What is an indexing unit in an alphabetic filing system for medical records?

Name

The use of the patient's full name is recommended whenever possible. If the middle and maiden names are given, record both. Very often the middle (or maiden) name will be given only as an initial and should be so recorded. However, every effort should be made to avoid the use of initials for first names.

For married women, the first name of the husband should not be used; record the name of married female patients, for example, as Jones, Paula Ann, not Jones, Mrs. John T. The husband's name will be recorded under the heading spouse.

For children, the name(s) of the parent(s) should be recorded.

In recording the name of Catholic clergy, it is preferable to use family names, if known. Use the title (Sister, Brother, Father, Mother) as a family name only until the true name is known. A cross reference will probably be necessary to facilitate this matching of names and avoid duplication.

For male patients who are Sr., Jr., III, indicate so following the last name. Also, if it is known that the patient has a graduate professional degree (M.D., D.D.S., D.D.), indicate -- for example, Smith, III MD, Robert Quintin.

Hospital Medical Record Number

Record the number assigned to the patient by the hospital admitting office. If the hospital has a unit numbering system, all patient records will carry this identifying number. If the hospital has a serial numbering system, a new number is assigned on each admission to the hospital. In this case, each registry must work out a system which will best serve as a cross reference to the hospital medical record, for example, an alphabetic card index file. This file can then be checked against the medical record department's alphabetic file to determine the patient's latest admission. You may decide to retain as your registry number; the number assigned to the patient by the hospital at the time the neoplasm was first diagnosed. If the hospital has a serial unit system, each admission is given a unique number, such as an accounting number, but the patient's record is filed under a unit number in medical records.

Local Registry (Accession) Number

A patient's registry number should remain the same regardless of the number of admissions or primary sites. This method is recommended by the American College of Surgeons.

Address and Phone Number

Record the number, street, city, state, and zip code of patient's usual residence. Record the phone number, including area code, if it is known.

Social Security Number

Record the patient's Social Security number. In Veterans Administration hospitals and military hospitals, the Social Security number of the sponsor, or a portion of it (last 4 or 6 digits, or first 4 or 6 digits), is the hospital medical record number. For Medicare patients, the number of the husband, not that of the patient, may be that of the primary beneficiary--for example, the number of the husband, not that of the patient.

Spouse

Record the complete name of the husband or wife. For single adults and children, record as "not applicable" (N/A)

Physicians

1. Family: Name, address, and telephone number of any family physician
2. Attending: Name, address, and telephone number of any attending physician
3. Admitting: Name, address, and telephone number of any admitting physician
4. Referral: Name, address, and telephone number of any referring physician
5. Hospital Staff: Name, department, and the telephone number of the physician who attended the patient. In hospitals where patients are not under the care of a particular physician, record the name of the physician in charge of the department

Employer

Record name, address, department, and telephone number. Other applicable entries are: self employed, not employed, unknown.

Presentation on theme: "Medical Records Management"— Presentation transcript:

1 Medical Records Management
Chapter 43 Medical Records Management Copyright 2016 by Elsevier Inc. All rights reserved.

2 Introduction to Medical Records
Medical records document all aspects of patient care Care patient receives Patient progress Also used to review quality of care and obtain statistics Medical records management is named for the process of creating, handling, and storing records What is a medical record? What statistics might be obtained by studying medical records? Copyright 2016 by Elsevier Inc. All rights reserved.

3 Introduction to Medical Records (Cont.)
Medical records are legal documents, used by the physician if there are questions about the care given Physical record belongs to person, group, or institution that produced it Information and access to information in the record controlled by the patient or his or her representative When does a medical office create a medical record for a patient? Who does the medical record belong to and why? How does the patient control the information in a medical record? Copyright 2016 by Elsevier Inc. All rights reserved.

4 Introduction to Medical Records (Cont.)
Original record never released If required in a court case, representative of the office accompanies the record Important to keep complete medical records for legal protection How do complete medical records provide legal protection? Why should a staff member accompany the record if the original record is subpoenaed for a court case? Copyright 2016 by Elsevier Inc. All rights reserved.

5 Paper-Based Medical Records
Created using manila file folder Contains all documents related to an individual patient Used at each patient visit Why are paper medical records usually stored in individual manila file folders? Why is a patient’s medical record used at every patient visit? What methods are used to enter new information into a paper medical record? Copyright 2016 by Elsevier Inc. All rights reserved.

