There is a lot of reasons why the medical records are so important. Fist of them is that the properly saved Medical record can help us in case of lawsuit. Second reason - documentation of the history of examination, diagnosis and treatment of the patient can help with future diagnoses for serious illnesses – these information’s are also vital for all other providers involved in a patient’s care and for any following new provider who accepts responsibility for the patient. Last, same important reason for keeping Medical Record is to protect patient’s confidentiality. In my essay below I would like to present example and little explanations why those three reasons, require to keep accurate, updated, clear, save and stored correctly.
Fist I would like to talk about importance of medical record in case of law suit. The legal system trusts mainly on documentary which are sign. In a charge of negligence, very often the most important are the record which can proof the action doctor took. With the increasing use of medical insurance for usage, the insurance companies also need proper record keeping, to prove the patient 's request for medical expenses. Improper record keeping can result in decreasing medical cl...
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...nd records by third parties is legally limited. At the same time, clinicians have a duty to protect identifiable individuals from any serious, credible threat of harm if they have information that could prevent the harm. The determining factor is whether there is good reason to believe specific individuals (or groups) are placed in serious danger depending on the medical information at hand. An example is homicidal ideation, when the patient shares a specific plan with a physician or psychotherapist to harm a particular individual. in many states adolescents may seek treatment without the permission of their parents for certain conditions, such as treatment for pregnancy, sexually transmitted infections, mental health concerns, and substance abuse. Familiarize yourself with state and local laws, as well as institutional policies, regarding adolescents and healthcare.
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