When faced with a case that has voluminous medical records and/or multiple concerns or claims, creation of a medical chronology is often the place to start. Since 1993, MRN has specialized in reviewing and summarizing medical records, and we have experience working on extremely large cases, across many types of insurance and litigation spectrums.
Medical Chronologies That Give A Clear Picture Of Events
We strive to ensure that our medical chronologies provide a total picture of the individual and a clear outline of events. After reading the medical chronology, you should have a clear story of the events. If needed, we’ll supplement with information from the medical records and add details until the picture is clear.
Information Needed To Start A Medical Chronology
Before we can start a medical chronology, we’ll need the information listed below.
Format Of Electronic Medical Records
What format are the electronic medical records (EMR) in – wrapped or unwrapped? Wrapped EMR means the records continually flow from page to page. Do you anticipate needing another set of records? Knowledge of the EMR format can save valuable time.
Claims Or Issues Currently Identified
What are the claims or issues that are currently identified? Were any dates of service identified, what or who initiated this concern, and when was the concern recognized? At times, we’ve received and reviewed medical records that reflected an individual’s entire life. It’s essential to know if review of the entire medical record set is warranted, or if a limited review would suffice.
How Will The Medical Chronology Be Used
How will the medical chronology be utilized? If it’ll be given to expert reviewers, claims adjusters, and attorneys, the medical chronology can be a very different document than if it’ll be utilized for litigation alone. Expert physician reviewers often comment that medical chronologies are extremely helpful in review of large record sets. This doesn’t mean that these chronologies include every piece of information that each specialty expert will need, but the chronology can provide a road map of the case specifics that will help the expert reviewer find pertinent pieces of information in the medical records.
Custom Medical Chronologies
What are your personal preferences for a medical chronology? In our experience, we’ve found that this can be case specific, as well as client specific. Some clients want no repetition of certain pieces of information, while other clients request that every mention be documented. Some clients want a clear picture of the individual or a preexisting condition, so they request entries that review preexisting conditions, ongoing social history, and comments made by the individual. Abbreviated medical chronologies or chronologies that focus on one issue can be provided and occur often in specific types of litigation.
“Fish Tales” In Medical Chronologies
When looking at the history of a specific injury or incident that’s occurred in the past, it’s often the case that the injury or incident is reported as being much worse than the original incident. Providers often accept the individual’s description and record the incident/injury as the currently reported medical condition. For example, an emergency department visit for chest pain that ruled out a myocardial infarction may “become” a myocardial infarction in the medical records over time. Or a fall without a loss of consciousness is later identified as a fall with loss of consciousness. In some cases, it’s very important to review the long-term medical history and determine the actual “size of the fish”.
Patterns Of Litigation
Patterns of litigation are important to note and can often be seen in the medical records. Does this individual have a history of treatment for multiple injuries to the same body part, multiple motor vehicle accidents, or multiple on the job injuries?
When To Ask For An Analysis Or Summary Of Medical Records
Typically, the purpose of a medical records analysis is to describe an individual’s short story and identify issues in the medical records that could impact the claim or be raised at a later date after the opposing side’s experts have had a chance to review the claim. Additional thoughts regarding possible facility or provider concerns can be identified, as well as recommendations for expert reviewers. Hospital or system-wide problems can be identified, as well as missing sections of the electronic medical records.
We Can Tailor Our Medical Records Review Services To Your Exact Needs
At MRN, we can create different formats for analyzing medical records. If you have a specific request for an analysis format that fits into how you evaluate claims, we’d be happy to accommodate that.