Last week, another electronic healthcare record software vendor faced a putative class-action lawsuit alleging that problems with the software created inaccuracies in the stored patient health data. The suit also alleges that the cloud-based vendor misrepresented the capabilities of their products in order to become certified under meaningful use. The complaint described faulty usability including displaying inaccurate medical information, history, or treatments and simultaneously displaying the data of multiple patients. The suit now calls into question the accuracy of medical records for millions of patients.




Data integrity means that data should be complete, accurate, consistent, and current. Protecting the integrity of healthcare data is important because providers use them in making decisions about patient care. According to health.gov, when doctors and other healthcare providers have access to complete and accurate information, patients receive better medical care. Electronic healthcare record can improve the ability to diagnose diseases and reduce—even prevent—medical errors, improving patient outcomes. However, if the accuracy of a patient's record is damaged, the data loses integrity and the benefits of using electronic means to document patient encounters are lost, or worse, become a hinderance to quality care.


Unlike cloud-based applications, MacPractice stores data in a relational database called MySQL. At their heart, databases such as the one storing patient information in MacPractice are composed of columns and rows, similar to a spreadsheet. Relational databases tie information together to accurately reflect data across the platform.


Most interactions within MacPractice result in tying information together. For example, when adding a new patient, you type information in fields, select items from menus, or choose records from lists. All of this information related to the patient is tied together within the database permanently unless the ties are purposely broken by deleting all of the strings attached.


Many records in MacPractice are preserved for database integrity. User records cannot be deleted if that user is a provider and has a history of transactions, for example. Since most transactions in the Ledger are associated to a provider, deleting that provider would cause issues with every transaction associated to them. Therefore, providers can not be deleted from your database if that provider is tied to transactions. If a provider leaves your practice, the record is instead made inactive or archived so that past actions can still be tracked.


This might lead some to become worried about the size of a database over time. Most items in your database take up insignificant amounts of storage space. The majority of your data size will typically come from your financial transaction history in the ledger and any attachments, images, and PDF files in your database. If necessary, you can back up attachment file separately from your database.


Occasionally, you may wish to remove unwanted records in MacPractice. Database Utilities allow you to make major changes to your MacPractice data very easily. Learn more about the options in the Database Utilities section of the MacPractice Helpdesk site.