Parliamentary Questions

(a) is the Minister aware that some former Derby Hospital patients have multiple file numbers, which are known as Universal Medical Record Numbers (UMRN);
(b) is it true that in or around 1990, a number of Derby Hospital patients had new files and UMRN created:
(i) if yes to (b), why did this happen; and
(ii) if no to (b), why do several of my constituents, who were former Derby patients, have multiple records and UMRN relating to their long term treatment at Derby Hospital;
(c) is the Minister aware that some West Australians have extreme difficulty accessing their medical records due to the problem of multiple UMRN; and
(d) is the Minister aware that, where a West Australian has been allocated multiple UMRN, that the matching and merging of those multiple records is dependent entirely on the particular health service or hospital having the human resources to match multiple records to the patient's Global UMRN:
(i) if no to (d), does the Minister think it reasonable that some patient’s records may never be reconciled; and
(ii) if yes to (d), does the Minister plan to ensure that UMRN and their corresponding files be reconciled for all West Australian patients:
(A) if yes to (d)(ii), what is the timeframe for this?
(B) if no to (d)(ii), why not?
(C) if no to (d)(ii), does the Minister plan to take any other steps to assist West Australians who wish to access their multiple Health Deparment files?
Answered on 5 December 2017

I am advised that:

(a) As duplicate patient registrations may occur within all health services, Derby Hospital has processes in place to confirm patient identification at the point of care and also to maintain the integrity of the Patient Master Index which links patients to Universal Medical Record Numbers(UMRNs)/Medical Record Numbers (MRNs). All Patients are registered electronically within a patient administration system (PAS) that allows for linkages to any additional MRNs/UMRNs the patient may hold.

(b) Yes.

(b)(i) On or around 1990 a new medical record format was introduced. This triggered the need to move medical record documentation in primary storage from the superseded medical record cover to a new one. Medical records in secondary and tertiary storage may not have been given a new medical record cover but remained available to support patient care. This change of medical record format did not result in new MRNs for patients.

On or around 1990 Derby Hospital transitioned from a manual index card system to register and maintain patient details to an electronic PAS. The information and UMRN from the manual cards was transposed in to the electronic system. This did not result in new MRNs for Derby Hospital patients.

Some Derby Hospital patients have had multiple MRNs as it is not always possible to positively identify a patient at the point of entry. This can occur for multiple reasons. Of significance in Derby are cultural naming conventions within aboriginal communities and patient inability to provide identification details such as one date of birth. Where duplicate MRNs are identified there are processes in place to merge these MRNs both electronically and within the paper-based medical record.

(b)(ii) Not applicable.

(c) As there are processes in place to identify patients with multiple MRNs/UMRNs patients should not face extreme difficulty accessing medical records. It is critical that Release of Information officers work closely with patients seeking access to medical records to ensure that a thorough search has been conducted to identify information in scope for release. This includes determining if the patient has had any previous names, dates of birth or other identifying attributes.

(d) Yes. There is a process in place to identify when a patient may have a duplicate UMRN. Reports aiming to identify duplicate UMRN are generated daily by Health Support Services (HSS) and provided to the relevant sites that control patient records. Sites are then required to confirm if a duplicate record exists, and if so, merge the records. The duplicate UMRN is then retired.

(d)(i) Not applicable.

(d)(ii) Yes.

(A) The process outlined in answer to (d) is firmly established and is conducted on a daily basis to ensure that patients with multiple UMRN are identified and rectified.

(B)-(C) Not applicable.