Merge Patient Screen

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Merge Patients Screen

Purpose

Sometimes a single patient has multiple records in the immunization system. When a case of duplicate records is found, a user will want to resolve them to a single record.

The Merge Patients screen allows the user to select information from two patient records and perform a merge that creates a single patient record to replace those two. It is also possible to mark two records as non-duplicates and work with three records at once.

Important Note: If the consent indicator is No for one of the patients, the system will hide the Merge button and prevent the merge from occurring. You may not modify the records of patients who have revoked consent.

Workflows for the Merge Screen:
Information Provided
Functionality

Selecting Details to Merge

You need to choose which information to keep in the final record which is created to replace the records that are merged. Information which is a single value per patient record is indicated by circular radio buttons, in which case you must choose exactly one of the values. Information which is multi-valued per patient record is indicated by check boxes. The steps taken to select details to merge are as follows:

If you are working with more than two patient records on the Merge Patients Screen, select which patients you want to merge by checking the check boxes next to their patient ID's.
Go down the list of data associated to each patient. In each row, select the information you want to keep in the final merged patient. Some data, such as Date of Birth, have radio buttons because you can only keep one Date of Birth for the final patient. Other data, such as Insurers, have check boxes because you can choose multiple insurers to keep for the final patient. Patient status (active indicator) has a drop down feature, which defaults to the patient status originally entered by the user. You can change the patient status from the merge screen by selecting the drop down.
Alternatively, you may also use the All and None buttons to select the data for the final merged patient. The All button selects all the data for the patient. The None button unselects all the data for that patient.

Note: If you click All on one record and then click All on the second record, the system selects all checkboxes from both but only selects the radio buttons from the second record.

Merging Patients

The steps taken to merge patients are as follows:

If you are working with more than two patient records on the Merge Patients Screen, select which patients you want to merge by checking the check boxes next to their patient ID's.
Continue by selecting details to merge.
Click the Merge Selected button. The system creates one single new patient with the selected details to replace the previous patient records.
If you were working with three patient records and merged two of the three, the system will return you to the Merge Patients screen, and you may continue to merge or unpend with the new merged patient which the system created. Otherwise, the system will take you back to the Select Patients to Merge screen.

Unpending Patients

Unpending patients is the term used for marking possible duplicate patient records as true non-duplicates. The steps taken to unpend patients are as follows:

Make sure all duplicates on the Merge Patients screen are completely resolved before deciding to unpend patients. All patients on the screen must be true non-duplicates.
Check the checkboxes next to all the patient ID's on the screen.
You do not need to check or select any other data. Click the Unpend button.
The system will add any pending patient on the screen as a new patient and marks all the records on the screen as non-duplicates.

Adding a Pending Client

A pending patient is one which comes in through data exchange and matches against one or more patient records already in the system. A pending patient does not yet exist in the immunization system. The steps taken to add a pending patient as a new patient record in the system are as follows:

Check the check box for the PENDING patient you want to add.
Click the Add Pending button.
The system adds the pending patient as a new record in the system and keeps you on the Merge Patients screen. You may continue to work with the patient you just added on the Merge Patients screen.

Information Provided

The following table describes the basic patient information on the patients to merge:

Field	Description
Last Name	The last name of the patient.
First Name	The first name of the patient.
Middle Name	The middle name of the patient.
Name Suffix	The suffix, such as Jr. or Sr., which the patient appends to his or her last name.
Date of Birth	The date when the patient was born in MM/DD/YYYY format.
Birth Certificate #	The state birth certificate number assigned to the patient. This field is populated through the immunization system vital loads.
Birth Order	The number indicating which order the patient was born in for cases of twins, triplets, etc.
Date of Death	The date when the patient died.
Death Certificate #	The state death certificate number for the patient. This information is populated from a vital load.
Gender	The sex of the patient: Female, Male, or Unknown.
Race	The race of the patient: American Indian or Alaskan Native, Asian, Native Hawaiian or Other Pacific Islander, Black or African-American, White, or Other Race
Ethnicity	The ethnic background of the patient: Hispanic or Latino, Not Hispanic or Latino.
Language	The language to be used on any reminder recall mailed to the patient or patient's parents/guardian(s).
Medicaid ID	The Medicaid ID for the patient.
Address	The address where the patient currently resides.
Phone Number	The phone number where the patient or patient's parent/guardian may be reached.
Mother's First Name	The first name of the patient's mother.
Mother's Maiden Name	The last name of the patient's mother before she was married.
Provider-PCP	The physician or other medically trained personnel who serves as the patient's primary care provider.
School	The school which the patient currently attends.
Graduation Date	January 1 of the year the patient would graduation from high school.
Country of Birth	The country where the patient was born.
Sharing of Imm's	This is the consent/opt-out indicator. If it is No, then the patient has opted-out of IRIS and access to the record is locked to the Idaho Department of Health and Welfare organization. The Merge button will be disabled. If it is Yes, then the patient file can be maintained in IRIS and the Merge button is enabled.
Contact Allowed	This indicator tells whether a provider organization may send mailings of reminder letters to the patient.

