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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

The Need for a Master Patient Index (MPI)

Terry McLeod Updated: Dec 14th 2010

When you visit your friendly neighborhood Community Mental Health Center, the gap between adaptation of the Electronic Health Record (EHR) in general healthcare and the behavioral / addiction treatment world becomes evident pretty quickly, especially if a consumer is filling out paper forms in the lobby with a worn-down pencil with no practically no eraser left.

nurse working at a computerIt's getting better.

Recently, in helping a large New York City agency select an EHR, I was surprised to hear they had no common Master Patient Index (MPI). That's a program that can relate the EHR to other software, like the Human Resources system. The goal of that sort of internal interoperability is keeping the same demographic data common among all the software systems in an agency.

Small and mid-sized agencies end up having to pay software vendors extra to connect their programs, foregoing an MPI mostly because of the added expense. Few saw that this could blossom into a continuous pain, so internal interoperability, sharing of data among an agency's software programs, takes a back seat to paying the electric bill or giving holiday bonuses (hallowed ground, the holiday bonus).

Most physical health hospitals spent a lot of time and money over the past few decades concentrating on the MPI because they don't want their doctors and nurses to spend their high-priced time re-writing a consumer's name, address and other demographic information. Mental health and addictions treatment is just catching up, but we still find licensed professionals and front line staff re-writing this information...oh, and don't forget about that consumer in the lobby with the worn down pencil. That little metal thing that holds the eraser onto the pencil has just torn through the form for the eighth time...he could get frustrated any moment, and he just wants help with his mental health problem. Perhaps an MPI would help expedite his treatment

Most of the larger agencies bought software for programs piecemeal. First, the accounting department got their software, then the automated time-clock appeared, which by rights should share professionals' information with the human resources get the picture. The result was a plethora of disconnected software, and it's not difficult to see how we got to the point of needing the MPI, but not knowing much about it.

If you have three software programs feeding into a central MPI, the MPI must be king of the data, so it can send updates to the consumer's record out to all those other programs. Sounds simple, but it's not. Vendors of MPIs charge a pretty penny for their software and support with good reason...brokering changes to a consumer's health information is serious business, and you gotta get it right, every time.

The agency I mentioned earlier (with no MPI) grew into the need over time, adding different sorts of programs to help them serve people with developmental disabilities and mental health disorders. Not-for-profit agencies' business priorities seem to have a history of underestimating the value of all those minutes that can be saved when staff, professionals and consumers don't have to fill out their name and address with that worn down pencil over and over again...not to mention the great benefit of cutting down on graphite and rubber (eraser) pollution.

Like I said, it's getting better. At least we know what an MPI is, and are learning the value of it in this age of mergers and acquisitions.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

Reader Comments
Discuss this issue below or in our forums.

We'll Pass - - Dec 14th 2010

We'll pass when we can on "master" anything these days.  The physician office/hospital just invited our son to be a part of their electronic system - we opted out and will continue to do so.  Everyone in the family has already had "secure" information comprised so we'll be the ones with the stubby pencils in the waiting room if we decide to actually go to a "professional" office for treatment of any kind. 

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