. Depending upon your organization’s search configuration, enter the patient’s First Name and Last Name (or
first and last initials) or the Patient Identifier (MRN, Patient ID, etc.); or enter the mandatory Patient
Identifier, patient Last Name, and patient Date of Birth. Click Search.
3. The service returns a list of matching patient records from affiliated entities. To expose the most relevant
potential matches and assist users who may receive a high number of potential results, the results list filters out
those patients who are already in your own practice(s) or first-level affiliations.
4. Click the Details link to review additional detail from the patient’s record (e.g., Providers, Practices, clinical
data, etc.). The details displayed are intended to assist users with confirming that the patient selected is the
correct patient.
21
5. Click the patient’s Name.
6. Depending on the patient identifier configuration for your organization (required/not required), you may enter a
Patient Identifier if this field displays.
7. On the Create Patient Relationship screen, select a Provider from your practice for the new patient relationship.
8. Click the checkbox next to ‘By checking this box…’ This action is required to verify that the appropriate
permissions are in place for patient record access.
9. Click Confirm.
The relationship is created immediately. Online patients and each of the patient’s established providers will receive
notification of the new relationship.
RelayClinical Record Method
This search workflow allows providers and staff members who have Merge Proxy privileges to merge patient records
from the Search Your Entire Network results, if necessary. This option is available only when patient context is
established (i.e., from within the patient’s RelayClinical Record) and is not included in other Search Your Entire Network
workflows (e.g., search from Patients tab, patient messaging, search from global address bar, etc.).
1. In the patient’s RelayClinical Record, click the Network Record Matches count in the Notifications module or
select Search Your Entire Network from the Actions dropdown.
2. Depending upon your organization’s search configuration, enter the patient’s First Name and Last Name (or
first and last initials) or the Patient Identifier (MRN, Patient ID, etc.); or enter the mandatory Patient
Identifier, patient Last Name, and Patient Date of Birth. Click Search.
3. The service returns a list of matching patient records from affiliated entities. To expose the most relevant
potential matches and assist users who may receive a high number of potential results, the results list filters out
those patients who are already in your own practice(s) or first-level affiliations.
22
4. Click the Details link to review additional detail from the patient’s record (e.g., Providers, Practices, clinical
data, etc.). The details displayed are intended to assist users with confirming that the patient selected is the
correct patient.
5. Merging Records: If the search results include records that you feel should be merged, and if you have active
Merge Proxy privileges, you may select two or more records to merge by clicking the checkboxes to the left of
the patient names. If search results do not include records that should be merged, skip to the Step 6 below.

If the "source" patient is Online, you may merge only Offline records.

If the "source" patient is Offline, you may merge a maximum of one online record with the Offline
record.

If you select multiple Online records from the search results list, the service will allow you to Link to
Patient only. See below.
After selecting the records to merge, select a Provider from your practice for the new patient relationship, and
click the checkbox next to ‘By checking this box…’ This action is required to verify that the appropriate
permissions are in place for patient record access and will enable the Merge Records action button. Click Merge
Records.
On the Merge Patient Data screen, select the data elements that should be included in the “surviving” merged
record. You may also add patient identifiers if necessary. If you have other patient information that should be
included in the record (such as an alternate phone number), click the Add Additional Info button on the
Merge Patient Data screen to add the information and complete the merge. Otherwise, click Merge Records to
merge the records, and create the patient relationship, and return to the patient’s RelayClinical Record.
6. Linking to Patients: To create one or more the patient relationship(s) without merging records, click the
checkbox(es) to the left of the patient name(s). Select a Provider from your practice for the new patient
relationship(s), and click the checkbox next to ‘By checking this box…’ This action is required to verify that the
appropriate permissions are in place for patient record access and will enable the Link to Patient action button.
Click Link to Patient to create the relationship(s) and return to the patient’s RelayClinical Record.
23
Appendix A: Patient Match Merge – Frequently Asked Questions
How can I resolve duplicate patient records in my practice?
If your account has Merge Proxy privileges enabled, there are several ways to resolve potential duplicate patient
records:
1. When you accept a new patient for online communication in the RelayClinical service, you are alerted
automatically to other patient records that may be duplicates. You can then choose to merge the duplicate
records with the newly registered (online) patient.
2. You can select a single online or offline patient record by searching for a patient in the Global Patient Search
field. Then, use the Actions dropdown to select Find Duplicates. The service will identify any patients who
may be duplicates of the online patient record that you selected. If there are one or more duplicate offline
accounts, they can be merged into the online account.
3. You can resolve duplicates using the Patient Record Manager under the Patients tab. This area of the
service presents a list of potential patient duplicate records in a task-based queue. Select a duplicate from the
queue on the left, and choose the records to merge.
4. The service proactively searches for and surfaces potential duplicates in the ‘Notifications’ module of a patient’s
RelayClinical Record (Chart Summary view). If potential duplicates exist, click the number link in the notifications
module to review and resolve the records.
What happens when I merge duplicate patient records?
The service will merge most of the information in the duplicate records into the online record; however, you will
have the option to select individual data elements for the ‘surviving’ record if you are completing a Resolve Patient
Record workflow. Additionally, if the record is missing information, such as a patient identifier or phone number, you
will have the option within the workflow to add the missing data. The table below details information kept and
information discarded during a patient record merge.








