An interesting research letter in JAMA Internal Medicine highlighted a grim trend in health system record keeping: EHRs frequently overlook patient deaths.
That’s a major issue for plenty of reasons, which UCLA Health researchers laid out after analyzing roughly 11,700 seriously ill primary care patients across 41 clinics (2020-2022).
Almost 700 patients whose medical records showed them as alive were actually deceased according to California public health filings, nearly 20% of the entire cohort.
The discrepancy led to hundreds of unnecessary interactions such as prescription refills and appointment reminders, needlessly straining resources and staff bandwidth.
Of the patients found to be deceased:
- 310 had an active appointment on the calendar
- 541 had an appointment still pending
- 221 received 920 letters about preventative care such as flu shots or screenings
- 166 received 226 mailed correspondence
- 158 had 184 orders placed for vaccines and other care
- 88 medications were authorized
That’s a serious amount of wasted outreach for healthcare workers that don’t exactly have extra slack in their workflows, and the authors point out that addressing just this issue would provide immediate benefit to staff (at least at one California academic health system).
It’s worth noting that California prohibits death file information from being shared with any party except for financial institutions, so the issue varies state to state.
The Takeaway
Not knowing which patients are dead isn’t ideal for provider operations, hindering everything from effective rev cycle processes to quality improvement programs. We’ve covered countless studies related to burnout caused by administrative tasks, but this is the first research we’ve seen that suggests a decent chunk of that burden could be alleviated by simply knowing which patients are still alive.
