- Law

Challenges in Medical Record Review for Attorneys

Attorneys are the ones whom the people believe to succeed in their legal fights. They are the personalities who are carrying the law at their back.

Even though they are well-versed in the law, they also need specific evidence to succeed in their lawsuits.

The plaintiff’s medical record is one of the crucial pieces of evidence that attorneys require in nearly all types of lawsuits, such as personal injury, worker’s compensation, wrongful death, mass tort, product liability, and so on.

However, attorneys face several challenges before utilizing medical records as solid evidence in any lawsuit.

Yeah… The main thing they need to do with the plaintiff’s medical record is medical record review.

Through this blog, let me explain to you what are the challenges that attorneys face while reviewing their plaintiff’s medical records.

Before that, let me explain to you about what is a medical record, how it acts as evidence in lawsuits, how medical record review helps attorneys, and so on.

Kindly go through the entire blog because only at the end of the blog you will come to know how to overcome the challenges in a medical record review.

What is a medical record?

A medical record is any information regarding a patient’s health condition and treatment that has been documented by medical professionals or doctors in written or electronic format. It also includes information on the person’s

  • Medical history, including past and present illnesses
  • Radiology reports
  • Lab results
  • Treatments taken
  • Discharge summaries
  • Prescribed medications, etc.

Medical records are also called medical charts, medical documentation, and health records.

How do medical records act as evidence in lawsuits?

As medical record carries the complete form of the patient’s medical history, it serves as the best evidence for the attorneys to prove their lawsuit.

For instance, in a personal injury lawsuit, if a car hits the plaintiff, the attorney of the plaintiff needs to prove that the injuries of the plaintiff were only caused by the accident made by the defendant.

In that case, medical records play their role by showing that there were no such injuries sustained by the plaintiff before the subject accident. Therefore, depending upon the injuries and sufferings jury reward compensation for the plaintiff.

The one thing that attorneys need to do before utilizing medical records as evidence of their lawsuits is a medical record review.

What is a medical record review?

A medical record review is going through the patients’ complete medical records and highlighting or summarizing the crucial points for quick understanding.

There are specific processes in medical record review, which are as follows:

Sorting, interpreting, and organizing medical records 

Even complicated medical records from various medical professions may be sorted to organize records, and physician notes or claimant interviews to be interpreted.

Creating an accurate medical chronology/timeline

The chronology of medical activities will be clearly visible, with an accurate timeline of medical encounters from the time of the injury to the time of discharge.

Creating medical case summaries

Medical case summaries will include a detailed account of the nature of the illness or injury, ER services, data of the hospital stay, diagnosis, tests, and therapies, among other crucial elements.

Identifying missing records and categorizing medical records

It is necessary to identify any missing data or documents, which may be divided into categories such as doctor progress notes, surgical records, etc.

How medical record review helps attorneys for their lawsuits?

Avoid going through a lot of paperwork

When preparing for personal injury cases and workers’ compensation claims, lawyers frequently get stacks of medical records.

They do not need to review complete medical records when they have a medical record review summary since it gives them an overview of the case and highlights the essential details.

This enables lawyers to focus on developing their cases by assisting them in finding the facts they require promptly.

Greater comprehension of the information in medical records

Medical record reviews are helpful, particularly for legal experts without experience in medical terms, conditions, or consequences.

This is why they also commonly provide explanations of the abbreviations and medical terminology found in the medical records, as well as a summary of the decoded handwriting of the medical staff and notes.

More accuracy in case evaluation

When attorneys go through medical documents, they might need help comprehending the damage and how it relates to the occurrence of the issue since they often have limited knowledge of medical terminology.

Additionally, they could miss information like pre-existing diseases and treatment gaps that could be crucial to the case.

Healthcare experts can more accurately analyze the medical concerns involved in the case as they are the ones who produce medical record review summaries.

They take into account facts from the patient’s whole medical history, including any previous treatments, in addition to the events that led up to the accident because they might have an impact on the patient’s present health.

Additionally, they give evidence about the injury’s symptoms, causes, and treatments, including medical procedures.

Furthermore, they could also offer analysis of medical research as well as other data from journals and other sources that might be relevant to the case.

Utilize the advice given by medical professionals

Expert medical analysis and opinion related to the case are presented at the conclusion of a summary of a medical record review. You can then comprehend what the records state and what they signify for your circumstance.

Challenges in medical record review for attorneys 

The process of reviewing medical records is not easy and is fraught with challenges for the attorney.

The first step, procuring the relevant medical records from various healthcare providers, including hospitals, clinics, ambulance services, diagnostic facilities, pharmacies, and so on, is tedious and time-consuming. There are other challenges as well, which are as follows.

Time-consuming: Due to the vast quantity of medical records, attorneys and their internal teams will need to devote a significant amount of time to evaluating them.

Entirely disorganized documents: Most providers provide the information in an unorganized manner, making it impossible for the attorney to sort and make sense of them chronologically.

Multiple medical records: There may be a considerable number of medical records in many circumstances, especially when hospital admissions and other complicated procedures such as surgery are involved.

Lacking or incomplete records: It is critical for the attorney to find lost records and medical bills relating to specific dates or providers.

Irrelevant records: Due to the fact that medical records are collected at various times from various healthcare institutions and providers, there are issues with duplicate data, irrelevant records, records from before the incident, and so on.

Issues with understanding medical records: Providers may use their own forms for creating documents, which the legal team may find challenging to read.

Legal practitioners who do not have a medical background may have difficulty identifying the medical papers that are relevant to the case.

As a result, they may waste a lot of time attempting to interpret the content in meaningless data that are retrieved.

Inadequate information in electronic medical records: EMRs are legible, but they cannot include valuable data.

The provider often moves between many web pages in order to add information to the checklists. This might lead to the loss of narrative information, which is crucial for comprehending events and assessing a case involving a personal injury or medical malpractice.

Numerous EMR software programs are challenging, and records are frequently generated randomly.

Handwritten records: Some healthcare facilities continue to preserve handwritten records that may be illegible.

When attorneys attempt to identify which doctor wrote what and combine the multiple medical occurrences, it might result in significant inaccuracies.

Unfamiliar medical symbols and medical terminology: An attorney and their legal team could struggle to grasp the unfamiliar medical jargon and signs even if the medical record is well-organized.

These are the common problems that lawyers go across. Therefore, to guarantee that all relevant medical records are thoroughly checked as well as to save both money and time, attorneys usually employ the service provided by a medical record review company.

How to overcome these challenges in medical record review?

Outsourcing medical records for medical record review is the best option for attorneys to overcome the challenges in reviewing medical records.

Professional medical record review companies will have a team of expert medical record reviewers. Therefore, the quality they give, the time they consume, the data they secure, and the cost they charge are very favorable for the attorneys.

The professional medical record reviewer doesn’t miss any crucial points required for the lawsuit, and they also have enough experience to handle all sorts of medical records for cases like mass tort, worker’s compensation, product liability, etc.

Thus, it is very effective for the attorneys to join hands with the best medical record review company for the success of their lawsuits.

About Clare Louise

Read All Posts By Clare Louise