Ahima legal health record policy
[DOC File]Medical Records Policy - Kansas Department of Health and ...
https://info.5y1.org/ahima-legal-health-record-policy_1_eb62e1.html
POLICY: A medical record is considered a legal document used to protect the legal interest of a patient as well as the health care provider. Information maintained within the record serves as a basis for review, study and evaluation of the care rendered to the patient.
AHIMA
Once taken, clinical photographs become a permanent part of the legal health record and can be released as such according to state and federal regulations. Clinical photographs must be identified as a separate page/section of the electronic health record (EHR) with the appropriate patient-identifiable information including patient name, medical ...
AHIMA
Legal Health Record (LHR): Records documenting healthcare services provided to an individual in all delivery settings by clinical and professional staff. The LHR is a subset of the “designated record set”, which may be further defined by policy.
[DOC File]Sample Medical Records documentation
https://info.5y1.org/ahima-legal-health-record-policy_1_d2ec37.html
When a faxed document/signature is included in the health record, the document with the original signature should be retrievable from the original source. (AHIMA Practice Brief: Maintaining a Legally Sound Health Record) Only under rare circumstances will the HIM Department fax incomplete records to physician offices to be signed and faxed back ...
[DOC File]Guidance for Determining Designated Record Sets under HIPAA
https://info.5y1.org/ahima-legal-health-record-policy_1_f3a99c.html
“Legal Health Records” – Appendix C contains an excerpt of information published in the Journal of the American Health Information Management Association, Amatayakul, Margret et al. "Definition of the Health Record for Legal Purposes (AHIMA Practice Brief)." Journal of AHIMA 72, no.9 (2001): 88A-H.
[DOC File]Policy and Procedure Template - CCAHN
https://info.5y1.org/ahima-legal-health-record-policy_1_806b2b.html
AHIMA EHR Practice Council. “Developing a Legal Health Record Policy.” Journal of AHIMA 78, no. 9 (Oct. 2007) 93–97. AHIMA e-HIM Work Group on Maintaining the Legal EHR. “Update: Maintaining a Legally Sound Health Record—Paper and Electronic.” Journal of AHIMA 76, no. 10 (Nov–Dec 2005) 64A–L. American Bar Association.
[DOCX File]Legal Health Policy Template
https://info.5y1.org/ahima-legal-health-record-policy_1_71fb25.html
Sep 30, 2013 · “AHIMA--Developing a Legal Health Record Policy;” Members of AHIMA EHR Practice Council Policy Statement It is the policy of [organization] to create and maintain health records that, in addition to their primary intended purpose of clinical and patient care use, will also serve the business and legal needs of [organization].
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