Information Kept
Registration Information from Primary (Online)
Record
Messages from Primary (Online) Record
Medications from All Records
Allergies from All Records
Problems from All Records
Diagnoses from All Records
Provider Relationships from All Records
Referrals from All Records
Information Discarded


Registration Information from Duplicate
(Offline) Record
Messages from Duplicate (Offline) Record
(Duplicate Offline Records are unlikely to have
any message history.)
What is a ‘provisional’ patient record?
A provisional patient record is a temporary patient record waiting to be resolved. The service creates these records
as a result of the demographic matching process when core patient demographic data is missing, when more than
one exact demographic match is identified, or when a close demographic match is identified based on the minimum
match score. Practice and health system users may resolve the provisional record by adding missing demographic
data, merging the provisional record to an existing record, or designating a new patient record. In Results Manager,
users must resolve any provisional records in order to complete result workflows.
What is a Minimum Match Score?
The Minimum Match Score is a configurable threshold at which a “close demographic match” is flagged for user
review. By default, this score is set at 80%. See Appendix B: Patient Demographic Matching Process for a detailed
overview of the service’s match scoring logic.
24
I don’t see the patient’s Social Security Number under “IDs” in the Patient Record Manager. Why?
Social Security Number display in Patient Record Manager is a configurable option at the Affiliation level; the default
setting is “Disabled” for all Affiliations. If your organization prefers to display patient Social Security Number data in
the Patient Record Manager, please contact your RelayHealth Project Manager to enable this feature and ensure
your organization is consistently sending Social Security Number data to RelayHealth via inbound ADT.
If your organization has been enabled for Social Security Number display, only users who have Merge Proxy
privileges will be able to view this data, as it is intended to assist users with selecting the correct patient records to
merge. If you do not see Social Security Number data, and your role in your organization requires that you merge
patient accounts, please contact your Practice Administrator to request Merge Proxy privileges.
I just merged a duplicate patient record with a primary record, but then changed my mind. Can I undo the
merge?
To undo a patient record merge, please call RelayHealth Support at 1-866-RELAY-ME (1-866-735-2963) immediately
as incorrectly merged patient records may place your organization at risk for a HIPAA violation. Typically, we
complete requests to reverse a merged account in one business day.
I don’t see a link for Search Your Entire Network. Why?
Your organization must be configured as part of an affiliation that shares patient records among entities to view this
link. If you do not see this link, and you would like to discuss enabling this feature for your organization, please
contact your RelayHealth Deployment Specialist, Territory Director, or call RelayHealth Support at 1-866-RELAY-ME
(1-866-735-2963).
Is there any impact on branding when users merge patient records from different practices in the Search
Your Entire Network workflow?
No. Affiliation does not affect branding or internal reporting.
Why do the action buttons not behave the same way each time I access Search Your Entire Network?
Action button availability and functionality is dependent upon the method you used to access the workflow (e.g.,
from a patient search field versus from within the patient’s RelayClinical Record) as well as the potential matches
found in the search results. The following logic applies:

When users access Search Your Entire Network by search field (on the Patients tab, on the global navigation
bar, or from any patient messaging workflow), patient context is not established. In this case, merge
actions and the option to link to multiple records at one time are not available and users may link to a single
patient record.

