Lost/missing charts

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Working on std instructions on what to do about lost charts. More to come.

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What qualifies a chart as missing/lost

A chart should be considered lost or missing and "written off" if...

Attempts to locate have failed

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  • What (if anything) should be done to find the chart before writing it off? Obviously following the appropriate Category:Medical Records Requests instructions, but is there any special process to nudge a suspected lost chart?
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Deferral period has passed

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  • How long should we wait? Is 3 months after discharge or end of next quarter after discharge reasonable?
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Instructions for finishing off the profile

An profile for a missing chart might trigger CCMDB.accdb Data Integrity Checks, so it can't be sent the normal way and the following process applies instead.

Instructions for Collectors

  • Try to enter all available info and to check the complete boxes; this will make sure that data is internally consistent as far as possible
    • This includes any diagnostic imaging and procedure counts and results, lab results, etc
  • Where you can not get past a cross check because data is not available, explain that in the Notes field
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  • what should be the instruction for APACHE - the usual "enter normal if not available" or should they enter extremes or 0s, or leave blank? What will not mess with Julie's processes?
    • I would rather have a missing APACHE Score when any of the APACHE elements are missing due to Lost or missing chart. Entry of zero for numeric or blank for character on any of the elements results to blank APACHE Score (but this refutes the guideline for APACHE Physiologic Not available). Normal values result to Zero APACHE Score (when age pts is zero).
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the following doesn't apply yet, waiting to confirm as of 2021-04-07   
  • When you have entered all available information, and when the #Deferral period has passed, contact Pagasa and tell her the profile is a missing/lost chart
  • Once Pagasa has confirmed that this is understood, delete the chart using the ♻️ button

Instructions for Data Processor

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  • Do we want a different RecordStatus for these? If not, should they be considered complete or incomplete?
    • I suggest we enter a new one say, LostChart, in the RecordStatus which implies incomplete and some data are missing. --JMojica 13:34, 2021 April 7 (CDT)
      • Would there be any problems with reporting queries including or excluding these in unintended ways? Could happen if any use a "not incomplete" or similar. I am pretty sure if we change this some CFE cross checks will show false positives for these, but those would be easily tweaked as we encounter them. Would there be false negatives, though? Ttenbergen 14:15, 2021 April 7 (CDT)
        • do you have a query about missing entry in any fields? I can't think of any query with false negative. --JMojica 17:13, 2021 April 7 (CDT)
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Incomplete/lost profiles

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Julie says Pagasa keeps a list of records for which this applies. Can we keep it here instead? If there are good reasons not to, can we link from here?

  • If we change the RecordStatus to LostChart for these there will be no need for lists, just a one-time update needed by Pagasa; I think that would be the best way to do this.
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click expand to see list   
  • HSC_D5-36
  • HSC_D5-39
  • HSC_D4-3
  • HSC_SICb-1409
  • HSC_SICa-1887
  • STB_MICU-15213

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