Monthly Archives: July 2012

Offshore Record Reviews

Is offshore outsourcing the future of medical records services? I do not think so; the purpose of a medical chronology is to isolate critical data for the attorney and his experts.
Every attorney wants a focused chronology that isolates relevant facts with an explanation of why that fact is important. This allows them to formulate questionnaires and affidavits and prepare for depositions. They do not want hundreds of hours of billing.
The reason there are thousands of pages is because facilities, hospitals and providers are asked to produce each and every document in their possession. An all-inclusive compilation of thousands of pages contains lengthy and irrelevant information, making it difficult for an attorney to find what s/he is looking for. This type of chronology requires only literacy, not discrimination on the part of the reviewer.
By contrast, nurses know hospital and office records, abbreviations and handwritten documentation, and we can weigh care delivered against known standards and guidelines. We are selective in the data extracted, and concentrate on the seminal event while noting pre-existing conditions and discrepancies in care. We do not skip pages that are difficult to decipher and we scan, choose and discard data rapidly. The merits or defense of a case take shape during this review, and those findings are shared immediately, as well as requests for missing documentation.
Without this informed review of records, the attorney is left with hundreds of pages of data that is a timeline, not a focused evaluation. Unless we go to a PCS-based compensation system for medical malpractice, I do not see offshore outsourcing replacing legal nurse reviews.



I am blessed, and if you are reading this now, you are also blessed. We both have electricity, internet access, computers, an education, and by default, the ability, or at least the opportunity, to “make something of ourselves”.

I forget about that sometimes, but all it takes is a little change to remind me. The electricity just returned after being off for four hours. Four hours, not four days. Suddenly I was excommunicated (the Catholic in me) from hundreds of people I may never meet, but are my friends by every definition of the word.

Gone was the air-conditioned comfort, reading lights, Netflix and worst of all, Dogs of War or whatever that Xbox game is that makes my teenage son scream like a little girl with his online gaming friends.

Might as well go to bed, which I did, but I have never noticed how quiet the house is without the sound of the air conditioner, fan, or my woosher (the civilized world calls it a sound machine, but it will always be my woosher, tuned to the ocean setting that reminds me of Sanibel).  What was left? The persistent sounds my dog makes in his undisturbed sleep – little snores, dry swallows, and an assortment of unidentified noises that jolt me into awareness at the precise moment I am falling asleep.

“Count your blessings”, “things could be worse”, “be glad you are not that one”, “at least you have your health”…things people say to comfort each other. In times of disaster, people must reach very deeply to find their gratitude but most will succeed. “At least we have each other”, as they mourn the loss of their home. These expressions are not platitudes; they are truths that guide our lives.

I know that I am spoiled when my biggest complaint is bemoaning the passage of time and youth, and I will spend more time being grateful, I promise. Although…I can still hear my dog swallowing above the sound of the woosher. I should wake him up and remind him that he too is blessed to have electricity, and that porcelain thing he is so fond of using as a water bowl.