Does your LIS not have a way to log alternate or "alias" names? We often would get trauma specimens with a "trauma name" like ie. RJZ1234 Hispanic, Male, Then in the middle of the trauma they would put in his real name, ie. Jaun Ortiz, then 2 hours later we would go to issue blood and his name is James Smith (hospital assigned alias). Got really confusing in blood bank but the HIS (MediTech) had a great way to tie the names together. Are they using the same medical record number? This would be a way to tie the two together in the system. If your system can't tie them together I would put a detailed note on both names for future reference. I think legally your ok as long as you can tie the names together and the patient is not using the "alias" to commit fraud - like to use someone else's insurance. (Just my opinion).