How To Review And Summarize Medical Records In Personal Injury Cases

Medical records are a collection of documents detailing a patient’s medical history and care throughout a period. It comprises different types of notes both handwritten and electronic including test results, X-rays, medical diagnosis, discharge summaries, prescriptions, vaccination details, and reports from multiple healthcare providers. A well organized medical records not only aids patients and doctors for continued treatment, it also helps attorneys in personal injury and medical malpractice cases.

Before appearing for a trial or pre-litigation settlement process, the attorney must study and understand the complete medical record. Lack of detail or inaccuracy in the record leads to legal implications. There are even cases that have lost the trials due to medical negligence and improper maintenance of medical records. 

However, understanding the medical terms and summarizing voluminous clinical data is not a single night’s job. It’s a time-consuming process and needs complete attention. Besides, knowing how to extract accurate medical summarization is essential before getting into work.

Below are the important things an attorney should consider when dealing with medical records for a personal injury case. In most cases, attorneys usually outsource the work to medical records review professionals to save time and be efficient.

Review And Summarize Medical Records In Personal Injury Cases:

Collection Of Medical Records

The foremost is the collection of all medical records. It is imperative to collect medical records from all sources. HIPAA guidelines and other regional laws protect patient’s medical records. Therefore, to request and get access to medical records from a healthcare provider, it is required to get prior authorization from the injured plaintiff for the concern medical records. How do the medical records help in personal injury cases?

Medical Chronology

In the case of a personal injury trial, medical case chronology helps in pre-trial preparation, as it helps the attorney to claim settlement rather than going to trial

Some of the common denominators in medical case chronology include:

  • Date of injury/ hospitalization
  • Diagnosis and treatment
  • Doctor/ nurse observation
  • Impact of the injury
  • Procedures
  • Follow up medical treatment/case
  • Doctor/ nurse notes
  • Prescription
  • Alternative treatment

Medical records review provider offers complete medical information about a patient for the course of their medical care. Acquiring medical records summary from an experienced team like PreludeSys is profitable as they deliver highly accurate, reliable and legible documentation of patient records.

Medical Record Accuracy

It is crucial to organize the medical records accurately relevant to the events of an injured person.

Attorneys and paralegals do not have the innate knowledge to understand medical terminology. It is a time-intensive and complicated process to extract relevant medical data. Experts in medical records review service have the proper training and knowledge to summarize the comprehensive medical records in a legible format with complete accuracy. Medical records review services can quickly detect

  • Reptitions in physicians observation notes and
  • Uncover missing information. 

Medical Evidence

The authenticity of the medical records plays a vital role in the personal injury case. Lawyers have to ensure the complete authenticity of the medical records. A small error in medical evidence creates a loophole for the defendant’s side to pass a motion for mistrial. A lawyer can confirm the true nature of the medical record with the plaintiff’s medical practitioner. Medical evidence should be

  • Verified at the source of collection and 
  • Fact-checked. 

Security

Medical records in a personal injury case are considered highly confidential and contain sensitive data. A hacked or tampered medical record cannot be used as ‘medical evidence’ in a trial or settlement. Data leak and breach can be avoided when you outsource the service to a third-party service provider that offers data security at every level of the medical records review process. With advanced data encryption techniques, all the documents/records will be perfectly guarded.

Summary

For legal teams, reviewing medical records and understanding the nature of the case is vital to list out the strengths and weaknesses. But retrieving, securing, and organizing the data is not easy as it requires expertise. Approaching a primary medical records review provider like PreludeSys can help you extract accurate information from medical records.

With a team of professional medical experts, we ensure to provide concise and sensible versions of custom-made summaries. Our advanced data encryption and hyper-linking navigation techniques help you preserve confidentiality and extract the needed information effortlessly.

To learn and explore more about our medical records review and analysis services, give us a call today.

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