Patients with duplicate medical records face a significantly higher risk of death and intensive care admission after hospital admission, according to research published in BMJ Quality & Safety. The study analyzed data from 12 hospitals within a large US health system between July 2022 and June 2023.
Researchers reviewed over 103,000 medical records and included more than 73,000 patients discharged from medical, surgical, or orthopedic teams. Of these, 1,698 had duplicate records while 4,388 did not. Using propensity score matching to balance patient characteristics between groups, the study found that inpatient death occurred in 11% of those with duplicate records compared to 2.5% among those without duplicates. Patients with duplicate charts also experienced longer hospital stays—an average of 101 hours versus 74 hours.
The likelihood of requiring emergency intervention was slightly higher for patients with duplicate records (6% vs. 5%), as was the need for intensive care (46% vs. 19%). Thirty-day readmission rates were also elevated at 12% for those with duplicates compared to 11%. After adjusting for additional factors such as discharge destination and support needs, researchers determined that patients with duplicate records were nearly five times more likely to die during their hospital stay and over three times more likely to require intensive care than those without duplicates.
The study notes limitations including its observational design and use of data from a single health system, which may affect how broadly the findings apply elsewhere.
"Despite these limitations, our study highlights a concerning association within our system and underscores the importance for outside systems to investigate their own associations, determine causal pathways, and develop mechanisms to prevent duplicate chart creation and/or conduct data integration expeditiously," the authors wrote.
They suggest that duplication may hinder providers’ access to critical information like allergies or medical history that could influence treatment decisions. "An additional hypothesis relates to efficiency: the presence of duplicate charts may contribute to care delays or inaccurate orders as medical teams search for information that is not readily accessible, spend extra effort navigating between multiple charts, or inadvertently overlook key details," they added.
"These findings highlight the association between duplicate medical records and adverse patient outcomes, emphasising the need for research to understand the impacts of duplicate charts as well as targeted interventions to improve data integrity, enhance patient safety, and inform policy changes in health information management," they concluded.
