Clinco recommended for ISO 27001 re-certification

ISO 27001 re-certification

We are delighted to say that following a  rigorous two day external audit, Clinco has  been recommended for re-certification to ISO 27001, the leading international standard on data security.

Having completed our first full three-year cycle under the audit regime, we would like to reflect for a moment on the satisfaction of a job well done.

A secure service

Clinco first made the  commitment to ISO 27001 in 2016.  We wanted to be able to offer those sending us medical records concrete evidence that they were choosing a secure service, as well as a good quality, prompt and helpful one.

A considerable investment in systems and processes

We were certified as meeting the standard in 2017,  following  a considerable investment in systems and processes, all designed to reduce the risk of loss or compromise of the medical records sent to us for pagination.  Those systems have been independently audited every year, to ensure that they continue to improve and to meet the high level of information security required.

Thank you!

We would like to thank all our staff and management team for their investment and encouragement!  We would also like to thank the external auditor who tested our information security measures so thoroughly and knowledgably.

Clinco recommended for ISO 27001 re-certification

 

Resilience in unprecedented times

We have been impressed by the resilience of the firms who have continued to send us new pagination instructions over the last month.  It’s good to see that departments are working well and finding new ways to communicate, share work and move matters forward.  We continue to receive a high volume of medical records in hard copy via DX and courier, so it is clear many companies are managing to operate at a safe personal distance.

At Clinco we aim to support, assist, problem solve and provide an efficient resource through collaboration with clients, colleagues and suppliers. Our team is fully employed and office based. We believe that this provides the best support to clients and staff alike.   However, we have always allowed staff to spend some of their time working remotely, for those who wish to have the flexibility this brings.  Our remote working systems have been tested and independently audited for data protection purposes.  We have therefore been able to move seamlessly to the current situation where a greater percentage of our work is done remotely, whilst remaining secure and compliant with ISO 27001. We did not want to test our business continuity plan in real life, but have found it to be fully effective.

We send our good wishes as we look forward to better times ahead.

Resilience in unprecedented times

Modern Law Awards

At Clinco, we aim to make a difference by working to a higher standard.  So any firm instructing us should find their expectations exceeded. We are here to lighten the load, solve problems and do the groundwork so that the case proceeds smoothly.
We don’t usually compare our organisation to others – we leave that to our clients to do.  The only true measure of success is if they choose to use us again and again.
Tonight at the Modern Law Awards we are going to find out if we have succeeded, according to the eminent panel of judges.  We’ve been told that the standard of nominations is high, so we were pleased to be shortlisted alongside a variety of different businesses in our category.  Whilst we’d love to be an award-winning company, we’re going to enjoy every minute of the evening regardless of the outcome…and will be back if we’re not chosen from the shortlist this time.
Our real work is to focus on the needs of our clients, and making sure they have every reason to make Clinco their first choice.

Good luck to everyone attending tonight!

 

At Clinco, we aim to make a difference by working to a higher standard

Happy New Year 2020! 

Happy New Year 2020!

We’re back in the Clinco office, ready to get to work on behalf of our valued clients old and new.

We’d like to wish you all the best for the coming year and hope that it will be a successful and positive one for you all.

 

Happy New Year 2020 to everyone reading this!  We’re back in the Clinco office, ready to get to work on behalf of our valued clients old and new.  We’d like to wish you all the best for the coming year and hope that it will be a successful and positive one for you all.

Merry Christmas!

Merry Christmas to all our clients, suppliers and friends – we wish you a happy and restful break over the holidays.   Thank you all for your instructions, support, input and feedback over 2019. It has been a busy and productive year!

Clinco Merry Christmas to all our clients, suppliers and friends

 

Medical records and pagination: the CJC report on fixed costs in lower value cases

We posted our general observations recently on the recommendations of the CJC report published in October.  As a medical records pagination service, our specific area of interest is the preparation of medical records.  The report makes several references to this stage of the case.

Fixed pagination costs

The report recommends that the claimant retain the responsibility for obtaining the medical records and sorting and paginating them.  This was an early area of agreement within the working party (para 3.52).  The working party also agreed (para 3.55) that the cost of this exercise should be included within the FRC limit, whether it was carried out by an external pagination service or inhouse.  At Clinco we already operate capped or fixed fee schemes in anticipation of this provision and are expecting these to become the norm in lower value cases.

Limiting the range of the medical records

At Clinco we are increasingly asked to use our expertise and experience to prepare a core bundle of key documents at the outset, often alongside the full bundle with dual pagination.

