Medical Records
Medical Records
By Michelle Albino, CVT
UW Veterinary Care
Referral Coordinator, Dec 2020 - June 2022
Client Services SUpervisor, June 2022 - Present
Patient Scheduling Representative, UW Health
March 2017 - October 2020
Dermatology, Rheumatology, and Endocrinology
CVT, Northside Animal Hospital
June 2010 - March 2017
Associates of Applied Science in Veterinary Technology, MATC
Class of 2010
Why are medical records important?
The primary purpose of the medical record is to provide an accurate and comprehensive description of the patient’s medical history, treatments, and outcomes of those treatment over the entire life of the patient
A comprehensive history will prevent things like repeating laboratory testing or other unnecessary procedures, for example, giving the patient ad rug they may be allergic to
In an academic setting, patient medical records can also help with research or teaching
Medical records are a legal document government by state laws and statutes
Usually required to keep medical records for 7 yrs
What makes up a patient's medical record?
Demographics
Client information: legal name, including middle initial, address, DOB, email address, reminder preferences, alternate contacts, alternate contact phone numbers
Usually collect DOB due to pet prescriptions and risk
Patient information: Name, species, breed, DOB, sex and reproductive status, color
Signalment: a complete description of the patient including species, breed, age and date of birth, sex and reproductive status (whether the animal is neutered or intact)
History - including diet, environmental factors, like if there are other pets in the household weight, vaccination status, etc.
Examinations - normal vs. abnormal values
Treatments - examples?
Outcomes of treatments
Diagnostics - examples
Photos, video, imaging (CT, MRI, etc.)
Billing/procedures, prescriptions, estimates, etc.
@ UW MADISON VET CARE
Some medical record items are on paper, some electronic, some are stored on other media like DVD, or stored in the cloud
We try our best to have all of the info available but it is challenging
We are working toward being fully paperless in the near future
Examples of items kept on paper
Authorization forms that need a physical signature
History - patient history might be taken in an area where a computer isn’t available. Sometimes necessary to jot down notes
Sometimes the computer system you use doesn’t have the capability recording info the way you want to.
Photos provided by the client
Others?
Examples of items stores electronically
Case summaries are typed up and printed for the client They are also sent via email or faxed directly femur the HIS (hospital information system), Stringsoft
Any communication with the client is logged electronically
Laboratory results
Prescription, refills
Diagnostic imaging reports
Others? Scanned in documents, billing, other medical record reports
Advantages of electronic medical records
Only have to record historical information once
Paper records can get lost
Always legible
Access information remotely
Info can be shared by multiple parties
Web portals similar to MyChart lets the client instantly access medical records for their pet(s)
Can identify trends like following lab results over time - i.e. blood glucose levels in a diabetic patient
Physical space for storage of records not necessary
Multiple people from different areas of the hospital can be accessing the record at the same time - i.e. student can be typing a discharge reports while radiologist is entering their finding
An audit trail is maintained and you can view who did what in the EMR
Important aspects of medical records
Whether stored on paper or electronically, always make sure medical records are:
Accurate
Completed in a timely fashion - it is important to write the medical record reports either during the patient visit or shortly after the visit. This is because you can forget details of the case as time goes by.
Chronological
Paper medical records put in order by medical records staff and then filed in the physical medical record
Complete - document everything that was done, also if O declines something
If it isn’t documented it didn’t happen
Medical record standards
Although we are not governed by all of the strict laws and guidelines that exist in human medicine, we always strive to meet privacy and security standards to protect the confidentiality and integrity of the medical record as well as the privacy of our clients.
Examples of how we strive to meet the standards are:
Retain records for 20 yrs after most recent visit
Maintain patient confidentiality - we only release records to the client unless the client has given us permission to release records to another individual
Store electronic medical record data on secure servers
Formal backup plan of electronic medical record data with off-site storage
Shredding of any paper containing configuration client info eg credit card number
Encrypt data on server when necessary
System security so that only clinicians (not students) can finalize medical record reports. This is a safeguard, ensure accuracy
How does your practice strive ot meet medical record privacy and security rules/guidelines?
UWVC Client Services Department
6FTE + Michelle
Supervisor
1 FTE Chart prep for next day’s visit and add-ons/emergencies
80-121 appts per day
In FY 2021 - 29,451 visit s
In FY 2022 - 28,685
1 FTE Chart check-in and form completion
1 FTE Referral Coordinator
3 FTE Client Services Specialists
1 Student worker
Charts for patients seen at UWVC in the past 4 years are stored in client services
Charts are checked out and checked back in when they are returned (just like a library)