The purpose of this qualitative grounded theory study was to explore and examine the factors that led to the creation of multiple record entries, and present a theory on the impact the problem has on the business performance of health care organizations. A sample of 59 health care professionals across the United States participated in an online survey allowing them to share their experience and perspective on the problem. The health care professionals served in various job roles and used the electronic medical record system to perform their daily tasks. The data gathered provided insight into the processes used to discover, manage, and resolve multiple record entries. The research produced three key findings: 1) merging and deleting multiple entries are the most critical challenge, 2) multiple entries are discovered downstream in the records management process rather than upfront when records are created, and 3) resolution of the problem is viewed as a joint responsibility between the health information services and information technology teams. Two main conclusions were drawn from the study; first, the admissions process within health care organizations needs to be reviewed and reengineered; second, a massive cleanup of the electronic medical record system data is necessary to restore the quality and integrity of master patient index records. The recommendations offered in the study presented leaders with best practices and process improvement options to develop a comprehensive, strategic plan of action to address the problem. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]