Patient in one system is the same patient in another system, The Master Patient Index, Introduction

health-information-analytics-series-posts-logoOne forum in a regional eHealth Information Network of which I am a subscribed member, has been actively having an open discussion of a subject of public interest in health Information Technology (IT) analytics in their public ListServ lists, this time around about the Master Patient Index (MPI).

It seems appropriate to me to talk about MPI and share what is in that forum that I can blog here, in a new series of blog posts named Health Information Analytics Series (HIAS), on MPI for the benefit of Medical Records PALS Malaysia readers outside that forum.

In getting the complete story on MPI, let’s start entering this post to know who is it about, when it takes place, what happens with it, where does it take place, why it happens, and how it happens.

The MPI is about the patient in a healthcare environment who attends an Emergency Department or an Outpatient Department or who gets admitted to the hospital. As the patient enters the healthcare environment, a medical record is started that according to Huffman (1990) “must contain sufficient data to identify the patient, support the diagnosis or reason for attendance at the health care facility, justify the treatment and accurately document the results of that treatment”. As we are aware, since the medical record is a written collection of information about a patient’s health and treatment, they are used essentially for the present and continuing care of the patient. Individuals managing an individual patient’s data may be providers, or members of a health plan. For an efficient and effective medical record system, correct identification is needed to positively identify the patient and ensure that each patient has one medical record number and one medical record ONLY.

Many countries still do not combine outpatient attendance at the Emergency Department (ED) or an Out-Patient Department (OPD) or a Consultant (Specialist) Clinic (CC) together with admission as an inpatient. A separate numbering system is used for the ED or an OPD or a CC attendance. If the ED or an OPD or CC attendance is combined with admission as an inpatient, then the medical record begins with the patient’s first admission as an inpatient or attendance as an outpatient to the health care facility. Thus, a unit record is created during his or her stays at the health facility, visits to the ED and other facilities at a hospital (Margaret 2003).

The collection of identification information from the patient is the first stage in adding to the MPI found at a single electronic system level or the facility level. MPI can extend to enterprise or health information exchange (HIE) levels. Most health facilities worldwide have electronic systems while many still maintain MPI in paper format. In either format, the MPI is the single most important resource in a healthcare setting that links the patient’s activity within this setting and across the continuum of care, since the unit record never always stays in one domain of the care provider (Margaret 2003).

I shall not dwell too much into the basics of a MPI but will continue in the following post of these series of posts, to talk about the pitfalls as each provider tends to have its own way of assigning a unique numeric or alphanumeric medical record number in the absence of a local, or regional or a national patient identifier to a patient during the creation of a new patient file. I think I will also cover the essential building blocks for a clean, reliable and workable MPI, and how important is it to have one and much more, leading to trends in MPI development as discussed in the ListServ mentioned right at the beginning of this post.


  1. Huffman, EK, 1990, Medical Record Management, 9th edn, Physicians’ Record Company, Berwyn. Illinois.
  2. International Federation of Health Information Management Associations (IFHIMA), Education Module for Health Record Practice, Paper 1, Module 2 – Patient Identification, Registration and the Master Patient Index, IFHIMA, 2014, viewed 18 August 2014, <>
  3. Medical Records Manual: A Guide for Developing Countries, 2006, World Health Organisation, Western Pacific Region, Manila, Philippines
  4. Margaret, AS (ed.) 2003, Health Information Management: principles and organisation for health information services, 5th edn, Jossey-Bass, San Francisco

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