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Duplicate medical records have been a longstanding issue in healthcare. This tutorial discusses how NextGate plans to eliminate them, starting with an overview of NextGate and AWS. It highlights the challenges caused by duplicate records and the role of enterprise indices in addressing these issues over the past 25 years. The focus shifts to how 100% of duplicate records can be effectively resolved. NextGate, which invented the enterprise master patient index (EMPI) 25 years ago, is now a leader in EMPI solutions, transitioning from on-premise systems to a SaaS model hosted by AWS. The EMPI enables accurate patient identification across various systems, improving record integrity and healthcare delivery.