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View Diary: KosAbility: I was a fetal experiment (66 comments)

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  •  I'm shocked at the number of DES product names (16+ / 0-)

    Maybe gobsmacked is a better term; how can any woman know for sure?

    •  I don't know and with it being so long (11+ / 0-)

      ago that medical records may not exist (and they SHOULD exist) how will we ever know

      Bumper sticker seen on I-95; "Stop Socialism" my response: "Don't like socialism? GET OFF the Interstate highway!"

      by Clytemnestra on Sun Dec 11, 2011 at 02:31:47 PM PST

      [ Parent ]

      •  In many clinics, after 3-7 years, an 'inactive' (0+ / 0-)

        chart may have been pulled for long-term storage...often to an 'off-site' location.  Depending on medical records procedures in effect at a given time, there may or may not be some sort of brief summary left in it's place indicating where the full set went, whether additional copies were made (after photocopiers became common office equipment, and later 'scanners').  And that summary might not have been kept up to date as subsequent changes occurred.

        The handling of archived medical records can become complicated after clinic ownerships change or partnerships dissolve, or when outside records archiving services change, or when the outside services internal tracking process and index data change, and when clinics move in and out of network provider relationships--records/data held as 'common shared data/records' can end up retained only on one side of a dissolved/altered relationship.  Clinic closings can create dead ends as well if no provisions are made for archived records and whatever patient history records were kept on file at the clinic at the time.  

        And of course whenever major technology changes are brought in, which retains or links to/updates patient medical records, there is the potential of affecting the accurate conversion/update of past medical records.  It can take a many months or even a few years to get older data & paper records properly re-entered and converted into a new system if major format changes are involved (which is typical rather than the exception).  Triage decisions are made about what is essential to try to convert ASAP, what is needed for completeness, and then what might be convenient--and time for that is usually eaten up by dealing with correcting a few larger scale conversion errors which either a human processing mistake creates or automation process inadequately handles.

        History of the clinic's formularies, the set of drugs which the cliniic's practitioners routinely prescribed over time, isn't necessarily going be kept--this sort of data may only exist as 'institutional knowledge' which older staff with long experience might be able to recall.

        Even if record keeping is done to religious perfection, it's another thing for practitioners to take the proper time to utilize them. Some people I know have in common the experience of doctors moving quickly to prescribing drugs, treatments, making recommendations or responding to insurance inquiries, employer inquiries, without adequately reviewing or even a cursory review  of our several inch thick folders of paper records or their electronic medical record databases.  This can make substantiating histories of limiting or disabling conditions and eligibility for certain treatments, medical devices,  procedures, drug options, and establishing the need for a set of work accommodations a bit of a challenge.  Understanding and interpreting the history of clinical practices, old technologies, and treatments more than a couple decades back can be challenging as time goes by.  

        When life gives you wingnuts, make wingnut butter!

        by antirove on Thu Dec 15, 2011 at 08:40:52 AM PST

        [ Parent ]

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