Medical Records Department - Organization example



1. The DIJON Regional Hospital center:


Although Dijon's international reputation is based primarily on its cuisine, the prestige of its hospital establishment is also undeniable.


It overlooks the center of an urban agglomeration of 250,000 inhabitants. It has 1,300 beds (long stays not included) in 40 medical departments and an average of 47,000 hospitalizations and 150,000 consultations per year.


This hospital is a federation of several establishments scattered around the urban center. Each establishment has its own independent history. A major effort to build a central building took place during 1993-1994. Before this project began, each department (regardless of its distance from the central building) managed its own medical records with its own secretariat.


This federation project (started in 1995) had the following goals:

     Creation and organization of a Centralized Medical Records Department (CMRD).

     Consolidation of all close and distant department files.

     Consolidation of all files for a single patient, regardless of the Medical Department which provided treatment.

     Implementation of software to ensure folder confidentiality, and the concept of folder ownership relative to medical departments as well as independence from hospital organizational changes.

     Computerization of the entire chain of requests, re-integration, reminders and the management of medical folders and storage spaces.



2.   Project history:


The AMIG company was chosen to implement this project, which took about 9 months. The different phases were the following:


     Implementation of Ariane software.

     Personnel training.

     Retrieval and data entry of folders from departments, at a rate of one department per week, i.e., an average of 2,500 folders per week.

     Start-up of this new organization.



3. Ariane software:


Ariane software is installed on a Windows NT Server, connected to (approximately one hundred) workstations running under Windows 3.11 via a TCP/IP network.

The Ariane software package allowed application of the following procedures:

     Each medical department with folders in the CMRD requests folders for hospitalizations and scheduled consultations directly on the computer. The user simply selects the name of the requesting doctor, the date when the folder must be in his department and the patient's name.

     All incoming requests to the CMRD are processed automatically. There is a reject rate of approximately 6%, for several possible reasons:

     The patient does not exist (this means you must check the correct spelling).

     Several responses existed for a single patient and manual processing was required to check this duplicate.

     The requesting doctor does not own the requested folder, making manual processing necessary.

     A pick list of folders is printed twice per day and the folders are conveyed to requesting parties by CMRD personnel, who also carry the folders to be reintegrated.

     Reintegration is performed on-screen via a very fast procedure and folders are replaced on the shelves.

     A reminder procedure for non-reintegrated folders is also applied.

     For each verification, the user can display a list of folder movements over the past 5 years. Do not forget that archiving periods are greater than 70 years in the majority of cases and that we manage approximately 50 000 cubic feet of medical records.

     Very extensive reporting is printed monthly for the hospital's general management.


A brief representation of the software is provided in the appendix.



4.   Conclusions:


With a team of 8 persons, the CMRD operates to the doctors' great satisfaction.

Initial reservations, caused by the fact that we were removing folders from medical departments were forgotten and the record manager's function was validated.


Thanks to IT, we succeeded in rapidly consolidating all of a single patient's folders into one file while maintaining the concept of folder ownership for each health care department.


Automated requests and software processing have economized on personnel and provided greater freedom of action for health care personnel.




Medical record data entry is performed very quickly with list boxes and shortcut keys.

The access number is automatically assigned by Ariane but Ariane can also integrate other HIS identification numbers.

A medical record can be composed of one or more sub-records.


Click the search button to retrieve a single medical record to display or update patient data.



Based on simple criteria, Ariane lets you locate a medical record and then display it.






Search results are displayed on the following screen.

Just click to see all of a patient's medical record data.