Authors (including presenting author) :
Tse TY(1), Tung MK (1), Kan WY(1), Chen ZK(1), Lam KY(1)
Affiliation :
(1) Administrative Services Division, Kwong Wah Hospital
Introduction :
The capacity for both Central Medical Record Store (CMRS) & Out-patient Medical Record Store of the Kwong Wah Hospital (KWH) are almost reached to their maximum (~98% for both stores). Excepting increase in services & numbers of patient activities after the commissioning of new KWH & amendment of scope of services, more spaces shall be reserved to cater the needs. Before the commissioning of new, integrated medical record stores in Phase II redevelopment & full implementation of paperless medical records initiative. Interim, time-buying measurements shall be taken in meeting the growth of service. Effective management in existing medical records would be the upmost concern. Outsourcing record keeping facilitates & handling services would be an option in achieving the purpose.
Considering outsourcing record services are prone to risk of beach of data security as regulated by Personal Data (Privacy) Ordinance (PDPO). Thus, needs of vacating spaces & data protection shall be cautiously balanced.
To prevent disruption to services to patients, active medical records for living individuals would than bounded within hospital storages. The deceased patients, who are not under the protection of PDPO, their medical records thus become the first option for relocation. The deceased medical record not only cater the concerns over PDPO, but also available to be relocated as a result of inactiveness in nature. The relocation of deceased medical records will make rooms for actives medical records for the living patients.
Given the existing Medical Record Tracking System (MRTS) is a close system for protection of patients’ personal data. The MRTS have not intentionally designed for relocation to outsourcing storages. At the same time, logistic system provided by the supplier is an external, open system, with potential risk to the personal data.
Despite PDPO no longer effective to deceased patients, the KWH still take cautious approach in protection of their data. The KWH therefore introduced a programme and database in bridging up gaps between MRTS & external system while making balance between protection to the deceased personal data & needs of services.
Objectives :
Release storage spaces, by relocating inactive, deceased records to outsourced storage for future service need, while avoid violation to PDPO;
Introduce bridging-up database in tracking of records in outsourced stores. The database can easily track & locate the outsourced records down to volume level, satisfying demand on retrieval for research, legal or other business related purposes.
Methodology :
1) Identify compliance to PDPO; 2) Set up assessment criteria for records to be relocated (i.e. records for deceased more than 1 year but less than 6 years; fully completed medical records with no further assembling, legal cases or enquiries expected; less retrieval demand is expected); 3)Identify constraints and gaps between MRTS & outsourcing system and establish data control to outsourcing system; 4) Develop database linking MRTS & outsourced system, with consideration in data input methods; record identification, crosschecking algorithm & data protection; 5) Prepare workflow, procedures for pilot run; 6) Pilot run; 7) Evaluate & improve workflow; 8) Phase I – relocate deceased records for IP & OP departments; 9) Phase II - reaching final goal of paperless records; 10)Final review
Result & Outcome :
Around 98,000 volumes of IP & 280,000 volumes of OP records of deceased will be relocated to outsourcing stores by end of the project. All relocated records can be easily traced & retrieved upon users’ request, with minimizing the risk of leaking personal data of deceased.
The spaces vacated, can cater the increase in services need & make time for full implementation of paperless medical record initiative & relocation of medical records stores;
The experience gained can make reference for further review & development of record management procedures for inactive records and to archive records with permanent values.