6 Copyright 2016 by Elsevier Inc. All rights reserved.
Storage Equipment File cabinets Heavy construction with proper weighting to prevent tipping over Locking system Lateral drawers more common than vertical file cabinets Why is it especially important to be sure that medical record files are stabilized to prevent tipping over? Why should file cabinets for medical records always have a locking system? Copyright 2016 by Elsevier Inc. All rights reserved.

7 Storage Equipment (Cont.)
Shelf filing units more common than file cabinets Horizontal shelves with adjustable metal shelf dividers Require file folders with side tabs Records are accessed from the side Open shelves must be in a file room that can be locked Shelves with pull-down fronts allow locking of each shelf How can open shelving units be secured to prevent access by unauthorized individuals? Why are file folders with side tabs used if medical records are filed on shelf filing units? Copyright 2016 by Elsevier Inc. All rights reserved.

8 Copyright 2016 by Elsevier Inc. All rights reserved.
File Folders Manila file folders with tabs are used to protect records Prong fasteners hold papers Top tabs for file cabinets and side tabs for shelf units Indentations ensure uniform placement of labels Why should filing folders have indentations for colored labels? Where are the prong fasteners usually located in a medical record file folder? Figure 43-1 shows file folders for shelf units. Copyright 2016 by Elsevier Inc. All rights reserved.

9 Copyright 2016 by Elsevier Inc. All rights reserved.
Folder Labels Color-coded labels are usually used for letters in the patient’s name or numbers in the patient’s clinic number Additional labels or colored folders may be used to indicate the year, the physician, allergies, insurance information, etc. Using a current year label simplifies removal of inactive files How do color-coded labels facilitate filing? What is the reason for using labels to identify the current year? To identify the physician? To identify medication allergies? Copyright 2016 by Elsevier Inc. All rights reserved.

10 Copyright 2016 by Elsevier Inc. All rights reserved.
Chart Dividers Used to identify each section of the medical record by subject Common categories Progress notes History and physical examination Laboratory reports Diagnostic testing Hospital reports Immunizations/Medications Correspondence What is a chart divider? What are common categories are used to divide medical records? Where are the tabs for chart dividers located? Why? Copyright 2016 by Elsevier Inc. All rights reserved.

11 Mounting Sheets and Other Supplies
Sheets of paper for mounting items smaller than 8½" × 11" First item mounted at the bottom Each succeeding item mounted above ("shingled") Other Supplies Outguides placed in the file to mark where a record has been removed Pocket or line printed on out guide to identify location of file that has been removed Sorter facilitates placing documents or files in order What are examples of items that may be mounted using mounting sheets? Why is the first item placed at the bottom of the sheet with successive items mounted above? Figure 43-2 shows a type of mounting sheet. What is an outguide? Why do some facilities fail to use outguides? When can a sorter be used for filing? An outguide is shown in Figure 43-3. Copyright 2016 by Elsevier Inc. All rights reserved.

12 Preparing a Paper-Based Medical Record for a New Patient
When a new patient comes to the office for his or her first visit, a medical record must be prepared for that patient The method used to prepare the record depends on: The format used to organize the record The filing system The type of storage equipment See Procedure 43-1: Preparing a Medical Record. Many offices keep partially prepared medical records at the front desk and add the patient’s name and labels on the day before or day of a new patient’s first appointment. Copyright 2016 by Elsevier Inc. All rights reserved.

13 Copyright 2016 by Elsevier Inc. All rights reserved.
Filing Systems Purpose of filing system is to organize records so that one individual record can be efficiently located Filing system must also allow for expansion as records are added What is the purpose of a filing system? How does a filing system allow for addition of new records? Copyright 2016 by Elsevier Inc. All rights reserved.

14 Copyright 2016 by Elsevier Inc. All rights reserved.
Alphabetic Filing Direct system because patient's name used to locate medical record Alphabetic filing uses legal names as the basis What is the basis of an alphabetic filing system? What are advantages of an alphabetic filing system for medical records? See Procedure 43-2: Filing Patient Records: Alphabetic. Copyright 2016 by Elsevier Inc. All rights reserved.

15 Alphabetic Filing (Cont.)
Each part of the name is considered an indexing unit Indexing unit is a piece of information used to identify the correct filing location In an alphabetic system, records are arranged alphabetically on the basis of the indexing unit If the patient has more than one name, the record may be cross-indexed What is an indexing unit? Why are names sometimes cross-indexed? What is alphabetical order? When arranging names or titles in alphabetical order, what words are commonly not considered? Copyright 2016 by Elsevier Inc. All rights reserved.

