Numbering and Filing Systems

Numbering systems- the methods utilized to assign medical record numbers to patients. Filing systems- The methods used to file or retrieve a paper or microfilmed medical record, regardless of the numbering system used.

Unit Numbering System- Patient receives the same medical record number on every admission. Objective: To leave all of the patient's previous medical records located in the same place in the file. (best system) Serial Numbering System- Patient receives a different MR# on each admission. Objective: To issue each patient a new MR# each time he or she is admitted. Serial-Unit- Pt receives new number each time, each one is pulled forward and filed with subsequent chart. Objective: To assign a new number each time, but to have all of the patient's previous charts filed in the same location.

Serial Numbering System- Advantage: Don't have to look under MPI, just assign newest #. Disadvantage: All of patient's information is not under one number, and is harder to access. Unit Numbering System- Advantage: Quickest Access, automatically one #. All info on patient linked together. Disadvantage: Must look under MPI to assign number. All clerks in admitting, emergency, and clinical departments must have database access. Files become very thick. Serial-Unit Numbering System- Advantage: Assign next available # and keep old records filed in the same place. Disadvantage: Have to retrieve old records to file with current record #.

Social Security # is used as MR#. Not recommended because of confidentiality/security issues. Family Numbering System Family Number is assigned 12345 Head of household= 01 01-12345 Spouse= 02 02-12345 Oldest Child= 03 03-12345 Next Child= 04 04-12345 etc. Recommended only in limited applications. This type of numbering system is most appropriate for primary care clinics where all members of a family may receive health care. The major disadvantage is that families change. Marriage and/or divorce cause changes of household number and/or extra digits. When it is important to link family numbers a combination of a family number with another individual number is suggested. It is safer and easier to use.

A pseudo-number (9 digit #) is assigned for patients who do not have SS#.

-Master Patient Index -Medical office with less than 5,000 records. Minimal computerization and stable population. -Doesn't work in healthcare- too many similar names, or pts with exact same name.

-File by last name first, followed by first name, then middle name or initial. -If there is more than one person with identical last, fist and middle names, use the birth date, filing the oldest patient first. -File names with prefixes as one word. -File abbreviated names as if spelled out -FIle hyphenated names as one word -Disregard titles such as Revered or MD, and seniority -If an initial is given instead of a first or middle name, file \"nothing\" before \"something\"

Straight Numeric Filing- Records are filed in exact chronological order. 1) The advantages of straight numeric filing include: people are used to this \"logical\" order and training is easy easy to retrieve consecutive numbers for research or inactive storage. 2) The disadvantages, however, outweigh the advantages, particularly in large hospital health record departments. The disadvantages include: easy to misfile, one must consider all the digits of the number in order to file the record easy to transcribe numbers where one digit is wrongly written or read, for example: 1 for 7 easy to transpose numbers (reverse digits), for example, record number 194383 is filed as 193483 the highest numbers represent the newest, and therefore most active records, causing a concentration of record activity in one particular area of the file room, where these records are filed it is not feasible to assign filing responsibility to one clerk since most of the records and loose sheets are filed in the same area. TDO filing: A numeric filing system which reorders the manner in which the number is read and filed. Advantage:improve retrieval and filing efficiency. Even distribution of files. Clerks can be assigned certain areas. Misfiles less likely. Disadvantage: Must place numbers in new order, train employees on system.

Example. Record number 247653. 24-76-53. 53 is Primary number. 76 is middle number (secondary). 24 is tertiary (terminal).

The tertiary digits in the TDO number, will range from 00-99. There are 100 possible tertiary digit numbers a medical record could have.

If one number is assigned to more than one patient, each patient with that number will not be uniquely identifiable.

If a record is misfiled, it may not be easily accessible.

The number is always assigned at the time of admission. Paper-based- admissions staff assigns number using a number log. Electronic- System is programmed to assign the number.

Chronological register of assigned/available numbers. Maintained by either the HIM department or the Admissions Department.