Code Red in the EHR: The Data Integrity Specialist's Guide to the "Contact Mover" Rescue

Picture this: It’s a hectic Tuesday morning in the Emergency Department. A patient, Mr. John Smith, is being treated for chest pain. A nurse, moving quickly between patients, accidentally opens the chart of another patient, Robert Brown, and begins documenting Mr. Smith’s vital signs, ECG results, and medication administration.

The mistake is realized minutes later, but the damage is done. Critical clinical data now lives in the wrong patient’s record. This isn't just a data error; it's a patient safety risk. A clinician relying on Robert Brown's chart would now see a dangerously inaccurate clinical picture. This "Code Red" in the EHR system is immediately reported to the Health Information Management (HIM) department, and the Data Integrity Specialist is dispatched to put out the flames.

This is where the Contact Mover tool comes in. It is our most powerful fire extinguisher for this specific type of data inferno.

The Step-by-Step Rescue Mission

Handling a Contact Mover request is a high-priority, high-stakes procedure that requires precision and clear communication. Here’s how it’s done:

Step 1: Triage and Communication

The moment the ticket arrives, the first action isn't in the software. It's on the phone. The Data Integrity Specialist must immediately contact the unit nurse manager or charge nurse.

• The Goal: Get every single user out of the incorrect patient chart.

• The Reason: The Contact Mover tool cannot run if the encounter is actively in use. The specialist will also inform the unit to verbally alert any providers with pending orders in the wrong chart to close out immediately.

Step 2: Execute the Move

With the chart cleared, the specialist moves to the technical rescue.

• Action: Open the specialized Contact Mover tool within the EHR (like Epic).

• Process: Identify the incorrect patient chart (Robert Brown) and the correct patient chart (John Smith). The tool is then run to move the entire misplaced encounter (including all notes, orders, and results) from the wrong chart to the correct one for that specific date of service.

Step 3: Verify and Validate

A move is not complete until its success is confirmed. This is a critical quality check.

• Action: The specialist opens both the source (Robert Brown) and target (John Smith) charts.

• Checklist:

  1. Is the encounter completely gone from the wrong patient's chart?

  2. Does the encounter now appear in the correct patient's chart?

  3. Is all the associated documentation, including notes and orders, present and intact in the correct chart?

Step 4: Document and Inform

The final step is to close the loop with meticulous documentation and communication.

• Documentation: A detailed report is entered into the help desk ticket, creating a permanent audit trail of the event and its resolution.

• Communication: The specialist informs the originating unit that the move is complete, the charts are accurate, and they can resume their workflow safely.

Example of a Data Integrity Incident Report

After resolving the issue, the specialist would document it in the ticket system as follows:

Data Integrity Incident Report

Ticket Number: HIM-456-2024

Date of Incident: October 26, 2024

Time Ticket Received: 10:15 AM

Reported By: Jane Miller, RN, Emergency Department Charge Nurse

Issue Type: Wrong Patient Chart Documentation (Contact Mover Required)

Description of Error: Clinical documentation and orders for patient John Smith (MRN: 123456) were inadvertently entered into the chart of Robert Brown (MRN: 789012) during an ED encounter.

Actions Taken:

1. Contacted ED Charge Nurse at 10:17 AM to secure and clear both patient charts.

2. Executed Contact Mover tool at 10:25 AM to transfer the encounter of 10/26/2024 from MRN 789012 (Brown) to MRN 123456 (Smith).

3. Performed post-move validation in both charts at 10:28 AM. Confirmed all notes, vitals, and orders were successfully moved and are no longer present in the source chart.

Resolution: Resolved successfully. All data integrity has been restored. ED nursing staff notified of completion at 10:30 AM.

Completed by:

Kakashi Hatake

Data Integrity Specialist