16 Rule 1: Individual Names
The surname (last name) is the first unit, the given name (first name) is the second unit, and the middle name or middle initial is the third unit A name with only two units is filed before a name with three units What is the order of indexing units for individual names? Which name is filed first: John R. Smith or John Smith? Why? Copyright 2016 by Elsevier Inc. All rights reserved.

17 Rule 1: Individual Names (Cont.)
A unit with only an initial is filed before a unit with a full name beginning with that initial As a general rule, nothing comes before something (i.e., no letters comes before some letters) Business names are indexed in the order of the names in the business (excluding “a,” “an,” and “the”) Which name is filed first: John R. Smith or J. Smith? Why? Why do we say, “Nothing comes before something”? What is the first indexing unit in a business name? Which business name is filed first: John Smith Company or J. Smith Company? Copyright 2016 by Elsevier Inc. All rights reserved.

18 Copyright 2016 by Elsevier Inc. All rights reserved.
Rule 2: Prefixes If the last name has a prefix, the prefix is considered part of the last name Common prefixes include Mc, Mac, Van, de, De, Des, or D’ The prefix will begin the first indexing unit Mc and Mac are usually filed in regular order, but they may all be filed as "Mc" Why do some names have prefixes? Why do name prefixes sometimes begin with upper case letters and sometimes with lower case letters? Why do some offices pull out the records with the prefixes “Mc” and “Mac” and file them all as “Mc”? Copyright 2016 by Elsevier Inc. All rights reserved.

19 Rule 3: Abbreviations and Nicknames
ARMA International (a records management organization) recommends that abbreviated names be filed as written If an abbreviation or nickname is used on the record, it is indexed as if it were the legal name Acronyms in business names are indexed as one unit What are examples of abbreviated first names? Surnames? What would be the first indexing unit if you were using the ARMA International recommendations to file the medical record of Wm. M. St. James? What would be the first indexing unit of the name Wm. M. St. James if your office files abbreviations as if they were written out? Copyright 2016 by Elsevier Inc. All rights reserved.

20 Copyright 2016 by Elsevier Inc. All rights reserved.
Rule 4: Hyphenation Hyphenated names are indexed as one unit Rule applies to first name, last name, or name of a child using both parents’ last names When do patients have hyphenated names? How are hyphenated names indexed? Copyright 2016 by Elsevier Inc. All rights reserved.

21 Rule 5: Titles and Seniority Terms
Disregard titles unless the complete name is not given or it is necessary to distinguish between two individuals with the same name Seniority terms, such as Jr., may be indexed as the last unit Numeric seniority terms are indexed in numeric order before alphabetic terms What are titles that patients sometimes use? How are titles indexed? Where would the name John Trask III be indexed in relation to John Trask Jr.? Copyright 2016 by Elsevier Inc. All rights reserved.

22 Rule 6: Names of Married Women
A married woman may take her husband’s surname, but she retains her own first and middle names Her medical record is filed under her own name What are the indexing units for the name: Mrs. Melissa S. Fiore if her husband’s name is John R. Fiore? What are the indexing units for the name: Mrs. Joanne M. Case if her husband’s name is Walter M. Ryan? Copyright 2016 by Elsevier Inc. All rights reserved.

23 Rule 6: Names of Married Women (Cont.)
There are several forms for a married woman's last name Her own first and middle names and her husband’s surname Her own first name, her maiden name, and her husband’s surname Her own first and middle names and her own surname A surname formed by hyphenating her own surname with her husband’s surname What are the options a woman has for names when she marries? Why do some couples form a new name by hyphenating the surnames of both the husband and wife? What are the options for last names for children? Copyright 2016 by Elsevier Inc. All rights reserved.

24 Rule 7: Companies and Businesses
Names of companies and businesses are indexed in the same order as written Disregard punctuation, such as commas, apostrophes, or hyphens Disregard articles, such as “a,” “an,” and “the” Index acronyms as one word What is the first indexing unit of the name of a company? How are the indexing units different in company names from patient names? What is an acronym? How is an acronym filed? Copyright 2016 by Elsevier Inc. All rights reserved.

