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Dissecting and Streamlining the Medical Record Acquisition Process inDeath Investigation Systems

机译:剖析和简化医疗记录获取流程死亡调查系统

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摘要

Though medicolegal death investigation (MDI) systems are generally associated with criminal justice, they serve an integral role in the realm of public health and safety. Medicolegal death investigation offices collect information, including medical records, from a variety of outside sources. For data to travel efficiently, transmission should be fully integrated between the MDI office and external organizations. This is often not the case. Delays in the transmission of medical records in particular lead to subsequent delays in autopsy report completion and death certification or to resource waste in cases where a timely record would have let the pathologist know an autopsy was not required. Almost no peer-reviewed literature currently exists regarding the problem of record acquisition by MDI systems. To develop a better understanding of how electronic medical records have impacted MDI systems, we conducted a mixed methods survey through the National Association of Medical Examiners (NAME) e-mail listserv. We inquired about the medical records acquisition processes at MDI systems around the nation to gauge opinions about the use of electronic health data and the integration of MDI data in public health. Concurrently, we piloted a quality improvement project at the Alameda County Sheriff-Coroner's Office (ACSCO) inOakland, California, in which we worked with various hospitals to get ACSCOemployees direct access to decedents' electronic health records. With data fromthe survey and pilot project, we were able to document the barriers encounteredwhen attempting to reform medical record acquisition and to suggest systemicchanges to reduce delays and wasted resources.
机译:尽管通常将法医死亡调查(MDI)系统与刑事司法相关联,但它们在公共健康与安全领域中起着不可或缺的作用。法医死亡调查办公室从各种外部来源收集信息,包括医疗记录。为了使数据有效传输,应该在MDI办公室和外部组织之间完全集成传输。通常情况并非如此。病历传输的延迟尤其会导致随后的尸体解剖报告完成和死亡证明的延迟,或者在及时记录会使病理学家知道不需要进行尸体解剖的情况下导致资源浪费。当前,关于MDI系统获取记录的问题,几乎没有同行评审的文献。为了更好地了解电子病历如何影响MDI系统,我们通过国家医学检验师协会(NAME)电子邮件列表服务进行了混合方法调查。我们询问了全国MDI系统的病历获取流程,以评估有关电子健康数据的使用以及MDI数据在公共卫生中的集成的意见。同时,我们在阿拉米达县治安官办公室(ACSCO)进行了质量改进项目的试点我们与多家医院合作,在加利福尼亚州奥克兰市获得ACSCO员工可以直接访问死者的电子健康记录。来自的数据在调查和试点项目中,我们能够记录遇到的障碍在尝试改革病历获取并建议系统性时进行更改以减少延迟和资源浪费。

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