Health Information Technologies & Processes

Deleted Documents

  • 1.  Deleted Documents

    Posted 7 days ago
    What is your policy when a physician creates duplicate documents (for example a procedure or progress note)? They put all of the same information in it and then come to you because they realize they have created and signed the same procedure twice, the only difference is the time they drafted and signed it?

    Any Meditech users out there? Curious due to some of the limitations this EMR has compared to others.

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    Deanna Heinrich
    Director of HIM/Privacy Officer
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  • 2.  RE: Deleted Documents

    Posted 7 days ago
    I always make the physician review both copies and tell me which one they are keeping. Once the do that, I get rid of the copy they didn't want.

    Victoria Maans, RHIT





  • 3.  RE: Deleted Documents

    Posted 7 days ago

    This does happen, albeit infrequently, but our policy is the physician must contact me directly (HIM Director) and tell me which note to "cancel" and "delete".

    Donna

     






  • 4.  RE: Deleted Documents

    Posted 3 days ago
    Given the size of our organization we have a Chart Corrections team who process requests for deleting documentation. ​We have EPIC which functions much differently than Meditech, but our providers and end-users have the ability to send us a chart correction request. We require them to be as specific as possible when referencing what document needs deletion, especially if the document is a duplicate. Then the chart correction associate validates the information provided and takes whatever action is needed.

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    Kenneth Starkey
    Supervisor, Document Management
    UMass Memorial Healthcare
    Kenneth.Starkey1@umassmemorial.org
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  • 5.  RE: Deleted Documents

    Posted 2 days ago
    As others have stated we require the original provider who made the discussion contact our transcription team to determine which should be cancelled.  We have Meditech and we would just cancel the note.

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    Deloris Farthing
    Director, Health Information Management
    Hays Medical Center
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