The Moor Otters Trail
June 27, 2017
Costs Advantage in using a Medical Records Collation and Analysis Service
July 17, 2017

Several services can be available from a medical records collation and analysis agency. These services are usually available for both Claimant and Defendant personal injury and clinical negligence practitioners. The services may also be used by social services and the police. Essentially anyone who requires a set of medical records to be clearly organised, indexed with missing records identified and/or a full chronology of the records produced can use the service.


The normal services offered by these agencies are:


1) Collation, indexing, scanning & page referencing of medical records; and

2) Chronology/analysis of the medical records.


In addition to working with medical records, agencies also usually extend this service to the collation and analysis of other records such as occupational health, personnel, case management, DSS, council, military and other similar records.


Agencies, such as DMR Collation, also offer a trial bundle preparation service.


The collation, organisation, indexing, scanning and page referencing of medical records will involve the practitioner considering all the sets of medical records sent and organising them chronologically (in date order) in a lever arch and indexed file.


GP records will normally be divided into sections of:


  1. Hand-written Lloyd George clinical notes;
  2. Computerised records print out;
  3. Results & Investigations; and
  4. Correspondence


Hospital records tend to have additional sections which are normally arranged as:


  1. Clinical notes (Inpatient and Outpatient Notes);
  2. Operation notes;
  3. Investigations & results;
  4. Correspondence
  5. Nursing records and charts;
  6. Medication administration records.


The above sections would also be sub-divided into specific dates and hospital admissions.


If the records are extensive the clinical notes, laboratory reports and nursing charts will normally be expanded into more specific sections to make records easy to transverse.


Each medical record is separately reviewed to ensure that it is placed in the correct section and in the correct chronological order. It is through this process, in conjunction with a detailed index preparation, that any missing medical records can be identified.


Many agencies, such as DMR Collation, produce an electronic version of the medical records as part of their collation service which can have links inserted with bookmarks to make the document easily navigational. These electronic versions are often preferred by medical experts. They also eliminate the photocopying, admin and postage costs associated in providing paper copy medical records.


The medical records are paginated (paged referenced) to ensure each page can be easily identified. Some company use hand pagination to apply page numbering but others, such as DMR Collation Ltd, use an electronic page referencing system which ensures that all page references are presented neatly with no missed pages and the page referencing does not obscure any document data. DMR Collation Ltd, in particular, use a unique page referencing system which ensures that page numbers are not repeated and updating medical records can easily be added at a later date, without the need for extra sections.


Preparing a Chronology involves the analysis of the collated medical records and documenting details of any relevant records within the Chronology. The Chronology will usually be in the format of a table with 3 columns. The first containing the date and time of the medical record entry, the second containing the description of the record to include the comments the record makes and the third referencing the document page number so it can be easily found by the solicitor/expert in due course.


DMR Collation can also, on request, produce an indexed and bookmarked pdf version of the full medical records, which also contains the chronology. This has links direct from the chronology to the referenced medical record page, which enable you to more easily navigate the electronic set of medical records.


Medical record chronologies are a useful aid to both fee earners and medical experts when embarking on litigation.


The preparation of a medical record chronology can provide a useful timeline of events which assists in preparing the necessary pleadings.


A chronology can help the fee earner when assessing the merits of a claim. It will allow a fee earner to determine whether the Claimant’s statement of events is supported by the documented medical evidence.


Having a clear and concise chronology means fee earners focus on the key issues in the claim and can ensure that vital medical notes are not overlooked. It will also help in drafting accurate and detailed instructions to your medical expert.


At DMR Collation, chronologies are prepared by experienced and qualified nurse analysts who know exactly what to look for, depending on the case circumstances. A chronology checklist is used when preparing chronologies to ensure that nothing is missed and all issues relating to limitation, liability, contributory negligence, claimant credibility, causation and quantum are identified and documented.


In personal injury and clinical negligence claims various key issues will need to be identified from the medical records which include:


  1. The issue of Limitation. As you will be aware, claimants only have 3 years from the date of their injury or the date they knew or ought to have known their injury was caused by the Defendant’s negligence to issue court proceedings. These dates will need to be checked against the Claimant’s medical records to ensure court proceedings are brought in time.


  1. The description of the injury as recorded in the medical records. A crucial piece of evidence in litigation claims can be how the mechanism of the injury is described in the medical records. The court gives a lot of weight to the description recorded in the medical records as it considers this to be a piece of evidence made without the contemplation of litigation. If this differs to the Claimant’s version of events this would be highlighted in the chronology.


  1. The nature and extent of the Claimant’s injury. The medical records will need to be reviewed to identify any relevant pre-existing or post-existing injuries, in addition to the specific injuries sustained by the Claimant in the index incident, details of treatment received and planned, and the Claimant’s current condition and prognosis.


  1. Whether any medical records are missing. Only by reviewing the medical records fully can it be identified whether any relevant medical records are missing. When an analysis service is not used it is common for missing records to be overlooked resulting in the need for experts to issue costly supplementary reports and the medical evidence taking longer than expected to be obtained. If missing records are identified at the start of the claim these can be obtained and incorporated into the medical records bundle before the instruction of the medical expert.


The fees of an analysis service are recoverable on an agency basis. This allows law firms to bill profit costs for the work completed by the analysis service. This means that not only are records reviewed by qualified nurses, but that the instructing law firm can recover profit costs on the work completed by that agency.

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