25 Copyright 2016 by Elsevier Inc. All rights reserved.
Rule 8: Identical Names If two names are exactly the same, index them first under the name and then under the location Begin with the city as the first unit The state is the second unit The street is the third unit (list street number from lowest to highest) What is used to distinguish two identical names when filing? What are the implications for patient identification when several patients have identical names? Copyright 2016 by Elsevier Inc. All rights reserved.

26 Copyright 2016 by Elsevier Inc. All rights reserved.
Numeric Filing Indirect method of filing because number must be identified Computer record of patient names Patient ID card Easier to preserve confidentiality In large practice, easier to deal with a number of patients who have same surname by using numeric filing What is the difference between a direct filing system and an indirect filing system? Why is it easier to preserve patient confidentiality with a numeric filing system? Why is it easier to identify patients securely with a numeric filing system if several patients have identical names? See Procedure 43-3: Filing Patient Records: Numeric. Copyright 2016 by Elsevier Inc. All rights reserved.

27 Terminal Digital Filing Systems
Commonly used in large medical offices and hospitals Six-digit number with hyphens between each group of numbers What types of organizations have traditionally used the terminal digit filing system? How many digits are usually used in a terminal digit filing system, and how are they arranged? Copyright 2016 by Elsevier Inc. All rights reserved.

28 Terminal Digit Filing Systems (Cont.)
Each group of two digits is a filing unit, and final (terminal) unit is the first filing unit If the number is , first filing unit is 68, second filing unit is 25, third filing unit is 89 Nonconsecutive filing may also consist of assigning each patient a combination of both letters and numbers What does the word terminal mean? What are the indexing units of the number: ? If a filing system has a combination of letters and numbers, how are the medical records arranged? Copyright 2016 by Elsevier Inc. All rights reserved.

29 Consecutive Filing Systems
In consecutive filing systems, numbers are arranged and filed from lowest to highest In consecutive filing systems, zeroes are usually assigned or assumed as the first unit, so each number has the same number of digits Which is more suitable for the office of a single physician, a consecutive numeric filing system or a terminal digit filing system? Why? Which is more suitable for a large office or clinic, a consecutive numeric filing system or a terminal digit filing system? Why? How many digits are found in the medical record number in a consecutive filing system? Copyright 2016 by Elsevier Inc. All rights reserved.

30 Copyright 2016 by Elsevier Inc. All rights reserved.
Subject Filing Filing systems for documents may be arranged according to subjects Preprinted forms Invoices Purchase orders Service agreements Within a category, documents may be arranged alphabetically or chronologically Usually used for items necessary to manage the medical office Is subject filing used for medical records? Why or why not? When is subject filing an appropriate filing method? What type of storage is usually used for items filed by subject? Copyright 2016 by Elsevier Inc. All rights reserved.

31 Copyright 2016 by Elsevier Inc. All rights reserved.
Chronologic Filing A record using numbers or dates may be filed chronologically Appointment records Tickler file Cancelled checks When is chronological filing an appropriate filing system? Copyright 2016 by Elsevier Inc. All rights reserved.

32 Chronologic Filing (Cont.)
Tickler file is a reminder system Can be set up on computer, on a calendar, on index cards, or in a file folder Manual system uses one folder or file section for each month and one folder for each day of the month (43 folders or divisions) Tasks to be done in a certain month are filed under that month At the beginning of the month, items are assigned to a specific day of the month Entry in tickler file should contain date of action to be taken, type of action to be taken, other necessary information What is a tickler file? How many folders are required to set up a tickler file? What kind of electronic system can be used instead of a tickler file? What kinds of tasks would be organized in a tickler file? When are the items to be done on a certain day of the month assigned to the day numbered folders? When and how often should the medical assistant check the folders in a tickler file? Copyright 2016 by Elsevier Inc. All rights reserved.

33 Choosing a Filing System
Consider several factors when choosing a filing system for paper medical records Numeric records are best for maintaining privacy; more complex If several individuals will be filing paper records, a nonconsecutive system (i.e., terminal digit filing system) will make it easier Most EMRs allow a user to search both alphabetically and by a patient’s name and numerically by a patient’s medical record number. Copyright 2016 by Elsevier Inc. All rights reserved.

34 Retrieving Patient Records
Records are located using the filing guidelines of the particular office Medical records needed for patients’ appointments are usually pulled the afternoon before the scheduled appointment When are medical records usually removed from the files for patient appointments? When else may records need to be removed from the files? Copyright 2016 by Elsevier Inc. All rights reserved.

