Part 3: Concepts of Administrative Functions (Medical Records Management)
MAERB Competencies: VI.C.4, VI.C.5a, VI.C.5b, VI.C.6a, VI.C.6b, VI.C.6c, VI.C.7, VI.C.8, VI.C.9, VI.C.10, VI.C.11,

The medical record serves a variety of purposes and is essential to the proper functioning of the medical practice, especially in today’s complicated health care environment. The medical record is a key instrument used in planning, evaluating, and coordinating patient care in both the inpatient and the outpatient settings.

In class, you have practiced medical records management skills by organizing and analyzing sample medical records, both hard-copy and through EMR (CareTracker). Based on this practice and the information you learned from classroom discussions, assigned readings, and research; describe the following:
1. Differentiate between an electronic medical record (EMR) and a practice management system. (VI.C.8)
2. Explain the meaningful use as it applies to EMR within the healthcare setting (VI.C.12)
3. Define types of information contained in the patient’s medical record..(VI.C.4)
4. Identify equipment and supplies needed to create, maintain, and store medical records (VI.C.6a, VI.C.6b, VI.C.6c)
5. Compare and contrast the pros and cons of the two major systems for organizing medical records, source-oriented and problem-oriented records.(VI.C.5a, VI.C.5b)
6. Describe the standard protocols used for filing medical records. Include in your discussion, an explanation of each filing indexing rule, as discussed in class. This should include electronic, alphabetic, numeric and subject orientation. (VI.C.7)
7. How often should a medical office back up data and why is this important? (VI.C.11)
8. Identify the step needed to complete an inventory within the office setting. (VI.C. 10)
9. Explain the importance of the routine maintenance of administrative and clinical equipment within the medical office.(VI.C.9)