What Works: Effective Practices for Office-based CareComponents of the Medical Record
Legibility

Recommendation: All entries are legible

Source: CRICO/RMF Office Practice Handbook


 Exemplary Practice

Transcription service

Benefits:
  • Documentation of provider review
  • Approval of transcription
  • 24-hour turnaround
In practice at: North Shore Ear, Nose, and Throat Associates (NSMC)


 Exemplary Practice

Electronic medical record with electronic provider verification

Benefit: Eliminates legibility as an issue
In practice at: HVMA (all sites), CHA (most sites)


 Effective Practice
Labels with check boxes for documentation of care rendered
Benefits:
  • Low cost
  • Provider specific
  • Easy to use
In practice at: Family Medicine Shrewsbury (UMass)


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