Electronic health records often do not record when someone has died. The deceased continue to get a variety of healthcare reminders.
A substantial number of deceased patients continue to receive correspondence from their providers, according to a research letter published today in JAMA Internal Medicine.
The researchers found that one-quarter of the the almost 12,000 patients in a previous study of seriously ill primary care patients had died and were recorded as being deceased in a University of California healthcare system's electronic health record (EHR). But 676 (5.8%) of those who had died were still recorded as being alive in the EHR. Among those, 541 (80%) continued to be contacted. They received 221 telephone calls, 338 portal messages and 920 letters concerning unmet primary care needs such as reminders for cancer screenings. There were also 184 vaccine orders. Medications were authorized in 130 instances.
"Not knowing who is dead hinders efficient health management, billing, advanced illness interventions, and measurement," wrote corresponding author Neil S. Wenger, M.D., M.P.H., of the UCLA Division of General Internal Medicine and Health Services Research, and his colleagues. "It impedes the health system’s ability to learn from adverse outcomes, to implement quality improvement, and to provide support for families."
States keep track of deaths, but that information doesn't reach healthcare systems. Wenger and his colleagues note that the National Association for Public Health Statistics and Information Systems maintains a real-time fact of death service, but providers have been unable to use it.