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Many dead patients still listed as alive in electronic health records, researchers say
Nearly one in five deceased patients are marked alive in electronic health records (EHRs) and 80 percent received primary care outreach after their death, according to a research letter published online Dec. 4 in JAMA Internal Medicine.
Neil S. Wenger, M.D., from the University of California, Los Angeles, and colleagues investigated what proportion of active patients a health system is unaware are deceased. The analysis included EHR data from 11,698 seriously ill, continuity primary care patients (aged 18 years and older with two or more primary care visits during the prior year) seen at 41 clinics across an academic health system.
The researchers found that 25 percent of included patients were recorded as deceased in the EHR, while 5.8 percent were deceased according to the state death files but marked alive in the EHR. Eighty percent of the 676 patients not known to be deceased had an encounter or appointment outstanding after death and received an estimated 221 telephone calls and 338 portal messages.
Furthermore, 221 of these patients received 920 letters concerning unmet preventive care needs (e.g., flu shots, cancer screening), 166 patients received 226 other mailed correspondence, 158 patients had 184 orders placed for vaccines and other clinical care, and 88 medications were authorized in 130 encounters.
"Better awareness of vital status is needed for health systems to provide accountable care," the authors write.
More information: Neil S. Wenger et al, Consequences of a Health System Not Knowing Which Patients Are Deceased, JAMA Internal Medicine (2023). DOI: 10.1001/jamainternmed.2023.6428
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