What happens when duplicates are detected across exchanges?

• A. They are merged into a canonical record after matching and stewardship review
• B. They are duplicated across the system
• C. They are automatically discarded without review
• D. The system merges them with random data

Answer: (A)

When duplicates are detected across exchanges, the system aims to unify them into a single canonical patient record after matching and stewardship review. The idea is to create one authoritative view of the patient that all connected providers can rely on, instead of having several separate records for the same person. First, potential duplicates are identified using matching logic that compares identifiers, demographics, and sometimes clinical data to determine likely matches. Once a match is found, a canonical record is formed, but human oversight—stewardship review—is involved to verify accuracy, resolve any conflicts, and ensure privacy and consent considerations are respected before the merge. After the merge, data from the individual source records is consolidated into the canonical record, with provenance preserved so it’s clear where each piece of information came from and how it’s been updated over time. This approach reduces duplicates, ensures a complete and consistent patient history, and improves patient safety across exchanges. The other options don’t fit because duplicates aren’t simply duplicated across the system, they’re reconciled; they aren’t automatically discarded, and they aren’t merged with random data.