Duplication of client records may occur in CAREWare when clients are added manually or during the import process. In most cases, this duplication occurs due to a client reporting different genders, changes in a client's name, or a typo in a client's DOB. CAREWare has functions to prevent this duplication such as:

 

• The URN suffix edit window for clients with similar names and the same DOB

• Manual client matching in the import process

• A potential matches section based on the Client Matching Setup that allows users to review records that may be similar to existing clients in CAREWare.

 

When duplicatation of client records does occur, those records should be merged. CAREWare has options to merge client clients in the provider using the Duplicate Client option or centrally under Merge Clients in Cnetral Administration.

 

Central Administration users have unique options for managing duplicate client records, merging those records, tracking those merged records, removing clients as potential duplicates, reviewing potential duplicates, and evaluating clients based on URN field values or custom fields. This review process is conducted across providers for users with the Global User permission. The merge process can be used to clean up incorrectly added clients, clients added with incorrect information across providers, or incorrectly imported lists of clients.

 

Circumstances that often lead to these duplicates clients include situations where the client was imported or added with a discrepancy in a URN field.

 

Note: URN fields include a client's first name, last name, DOB, and gender.

 

• A client may marry changing their last name.

• A client may report a nickname as their first name.

• A client may choose a new first name and/or last name.

• A client may report a different gender.

• An EMR/lab may have limited options for gender that are different from how the client identifies.

• There may be a typo in a URN field.

• A client may have multiple first and/or last names reporting them interchangeably.

 

In each of these cases, adding or importing the client's data should include options to match clients based on those URN fields using Client Matching Setup.

 

Below are some circumstances that may prevent that matching process from occurring.

 

• Import Settings are set to automatically add clients.

• A potential match may be missing from the results.

• The client may exist in another provider and potential matches fails to show that record.

• Common Client Data is disabled changing how CAREWare handles clients getting services in multiple providers.

• The weight for certain client matching fields were lowered resulting in CAREWare recognizing the client as a unique client.

• A user identified the client as a new client, because the potential match was on a subsequent page or appeared to have a low score for matching due to a discrepancy in the client's DOB.

• The user is limited to viewing records for only a single provider, lacking the Global User permission.

 

Under each of these circumstances, a client is added a second time. The records need to be merged to make sure the client record is intact and users are entering data to the correct record.

 

If duplicates do arise, those duplicate records can be merged and the secondary record deleted to ensure client data is entered or imported to the correct records in the future. Clients can be flagged as a Duplicate Client in providers, flagged as a matched pair in Browse Client List, or flagged as a Duplicate under Browse Ranked Matches adding them to the Merge Clients list for review where the merge client process can be completed.

 

Clients are listed in the Merge Clients list side by side with a score. The client on the left is the primary client to be retained. The client on the right is the secondary client, whose records are copied to the primary client in the merge process. Clients with a 100% score are very likely to be a match. In some cases, clients that are a 100% match, appear so due to the only different being the client's gender and the Client Matching Setup having zero weight for gender by default. The Client Matching Setup settings include a threshold of 70% by default. This means that clients are generally considered a potential match if they are at least a 70% match of another client record in CAREWare. Clients with discrepancies for their DOB tend to have lower scores as more weight is given to DOB in the Client Matching Setup settings by default. If there are too many clients showing up as potential matches or too few under Browse Ranked Matches, the Client Matching Setup settings can be adjusted and the list scored again to update it.

 

Additional considerations regarding merging clients

 

Resolving duplicate clients across providers

 

When reviewing duplicate client records, reviewing potential matches for client records, or resolving client matching issues, it is important to consider if the client is present in the provider where the record is being added or if the client is being added to the provider for the first time and exists in another provider. Users that are entering data into CAREWare often have singular access to the provider for which they work. In a multi-provider CAREWare system or state wide CAREWare system, that user may lack access to see or review records for the other providers. In that case, a user may try to add a client in their provider and get a prompt that the client already exists or there is a duplicate URN. This can happen when editing demographics information as well. If you user lacks access to other providers clients, they may have difficulty matching the records, merging the records, or even viewing the records to review the entire situation. In this case, it is often best to complete the duplicate client review in Central Administration.

 

Protecting CAREWare from data loss during the merge process

 

The general premise when merging clients in CAREWare is that there are duplicate clients. One is the correct client, to be retained, and one is a duplicate that should be ideally deleted. For a number of reasons, under a number of circumstances, there may be an accident, where a client is flagged as a match to the wrong client or a client is merged with the wrong client. This could lead to records being copied to the wrong client or clients being deleted from other providers. As this is a possibility, it is important to carefully review the client matching and client merge process to ensure the correct records are involved in the merge and delete processes. The following actions can be taken to protect client data under these circumstances:

 

• Keep the secondary client for a period of time for review. This can provider clinical staff time to review the secondary client record to make sure that all of the records were copied. If the secondary client is deleted prior to the review and some of the records failed to copy to the primary client, deleting the secondary client immediately during the merge client process can result in the loss of those records. Again, these could be recovered if there is a recent backup or the records are exported prior to the merge process.

 

• Open and review both client records thoroughly to ensure which client level data records exist prior to merging the clients. This can also be done by exporting the records using the Provider Data Export. By exporting the records, a report exists displaying the existing records for both clients for review, the exported file functions as a backup of the data, and the exported file can be used as an import file to correct any mistakes, including deleting the clients.

Note: To use the Provider Data Export for the merge client process, the Provider Data Export client filter can be set to filter clients based on their eURN. That way only the clients involved in the process are included in the export.

 

Note: The Provider Data Export option for reviewing, protecting, and correcting merge client data issues typically works best when the duplicate client issue exists within a single provider. There are options to manage this process in Central Administration for multiple providers.

 

• Make sure that CAREWare is backed up on a regular basis or that a backup is completed recently before merging clients. Once the client records are merged and the secondary client is deleted, these are permanent changes to the client record. The process cannot be reversed. While the Provider Data Export may provide some options for recovering the records, the backup file may be the only option to bring CAREWare back to the same state it was in prior to that merge if needed. Restoring from a backup may be the better option in situations where a large number of client records where merged, the merge process resulted in attached documents being copied to the wrong clients, clients involved in the merge process have a long history of clinical data, or in situations where the client merge and delete processes are affecting clients across multiple providers. Any time there are large scale changes to client data, there should be recent backups of CAREWare data to fall back on in case there was a mistake in the process.

 

The merge client process appears incomplete

 

When merging clients, ideally CAREWare merges all of the client records copying them from the secondary client to the primary. The goal is that all of the secondary client records are retained. In some cases, users have reported this process is incomplete due to records being rejected during the merge process.

 

Records may be rejected for several reasons during the merge client process. The primary reason that records are rejects are due to both clients already having the same record entered on the same date and in that location in CAREWare duplicate records are rejected. An example would be that both clients already have the same service entered for the same date. CAREWare may only retain one. In other cases, a record may be rejected do to a business tier rule. If Common Storage Values are set to prevent users from adding services after a client's case closed date and the merge process changes the client's enrollment, that may generate an error during the merge process. These rejected records are recorded in a report called the Rejected Records Report, which explains each record that is excluded from the merge process.

 

In cases, where the merge process is incomplete, the records can be manually added to the primary client if there are only a few or the records can be exported and then imported back in to the primary client by changing the client identifying fields in the import process.