Double lock EHR storage can effectively protect donor information

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NEW ORLEANS—Electronic medical records (EMRs) that employ a “double lock” technique can be used to safely store matched unrelated donor (MUD) information and search-related paper documents, according to research presented at the Oncology Nursing Society 37th Annual Congress.

In order to protect patient privacy, several regulatory requirements exist for the storing and maintaining of donor-related charts and information. When paper records build up and storage space becomes an issue, an alternative method of archiving these records becomes necessary.

At City of Hope, an NCI-designated Comprehensive Cancer Center in Duarte, California, the number of transplanted patients reached the milestone of 10,000 and the center realized the need to standardize document maintenance and find an alternative to storing paper charts. They decided to find an EMR solution that could store the valuable patient information digitally in a way that was both private and easily accessible to those who required access to the documents.

The management, nursing staff, search technologist, clerk, physicians, and health information system office met to review the information contained in the MUD chart as well as how it was currently being stored and maintained. During subsequent meetings, they redesigned the forms to meet City of Hope requirements; created a purge plan to eliminate duplicated or unnecessary documents prior to sending them to storage; standardized the chart content; and developed an electronic process for scanning the documents to the city's EMR.

The MUD office held a series of “Forms Bootcamp” meetings to determine what sort of documentation was appropriate for inclusion in the medical record. Upon completing this series of meetings, all stakeholders agreed upon which content should be included within the electronic medical record (EMR); they determined that all remaining information pertaining to unrelated donor identification would be maintained in a separate, secure location that would ensure confidentiality of the donor's identity and information.

Next, taking current regulations such as FACT, CIBMTR, and JTC into consideration, the team used health information management systems (HIMS) to create an electronic “double lock” requirement to store the MUD charts. City of Hope set up an electronic folder within the EMR that was only visible to those with privilege access, which allowed for double lock storage—in other words, data was stored behind two private-access-only barriers.

“This solution allows for less physical storage of paper documents and it is easily accessible electronically whenever the document is required to be reviewed for patient care, regulatory or research purpose,” the City of Hope staff said.

“This electronic medical record solution results in increased productivity of nursing as less time will be spent looking for the paper medical records. We will have the most updated information, including the allergies and any medication changes, at our fingertips,” the researchers concluded.

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