Medical records don’t always tell the full story of a claimant’s care, and a thorough medical record analysis can surface the gaps, inconsistencies, and unsupported conclusions that make a difference in a claim. As nurses with extensive clinical experience and strong critical thinking skills, Medical Resource Network (MRN) is able to perform a nuanced review of medical records in a cost-effective and timely manner. We provide an objective, unbiased analysis, identifying the circumstances surrounding the event or events that are the basis of the claim.
What a Thorough Medical Record Analysis Can Reveal
Our analysis identifies when assumptions have been made by care providers that are later treated as factual. An example would be when an individual initially reports a ground-level fall that they later report as a fall from the top of a 10-foot ladder, and providers begin to treat that individual based on inaccurate information. We identify relevant facts that were previously not noted. We also identify conclusions that are not supported by the medical records.
In combination with our extensive experience, we utilize evidence-based resources to support our analysis. Medical Resource Network provides these services in multiple types of circumstances and claims, including casualty and workers compensation claims, medical malpractice, personal injury, public entities, federal government, and class action lawsuits, including environmental, product liability, and pharmaceutical.
Confirming the Right Records Are on the Table
The first step in medical record reviews is to determine if the provided medical records contain enough information to address the claims and answer client questions. We confirm that the medical records provided are the records for the individual who has filed the claim and that they include the dates in question. Clarifying these issues up front allows our clients to obtain the needed information to address their concerns within their desired time frame.
If the medical records include records that are outside the dates in question, these medical records are briefly reviewed to determine if any portion of the records is pertinent to the claim. If there are records that are not pertinent to the claim, this information is communicated to the client. If the client wishes those additional records to be reviewed, then the additional records are included in the formal review process. If the client does not wish the additional records to be reviewed, then these records are set aside. This provides the client with a cost-effective medical records review process. If the client later requests that the additional records be reviewed, this request can be accommodated.
Building a Chronology to Identify Gaps
If the medical records are within the dates in question, the next step is to make sure that those hospitalizations and clinic visits are complete. This step includes putting information into a chronology format, which makes gaps in medical records easily identifiable. We communicate with our client on an ongoing basis as missing records become apparent; for example, hospitalization records that do not include any of the nursing flowsheets. Other examples of this type of missing records include documentation from departments outside of the main electronic medical records system, such as radiology, cardiac catheterization lab, transport, and lab work sent to outside facilities for testing. This provides early identification of missing records and allows the client to retrieve the records in a timely fashion and minimize delay in the workup of the claim.
Flagging Risk Issues Beyond the Original Claim
Another benefit of reviewing the medical records is the identification of potential risk issues that are not a part of the claim, but need to be pointed out to the client. This allows the client to determine if those issues need to be addressed as well within their healthcare system or within the claim itself.
Getting Value from an Initial Review, Even with Incomplete Records
Depending on the status of the claim, many of the desired medical records may not be accessible at the time of the initial review. An initial review is still helpful because it will identify missing medical records within the client’s healthcare system that should have been included. It also provides a list of missing medical records from identified outside providers and outside healthcare systems. We identify which of those records may be crucial to the case. This supports cost containment because the client does not request records they do not need. Obtaining up-to-date records addresses the claimant’s outcome and can clarify the validity of the claimed injuries.
Matching Cases with the Right Experts
When a client wants expert reviews, the medical records review helps us to identify the appropriate expert specialty and ensures that the experts have the appropriate information to complete their reviews in a cost-effective and timely manner.
Partner with Medical Resource Network for Medical Record Analysis
Since 1993, Medical Resource Network’s in-house Registered Nurses have delivered the medical facts on which our clients’ decisions depend. Every review is performed by one of our staff nurses, many of whom have spent time working in-house at defense law firms. We customize the format and content of our work product to meet each client’s needs, serving attorneys, healthcare systems, insurance companies, government entities, and pharmaceutical and medical device companies nationwide.
Schedule a free consultation to discuss how our medical record analysis services can support your next case.
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