The following table describes the Organizations information on the patients to merge:

Field	Description
Active Indicator	This indicator tells whether the patient is Active, Inactive, Moved, or Deceased. If the status is Deceased , the Merge button will be disabled.
Provider Organization ID	The internal identifier for the provider organization which the patient has an association with.
Patient ID	The patient identification number for the patient at the provider organization.

The following table describes additional information on the patients to merge:

Field	Description
Responsible People	This section lists the people who have legal responsibility for making choices and decisions for the patient, particularly in the case of parent-child relationships or legal guardianship arrangements. This section lists each responsible person's name, full address, phone number, and relationship to the patient.
Comments	This section lists the immunization-related comments associated to the patient record on the Client Comments tab on the Enter/Edit Client Screen. The types of comments include (but are not limited to) allergies, immunities, vaccine refusals, and medical conditions which cause complications or harmful side effects if the vaccine were administered.
Notes	This section lists non-confidential notes related to the patient's immunization record or general care of the patient.
Immunizations	This section lists the immunizations administered to the patient in ascending order by date. The vaccine group and trade name are displayed for each immunization, if available. New immunizations will also display the lot number, funding type, site, VFC Eligibility, Insurance Provider, and Policy number, if available. If there is a reaction associated with the immunization, the word Reaction will display.

Functionality

The following table describes the buttons you can use on the Merge Patients screen:

Button	Description
	Click on the Merge button when you want to merge the patients, creating a new patient record with the selected merge details to replace the two patients on the screen. Note: This button won't display if one of the patients is Over 19 and has Allow Sharing of Imms indicator set to No. The system does not permit any record modifications for patients who have Opted-Out of the registry. The button will not display if the patient is deceased.
	Click on the Merge Selected button to merge the two patients whose patient ID's are checked. This will create a new patient record with the selected merge details to replace them.
	Click on the Unpend button to mark all the patients on the screen as non-duplicates.
	Click on the Add Pending button to create the pending patient, which came in through Data Exchange, as a new patient in the immunization system.
	Click on the Cancel button to exit Merge Patients and return to the Select Patients to Merge screen.
	Click on the All button to select all the data for that one patient as the data to save for the final merged patient.
	Click on the None button to deselect all the data for that one patient so that none of that patient's data is saved for the final merged patient.

Notes

Required Fields Display in Blue or Red
Some fields are so essential to the integrity of a patient's data that they must be kept on the final merged record. These required fields display in blue/red and include immunizations administered by the provider organization (new immunizations) and vital record information, such as birth and death certificate number, date of death, and date of birth entered through a vital load.

Required fields such as these must be selected when performing a merge. This requirement means that the system will prevent certain kinds of merges, such as attempting to merge two patients with different birth certificate numbers.

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Immunization De-duplication for the Merge Screen
After you select the immunization information to save on the final merge patient and click the Save button, the system will check for potential duplicate immunizations, which are doses with overlapping vaccine groups on the same date or within a 2 to 4 day window of each other. The 4-day window applies for doses administered in the Medicaid organization or a WIC organization. Otherwise, the 2-day window applies.

The system will give warnings for each pair of potential duplicate immunizations. If both immunizations are historic, you should uncheck one of the historic doses. If one immunization is historic and the other owned (either deducted from IRIS inventory or not), you should uncheck the historic dose. If both immunizations are from IRIS inventory and are for the same organization, site and lot number, then the system will automatically delete one of them and adjust the IRIS inventory accordingly. If both immunizations are from IRIS inventory but are for different organizations or lots, or are owned immunizations not deducted from inventory, you need to back out of the Merge Client feature, call up providers and find out which IRIS inventory dose can be safely deleted.
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