Medical record numbering and filing is the most important tasks in the management of medical information in health care institutions. Well kept and filed medical records enhance effective and efficient collecting, recording and retrieval of patient health information whenever required. The patient record care system adopted influence the ease of maintenance and retrieval of medical records.
According to the Remote Health Branch of United States, health care institutions ought to adopt a standardized medical record numbering and filing systems during storage of valuable medical records.Notably, most health care institutions across the world file and number the medical records numerically basing on the patient’s medical record number. In the recent past, hospitals have numbered and filed patient’s records basing on their names, discharge numbers, or diagnostic code numbers. Some of the commonly used medical records numbering and filing systems include Straight System, Terminal Digit System and Middle Digit System (Terese, 2006).
Middle Digit Numbering and Filing System Terminal Digit Numbering and Filling System Under this system, numbers are grouped into units containing two digits each.The medical staff used use a six-digit number which they divide it with a hyphen into three parts. The six-digit numbers are often read from right to left. Notably, the last two digits of a number are referred to as primary digits and comprise of first indexing unit.
The middle two digits which represent second indexing unit are referred to as secondary digits. The first two digits represent the third indexing units are referred to as third indexing unit. This is illustrated below.Medical Records Numbering and Filing System: Terminal Digit System.
Number. Tertiary Digits Secondary Digits Primary Digits 12-32-44 13 32 44 13-33-45 13 33 45 13-43-45 13 43 45 The terminal Digit System requires that patient record is first taken to the primary section that correspond to its terminal digits to enable the practitioners match group of medical records according to the secondary units. After locating the suitable secondary digits that correspond to the primary section, the health practitioner files a medical record in numeric order that correspond to the tertiary digits. In the file created, the corresponding tertiary digits are modified to fit patient medical record (Terese, 2006).
The terminal digit file created has 100 primary sections that range from 00 to 99. Medical staffs are required to consider the primary section present in each primary section and ought to match medical group records as per secondary digit section. After they locate the appropriate secondary digit section, the medical staff should files the medical records in numerical order following the tertiary digits (Rajakumar, 2009). Terminal digit numbering and filing system usually involves six digits but health care practitioners are at discretion to adopt any number of digits.
Advantages of the System Terminal Digit System has been extensively used because of its numerous advantages. As new records are added to created terminal digit file, the terminal digit numbers distribute uniformly all through the 100 primary sections of the file. Importantly, new patient record file can be easily filed in the same primary section of the created terminal digit file. Uniform distributions of the terminal digit numbers have extensive positive implications.
It eliminates congestion that often occurs when large number of staff files active patient records in the same area.The presence of 100 primary sections allows staff to be assigned specific responsibility in a particular section of the file with minimal interferences of the vital medical information. The system also allows the medical staff to presort the medical records basing on the primary numbers hence several medical staff may undertake the filing process without overcrowding the file area. Under this system, medical staff numbering and filing the medical records are not required to recall numerous digit numbers at a time.
This is important because it reduces the probability of transposing numbers hence reducing misfiles as evident other system. Additionally, terminal digit system eradicates the need for the medical staff to back shift medical records (Rajakumar, 2009). Despite the numerous advantages, there are few limitations of terminal digit method. The biggest disadvantage is that filing room staff may fear learning the system as most consider it sophisticated to learn and use.
Terminal digit is a modern way of looking at numbers and can be confusing to many. The system calls for extensive training than other methods.This is a costly process to the health organizations. The system cannot be effective and efficient for file room that carries a small number of assigned numbers together with sub-folders as evident in large individual files (Terese, 2006).
How to Overcome Disadvantages of Terminal Digit System The fear that file room personals have can be eliminated by constantly encouraging them to develop positive attitude and perception toward the systems. This requires an elaborate and proactive change management system that would help to demystify the myths and fears associated with the realized resistance.The top management has the responsibility of motivating the file room personals to face the challenge. In other instances, employees can be encouraged to learn and develop skills applicable to the system by promising them rewards.
In order to cut costs and time of training, there is need to seek for experienced or fast learners (Rajakumar, 2009). Conclusion Basing on the advantages and disadvantages of the available medical numbering and filing systems, terminal digit system is the most appropriate hence should be extensively used in health care institutions. The adoption of patient care record system should be based on the pros and cons.