35 Retrieving Patient Records (Cont.)
Each time a record is taken from storage, an out guide is placed exactly where the record was removed A card or guide should be filled out indicating who will have the record for ease in locating it if needed What is the purpose of filling out a card each time a medical record is removed from the files? If happens if the record is given to a second individual while it is out of the files? Copyright 2016 by Elsevier Inc. All rights reserved.

36 Copyright 2016 by Elsevier Inc. All rights reserved.
Filing Records Records to be filed are usually collected in one location Before returning records to the file, the medical assistant makes sure the record is in good condition When are medical records returned to the files? Who is usually responsible for filing medical records? What is the difference between filing the medical record and filing a medical report? Copyright 2016 by Elsevier Inc. All rights reserved.

37 Copyright 2016 by Elsevier Inc. All rights reserved.
Filing Records (Cont.) Before returning records to the file, the medical assistant makes sure the record is in good condition Remove all clips, pins, or other extraneous material Repair any tears or broken punch holes Remove sticky notes and file loose papers Sorter can be used to arrange the records for efficient filing When filing, add any items in the pocket of the out guide to the record Why should the record be conditioned before returning it to storage? How does the use of a sorter facilitate filing medical records? Filing medical reports? Filing any papers? Why might medical reports be in the pocket of an out guide? Copyright 2016 by Elsevier Inc. All rights reserved.

38 Filing Reports and Correspondence
All reports, letters, and other materials that come into the office should be reviewed and initialed by the physician before filing Dictated progress notes must also be reviewed and initialed by the physician Follow-up should be completed before filing any report Why should the medical office have a system for physicians to review reports? What happens if a physician needs to respond to an abnormal laboratory report? Why do physicians review all transcribed progress notes before they are filed? See Procedure 43-4: Filing Reports. Copyright 2016 by Elsevier Inc. All rights reserved.

39 Filing Reports and Correspondence (Cont.)
Sort reports before filing File all reports in reverse chronological order (most recent on top) After placing materials in patient’s file, put the record back together if necessary Set aside items if the record is not easily located and search for records only if time permits How are medical reports sorted before being filed? Why are reports sorted with the most recent on top? Why is it sometimes necessary to take a patient’s medical record apart to file reports? Why does it save time to set aside reports for medical records not in the files instead of locating the record in the office? Copyright 2016 by Elsevier Inc. All rights reserved.

40 Measures to Ensure Accuracy or Locate Misplaced Records
Work slowly and carefully when filing records Use out guides, and always note where the record has gone Return records to storage—don’t just pass a record to someone else in the office If an office does not use out guides, what can happen? If an office uses out guides but doesn’t update the index card when records are passed from one individual to another, what can happen? Copyright 2016 by Elsevier Inc. All rights reserved.

41 Measures to Ensure Accuracy or Locate Misplaced Records (Cont.)
Encourage physicians and other personnel to return records promptly Encourage office personnel to keep records in orderly piles so that all labels are visible Always remove misfiled records from the files when you notice them and file them correctly Keep lists of “missing” records and be alert to find them in unexpected places Why do physicians often keep records for several days? What steps should a medical assistant take to locate a missing record? Copyright 2016 by Elsevier Inc. All rights reserved.

42 Electronic Medical Record
Electronic medical record has many of the same sections as the paper medical record Information is entered during or after the patient visit Paper reports, correspondence, and consent forms are scanned into the record as soon as possible What are the possible problems if documents are scanned into the electronic medical record? What do most offices do with documents such as hospital reports or test reports after they have been scanned successfully? Copyright 2016 by Elsevier Inc. All rights reserved.

43 Electronic Medical Record (Cont.)
Access to the electronic medical record, and often its sections, is password protected Access is controlled by the system administrator and should be secure Medical assistant should never allow other personnel to access information with his or her password What guidelines should the medical assistant follow when creating passwords for the EMR? What should the medical assistant do if he or she is viewing an EMR and must step away from the computer? Why? What should the medical assistant do if another staff member asks to enter one piece of data to the EMR? Copyright 2016 by Elsevier Inc. All rights reserved.

44 Storing Medical Records
Storage area for medical records should be well-lighted and climate controlled Relative humidity should be between 48% and 52% to prevent deterioration of the records Records should be protected from dust, insects, rodents, fires, and floods If a medical record storage area is damp, how can it affect the medical records that are stored there? What must medical records be protected from while in long-term storage? Copyright 2016 by Elsevier Inc. All rights reserved.

