The importance of proper documentation in electronic record

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Reference no: EM132201743

Correct documentation in patient records is vital to good patient care, as well as being essential for correct and legal billing of visits. Reports indicate most providers use “cloning” as part of their documentation. That means using the “copy and paste” function from a prior visit, and importing information into the current visit. This has sparked debate as to whether it is efficient use of time, or fraud.

For this discussion, research in peer reviewed literature this concept of “cloning” the medical record and use of the “cut and paste” feature, then answer the following questions:

1. In your first post answer the following:

o What is the importance of proper documentation in the electronic record and how does this help the fiscal health of the organization?

o What are the pros and cons arguments for this feature? Draw a conclusion and take a stance on whether this is an acceptable technique or not.

o What are the legal and financial consequences of intentionally misrepresenting the medical record?

Make sure that you perform credible, outside research to support your answers. You must then properly cite these references within your post to receive credit. All replies must be substantive, and not merely “I agree” postings. You must advance the discussion.

Reference no: EM132201743

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