Question

compare and contrast the varying filing systems in healthcare

Answer 1

In most of the healthcare institutions, the medical records filed numerically according to patients’ medical record or identification numbers. In the early hospitals have filed records according to patient’s names, discharge numbers, or diagnostic code numbers etc. The alphabetic filing is subject to more errors than numerical filing. Filing by discharge numbers and diagnostic code numbers are also troublesome as the other important records or registers in the facility are concerned exclusively with medical record numbers.

Numeric filing systems

1. Straight Numeric filing:

Straight Numeric filing refers to the filing of records in exact chronological order according to registration number. This will ensure that the consecutively numbered records would be sequenced on the file shelves. It is easy to obtain the consecutively numbered records from the file for study purposes or for inactive storage. The main advantage of this type of filing system is the ease with which personnel are trained to work with it.

However, it has some inherent disadvantages like easy to misfile as the staff must consider all digits of the record number at one time when filing a record.

The chance of error increases with the greater the number of digits that must be recalled when filing. Transposition of numbers is common (record 65424 can be misfiled as record 56424).

The heaviest filing activity is concentrated in the area with the highest new numbers and if several staffs are filing records at the same time in such areas is bound to get in each other's way. The quality control of filing is difficult with the Straight Numeric filing system.

2. Terminal digit filing:

A six-digit number is usually used in terminal digit filing and divided with a hyphen into three parts (66-31-06) and each part contains two digits. The last two digits are the primary digits, middle two are secondary and the tertiary digits are the first two digits. The staff must first consider the primary section within each primary section while filing, Then the groups of records are matched according to the secondary digit section, after locating the correct secondary digits section, the staff files in numerical order by the tertiary digits. The second tertiary digits change with every record in the file.

The main advantage of this method is the congestion that results when several staff file active records in the same area are eliminated. Staff can be assigned responsibility for certain sections of the file. The work is evenly distributed amongst each staff in each section as the registration numbers are still assigned in straight numerical order.

Inactive records can be removed from each terminal digit section as new records are added and thus the volume of records in each primary section is controlled, and large gaps in the file which require backshifting of records are prevented. Volume control also simplifies the planning of filing equipment and management.

3.  Middle digit filing:

In middle digit filing the staff files according to pairs of digits, as in terminal digit filing but the middle pairs of digits in a six-digit number are the primary digits, the digits on the left are the secondary digits, and the digits on the right are the tertiary digits.

The advantages are simple to pull up to 100 consecutively numbered charts for study purposes, the conversion from a straight numerical system to a middle digit system is much simpler, blocks of 100 charts pulled from a straight numerical file are in exact order for middle digit filing, more even distribution of records that does straight numerical filing., although it does not equal the balance achieved by a terminal digit.

Any staff can be assigned responsibility for certain middle digit sections and misfiles are reduced.

The disadvantages to middle digit filing are: more training needed and gaps result in the file when large groups of inactive records are pulled with more than six digits.