45 Storing Medical Records (Cont.)
Records should be secure when the office is closed According to OSHA, main aisles or entrances to rooms must be 5 feet wide and secondary aisles must be at least 3 feet wide How can the medical office keep medical records secure when the office is closed? Why does OSHA set minimum standards for aisles in the rooms of a workplace? Copyright 2016 by Elsevier Inc. All rights reserved.

46 Copyright 2016 by Elsevier Inc. All rights reserved.
Active Records Active records are records of patients who have been seen within the past 2-5 years Active records are usually stored in the office in the active patient filing system What is an active medical record? Where are active medical records usually stored? Why do active medical records need to be readily accessible? Copyright 2016 by Elsevier Inc. All rights reserved.

47 Copyright 2016 by Elsevier Inc. All rights reserved.
Inactive Records Inactive records are records of patients who have not been seen within the time period specified by the practice What is an inactive medical record? Do you think that patients who have not been seen within the last 3 years are likely to make appointments in the future? Why or why not? Copyright 2016 by Elsevier Inc. All rights reserved.

48 Inactive Records (Cont.)
Inactive records do not have to be immediately accessible May be stored in a storage room in the back of the office May be stored in another room in the office building (preferably not a basement) May be stored in rented storage space off site Where are inactive medical records usually stored? Are there different guidelines for storage of active and inactive records? If so, what are they? Copyright 2016 by Elsevier Inc. All rights reserved.

49 Inactive Records (Cont.)
At regular intervals inactive files are removed from the active file area A current year sticker is applied the first time the patient comes to the office in a new calendar year Inactive records are identified because they indicate the last year that the patient was seen in the office Why are inactive records removed from the active file area at regular intervals? How are inactive records identified? Copyright 2016 by Elsevier Inc. All rights reserved.

50 Copyright 2016 by Elsevier Inc. All rights reserved.
Retention of Records The length of time for which a medical record must be retained is difficult to determine Each state has a law limiting the time period for beginning a lawsuit for malpractice This is known as the statute of limitations for medical malpractice For minors, the statute of limitations should be considered to begin at the age of majority How do medical offices make decisions about how long to retain medical records? What is the statute of limitations in general? For malpractice? When does the statute of limitations begin to run? Copyright 2016 by Elsevier Inc. All rights reserved.

51 Retention of Records (Cont.)
Records of Medicare and Medicaid patients should be retained for at least 5 years after the last contact Owing to variations in the statute of limitations and state laws, physicians must retain inactive files for many years What government agencies set requirements about the length of time to retain records? Copyright 2016 by Elsevier Inc. All rights reserved.

52 Retention of Records (Cont.)
At the end of the retention period, the inactive medical record may be destroyed or put in final storage to be kept permanently If possible, a patient should have an opportunity to claim a record before it is destroyed Records that are closed (known that patient will not return) and records inactive longer than 7 years may be transferred to microfilm or microfiche In what formats may medical records be retained? Why is it recommended to allow patients to claim a record before it is destroyed? Copyright 2016 by Elsevier Inc. All rights reserved.

53 Retention of Records (Cont.)
Some other records should be retained Insurance policies and licenses should be kept indefinitely Drug Enforcement Administration (DEA) controlled substances records should be kept indefinitely All tax records should be kept for 7 years After 7 years, background records used to determine taxes can be destroyed but copies of tax forms should be kept indefinitely What other types of records should be retained for a significant time period? Why? Where would you recommend that the office store tax records, DEA records, etc.? Why? Copyright 2016 by Elsevier Inc. All rights reserved.

54 Storing Computerized Records
Electronic medical records should be backed up regularly Network storage External storage devices, such as hard drive, DVDs, or other devices Off-site backup storage is preferred in case of flood or disaster What methods can be used to back up electronic medical records? Why is it recommended to store a copy of electronic data off site? Copyright 2016 by Elsevier Inc. All rights reserved.

55 Storing Computerized Records (Cont.)
Inactive records may be removed from the main system after back-up System administrator must be sure that program updates are compatible with previously stored data Can inactive electronic records be removed from the general system? Why might this be desirable? How can updates of EMR software affect access to records that have been removed from the current database? What should be done to prevent problems? Copyright 2016 by Elsevier Inc. All rights reserved.

What is the first indexing unit in alphabetic filing?

What is the first indexing unit in alphabetic filing quizlet?

When indexing names for an alphabetic filing system are spelled out in full?

Which indexing unit is the patient's surname?