Exercise 2 (4 Points)

You just had your first request for an amendment of the medical record. The process failed miserably. Lack of communication and documentation were identified as the root causes of the problem. The request was not responded to within the appropriate time frame and the physician was not familiar with the process, and did not know what to do. When the physician asked what to do, the HIM staff person coordinating the process could not explain it to him.

The privacy officer at the facility knew that they needed to fix the problem. The decision was made to revise the existing form, to improve communication, and to update the process. You have been given the responsibility of revising the Request for Amendment Form to ensure that the request by patient for amending the record is addressed and the process is documented appropriately.

How would you revise the form shown in Figure 3-2 to ensure that you are compliant with all privacy regulations and have adequate communication via the form? Utilize good form design principles.

Figure 3-2

Hint: How would you revise the form shown in Figure 3-2 to ensure that you are compliant with all privacy regulations and have adequate communication via the form? Please utilize good form design principles as specified in Special Topic Assignment 1.

There are a variety of changes you can suggest. You may first want to examine the following aspects to make your suggestions:

• Is the form title informative enough for a patient to know what to do?
• Does the form provide for enough patient information to be filled so that it does not cause any errors when processing the form?
• Does the patient have any right to learn the whereabouts of his or her amendment request and keep updated on how the hospital processes the request? If so, what should be included in the form to enable such tracking?
• Is there any party that is involved in the process of the medical record amendment but not included in the form? If so, what should be added to the form, so that the responsibility of each party involved in the process can be traced?

Of course, your suggestions should NOT be limited by those considerations.

Request for Amendment Form Seaside Hospital 1123 Bay Drive Seaside, Florida 12345 Patient Name MRN: Error: 2014 Cengage Learning. All Rights Reserved. Decision: Revise Do not revise Date Signature