diff --git a/app/mixins/patient-id.js b/app/mixins/patient-id.js
index 464eb8a0af..7570d1ef33 100644
--- a/app/mixins/patient-id.js
+++ b/app/mixins/patient-id.js
@@ -19,11 +19,11 @@ export default Ember.Mixin.create(PouchDbMixin, {
     const maxValue = this.get('maxValue');
 
     const findUnusedId = (sequence) => {
-      let next, id;
+      let current, id;
       return config.getPatientPrefix()
         .then(function(prefix) {
-          next = sequence.incrementProperty('value');
-          id = sequenceId(prefix, next);
+          current = sequence.get('value');
+          id = sequenceId(prefix, current);
           const query = {
             startkey: [ id, null ],
             endkey: [ id, maxValue ]
@@ -31,14 +31,16 @@ export default Ember.Mixin.create(PouchDbMixin, {
           return database.queryMainDB(query, 'patient_by_display_id');
         })
         .then(function(found) {
-          if (isEmpty(found.rows)) {
-            sequence.set('value', next);
-          } else {
+          if (!isEmpty(found.rows)) {
+            sequence.incrementProperty('value');
             return findUnusedId(sequence);
           }
-          return sequence.save().then(function() {
-            return id;
-          });
+          if (sequence.get('hasDirtyAttributes')) {
+            return sequence.save().then(function() {
+              return id;
+            });
+          }
+          return id;
         });
     };
 
@@ -48,7 +50,7 @@ export default Ember.Mixin.create(PouchDbMixin, {
         var store = this.get('store');
         var sequence = store.push(store.normalize('sequence', {
           id: 'patient',
-          value: 0
+          value: 1
         }));
         return findUnusedId(sequence);
       });
diff --git a/app/patients/edit/controller.js b/app/patients/edit/controller.js
index b49ab490d5..ad10964590 100644
--- a/app/patients/edit/controller.js
+++ b/app/patients/edit/controller.js
@@ -6,6 +6,8 @@ import ReturnTo from 'hospitalrun/mixins/return-to';
 import SelectValues from 'hospitalrun/utils/select-values';
 import UserSession from 'hospitalrun/mixins/user-session';
 export default AbstractEditController.extend(BloodTypes, ReturnTo, UserSession, PatientNotes, {
+  config: Ember.inject.service(),
+
   canAddAppointment: function() {
     return this.currentUserCan('add_appointment');
   }.property(),
@@ -526,14 +528,35 @@ export default AbstractEditController.extend(BloodTypes, ReturnTo, UserSession,
     this.send('closeModal');
   },
 
+  _updateSequence: function(record) {
+    const config = this.get('config');
+    const friendlyId = record.get('friendlyId');
+    return config.getPatientPrefix().then((prefix) => {
+      const re = new RegExp(`^${prefix}\\d{5}$`);
+      if (!re.test(friendlyId)) {
+        return;
+      }
+      return this.store.find('sequence', 'patient').then((sequence) => {
+        const sequenceNumber = sequence.get('value');
+        const patientNumber = parseInt(friendlyId.slice(prefix.length));
+        if (patientNumber > sequenceNumber) {
+          sequence.set('value', patientNumber);
+          return sequence.save();
+        }
+      });
+    });
+  },
+
   afterUpdate: function(record) {
-    this.send('openModal', 'dialog', Ember.Object.create({
-      title: this.get('i18n').t('patients.titles.savedPatient'),
-      message: this.get('i18n').t('patients.messages.savedPatient', record),
-      updateButtonAction: 'returnToPatient',
-      updateButtonText: this.get('i18n').t('patients.buttons.backToPatients'),
-      cancelButtonText: this.get('i18n').t('buttons.close')
-    }));
+    this._updateSequence(record).then(() => {
+      this.send('openModal', 'dialog', Ember.Object.create({
+        title: this.get('i18n').t('patients.titles.savedPatient'),
+        message: this.get('i18n').t('patients.messages.savedPatient', record),
+        updateButtonAction: 'returnToPatient',
+        updateButtonText: this.get('i18n').t('patients.buttons.backToPatients'),
+        cancelButtonText: this.get('i18n').t('buttons.close')
+      }));
+    });
   }
 
 });