When users access Search Your Entire Network from within the patient’s RelayClinical Record (using the
Network Record Matches count in the Notifications module or using the option in the Actions dropdown),
patient context is established. This allows access to merge workflows and allows users to link to one or
more patient records.
With patient context established:
o
Merge Records and Link to Patient action buttons are enabled for use only after the user selects the
provider from the “Select Provider” dropdown and checks the consents and authorizations certification
checkbox.
o
If the user does not have Merge Proxy privileges enabled for his or her account, the Merge Records
button does not display, and the user will view only the Link to Patient action button.
o
When merging patient accounts, the user will have the ability to select the demographic data elements
that will be reflected in the surviving account (existing merge workflow functionality). If a patient
identifier is required, the service will display it on the data element selection screen as well. Users can
then select one or more existing patient identifiers, or add a new patient identifier, as necessary.
25
o
Users are prevented from merging multiple Online patient records (existing functionality), and the Merge
Records button will be deactivated if the user selects two Online records from the search results.

If the "source" patient is Online, the user may merge only Offline records.

If the "source" patient is Offline, the user will be able to merge a maximum of one online record
with the Offline record.

If the user selects multiple Online records from the search results list, the service will allow the
user to Link to Patient only.
o
When the user accesses the Search Your Entire Network workflow from the patient’s RelayClinical
Record, the service displays the “source” patient’s demographics directly under the Search Criteria and
above the search results. The “source” patient’s demographics are not editable and are displayed only
for matching purposes.
o
Users now have the ability to link to multiple patients (Online and/or Offline) from the Search Your
Entire Network search results. Previously, the service allowed only one patient link.

Once the user selects the record(s), the user will choose a provider to link them to as well as
add any identifier (if applicable). This will establish a relationship with the provider for those
patients.

If multiple patients are selected, those records will be merged into one and linked to the
provider chosen.
26
Appendix B: Patient Demographic Matching Process
The RelayClinical service uses the following logic to match/score patient demographics:
1) The service determines the set of patients who are in scope (i.e., considered for matching) based on
practice/affiliation relationships.
2) Next, the service intersects the in-scope set with patients who match on last name encoding. The RelayClinical
service uses multiple encoding types for last names (e.g., SOUNDEX, NYSIIS, etc.). As an example, NYSIIS
encoding maps the last name “Johnson” to “JANSAN,” which is also the mapping of names like “Jensen” and
“Johannson.” This allows mapping to handle misspellings, similar sounding names, etc. Additionally, if the
patient’s last name is hyphenated (e.g., Smith-Hancock), we can match on either one of the hyphenated names
(Smith or Hancock).
3) For the set of patients remaining after steps 1 and 2, we score their demographic components.
a. First score each of the components as follows:
Note: Word distance is a calculation of how similar/different two words are.
i. LNS = Score Last Name match (0-100) using word distance (we use a modified Jaro-Winkler
algorithm for word distance)
ii. FNS = Score First Name match (0-100) using weighted word distance (weights start more than
finish)
iii. DBS = Score DOB match (1-100) using similarity scoring on numeric components of date +
word distance
iv. GS = Score Gender match (0 or 50 or 100) (50 is scored when one of the gender values is null
or unknown)
v. PCS = Score Postal Code match (0-100) using weighted word distance
b. The Final Score (0-100) is the tuned, weighted average of the above scores, computed as follows:
i. Weighted Avg. = (4 * LNS) + (3 * FNS) + (3 * GS) + (3*DBS) + (1 * PCS) / 4 + 3 + 3 + 3 + 1
ii. Final Score = EXP(Weighted Avg., 1.3) (tuning exponent spreads range slightly)
27