Medical Record Archiving Standards and Infrastructure

Ideal vs. Reality in Medical Record Filing

Ideally, a building used exclusively for filing should be well-equipped, have a regular floor plan for better space utilization, and be located away from dangerous areas or facilities at risk of fire or flooding. The reality is that normally the file is located in the basement of the building, taking the weight placement of the documentation as its sole criterion.

Outline of Clinical File Departments

1. Restricted Area: Repositories (where clinical documentation is stored).
2. Work Area:
   • Documentation treatment.
   • Reception and clinical documentation.
   • Archiving of clinical records.
   • Reprographics.
   • MDS coding and extraction.
3. Private Area.
4. Public Area.

Calculating Shelving Space for 200,000 Inhabitants

Taking the average volume of clinical histories (HHCC) as 1.5 cm or 15 mm, the linear meters of shelving required would be:

• 200,000 / 2 = 100,000
• 100,000 * 1 cm = 100,000 cm (1,000 meters)
• 100,000 * 1.5 cm = 150,000 cm (1,500 meters)

Corridor and Movement Space

Main and secondary corridors should measure 75 cm to allow for efficient movement of files in active and passive states.

Functional Areas of the Archive

The Pre-archiving Area

This is a space for clinical histories (HHCC) to be pre-sorted before archiving or being sent to health center units and services.

Documentation Control and Reception

The control of provided documentation is performed in the Reception Area for clinical histories.

Documentation Treatment Area

This area is used for the opening of clinical histories, labeling, sorting, and ordering the documentation contained within, as well as performing quality control for the file.

Intellectual Treatment Area

This is the specific area for coding and the removal of the Minimum Data Set (MDS).

Public Areas

Public areas include the study and revision area for clinical histories, the lobby, and information areas.

Shelving Features and Systems

Required Shelving Characteristics

Shelves must be made of smooth metal surfaces. They should be closed at the top and sides to keep out dust. The shelving must be regulated, and the highest shelf must be at a height accessible to a person.

Comparison of Shelving Systems

• Classic System.
• Compact System (CD): This is considered the best system because it allows for the maximum protection of stored material from light, dust, moisture, and fire risk. The drawback: More than one person cannot search simultaneously because there is only one aisle available.

Custody and Preservation of Clinical Records

There are three main aspects to consider regarding the custody of documentation:

1. Conservation and preservation.
2. Facilities and spaces.
3. Preservation of clinical documents.

Risk Factors for Archives

The most dangerous factors that may affect a file include: fire, water, low or excessive humidity, temperature, light, noise, insects, rodents, people, dust, and pollution.

Security Conditions for Clinical Records

Security is categorized into three types of conditions:

• General conditions.
• Manufacturing conditions.
• Organic conditions.