Are Retrospective Patient Chart Audits an Affordable and Reliable Answer to Healthcare Data Needs? Assessing the Ground Reality
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 2
Abstract
Medical records at various institutes and hospitals are unrecognized and not utilized to the fullest in spite of their relevance in identifying crucial information on patient and disease management. If this medical data is appropriately channelized by outcome driven analysis plans like retrospective chart audits, the results will certainly provide insights for many unanswered medical queries. Retrospective chart audits are the scientific and systematic review of existing medical records suited for the quality assessments of patients with lifestyle disorders (like Obesity, Diabetes, etc.), specifically in epidemiology research. They also assist researchers to understand the safety profile of certain classes of drugs (e.g. Psychiatry and CNS disorders). This article offers an overview on the applications and the business insights derived from retrospective chart audits whereby assessing the reality of implementing this methodology in terms of standard clinical research and regulatory requirements. Medical records or charts are valuable resources for essential clinical information. A retrospective chart review (RCR) or medical chart audit (MCA) is a well-established research design in which pre-recorded medical or clinical information in the form of charts are thoroughly reviewed to arrive at research and business insights [1]. Retrospective chart audits are neglected and largely undervalued compared to randomized clinical trials in spite of their capabilities to harness valuable insights from historical medical records [2]. They could potentially provide meaningful insights in relatively lesser time and on a limited budget [3]. Chart audits have several distinct advantages like the relatively inexpensive ability to explore rich readily accessible existing data-sets within less time, easier access to conditions with a long latency between exposure and disease, the ability to study rare occurrences, and most importantly, the generation of hypotheses that can be tested prospectively [2]. Though RCRs have many advantages, they also have some limitations, which restrict researchers from adopting them. However, the advancement of technology and the advent of Electronic Medical Records (EMR) have made life easier for researchers in overcoming these limitations effortlessly. Less than a decade ago, nine out of ten doctors in the US updated their patient files manually and retained them in colour coded files. A report says that at the end of 2017, approximately 90% physicians will use the EMR system [4]. This report itself outlines the future landscape of the data collection method. The EMR system was introduced some time back in some Nordic countries in Europe, and within very less time these countries have 100% penetration in terms of both primary and secondary data. The EMR adoption rate among various hospitals from 2012 to 2017 has increased significantly at the rate of 27% [5]. Considering that EMRs are better accepted and adopted by clinicians, they provide a promising option for tapping into hitherto unavailable data. Discussion Patient chart review studies were conventionally used to understand the burden of illness and patterns of care in hospitals or treatment institutes. However, this methodology is increasingly being adopted to cater to the data requirements associated with marketing authorization and risk management, which also includes the data on off-label medication use. Pharmaceutical companies are more enticed towards these types of studies considering the research benefits, since they help generate significant insights from hitherto under-utilized resources.
Authors and Affiliations
Uttam Barick, Anto Vijaykanth, Hitesh Bharucha, Arun Gowda, Anand Patil, Stefan Bosbach, Behsad Zomorodi
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