The CJC recommended the scope of the records to be limited to:

  • the GP records
  • records from the healthcare provider(s) where the treatment giving rise to the allegations took place, and
  • records relating to follow-up care.

This proposal reflects current practice in the majority of cases, so there is nothing new here.  The amount of records can still be very substantial.  There was nothing in the report about making an analysis of relevance of medical records within a certain provider – we have seen many cases where there are years of complex history not relevant to the actual allegations.  The creation of an early core bundle was also not mentioned.

There are costs savings to be made here, of particular benefit in lower value claims, and practitioners do not need recommendations from the CJC to implement them.

Clinical pagination

The report used the term ‘clinical pagination’ to describe the experts’ representatives’ preference for sorting medical records by specialty rather than pure chronological order.  At Clinco, we always sort by category, specialty and (only then) date order as it makes analysis so much clearer.   The exception is that a core bundle of, say, 100 pages of key medical records will often be more useful if it follows the order of events.

We’re surprised that experts have ever seen a whole bundle in chronological order (but not at all surprised they found this hard to navigate!)

Central electronic storage

The CJC report referred (para 3.54) to the ‘clear advantages’ of pagination services such as Clinco having a role in the central electronic storage of medical records and providing access to the parties.  The advantages are particularly in the context of data protection for special category data.  Clinco was the first independent pagination service in the UK to invest in ISO27001, the international standard in information security, precisely so that we could offer this facility to our clients.  We have provided secure electronic storage of medical records for some time. This has evolved over the last year to create a secure central resource to assist our clients to enable both expert and defendant access to the collated records.

The role of the chronology – differing views

The experts’ representatives told the CJC that they did not need to receive a chronology with their instructions.  At Clinco, we are asked to prepare a chronology of relevant events in most cases coming to us for pagination.  The feedback we receive from both practitioners and experts is that it saves time and costs.  We have even been instructed direct by the experts themselves to prepare a chronology from the records, which speaks for itself as to the usefulness.  As the whole of the CJC report is restricted to lower value, less sensitive and more straightforward cases, that may be the relevant factor. We are always willing to accept cases on a ‘sort only’ basis and our indices are sufficiently detailed to provide a clear breakdown of the evidence including dates for admissions and surgery.

CJC report on fixed costs in lower value cases – some observations

The CJC report on fixed costs in lower value cases – some observations

Fixed costs are back in the spotlight with the report of the CJC in October 2019.  As a pagination service, we have paid close attention to the issues raised in the CJC report concerning the preparation and pagination of medical records and will be discussing these in a further post shortly.

Not surprisingly, given the conflicting interests within the core group, no consensus was reached.  However, agreement on process and FRC levels was brought closer, albeit with significant minority disagreement.  It is likely that change will be implemented at some point in the foreseeable future and this report gives an idea as to what shape those changes may take.  There are still large gaps on expert fees and ATE premiums which the report acknowledges have yet to be addressed.

CJC report on fixed costs in lower value cases

Light track

The new concept of a ‘light track’ is proposed for cases where no expert evidence at all is obtained.  Although one would think such a case rare in practice, this category (according to the analysis of Professor Fenn, para 3.19) accounts for 25% of lower value cases.  It’s hard to see how many claims could be settled safely without at least expert evidence on condition and prognosis. Such a case would need full admission on liability and clear determination of losses.  It will be interesting to see how many cases are considered suitable for the light track should this go ahead, or whether the lower proposed FRC rates (para 5.16) are viable at all.

Standard track

On any analysis most cases will require expert evidence and therefore be allocated to a proposed ‘standard track’. Is the disadvantage to the claimant of proposed sequential service of expert evidence addressed by a subsequent right of reply to the defendant’s report?  The proposal is highly contentious and did not result in consensus.  The claimant would be required to make their case without seeing any factual or expert evidence from the defence.  Any later supplement or editing by the claimant would inevitably lose impact compared with a primary position; this appears to be accepted by the CJC in introducing a retroactive ‘safeguard’ (namely unilateral right of reply). It could be argued that the Claimant is left with a fragmented case and increased costs in managing the expert evidence.

Mandatory neutral evaluation (MNE)

The proposed ‘mandatory neutral evaluation’ (MNE) looks like a creative and positive proposal which may receive a cautious welcome from some on both sides.  To justify the cost it would need to be a highly effective tool.  There remain many questions about how it would operate in practice.

Pagination of medical records – updates made easy…

A busy summer turned into a busy autumn.  We’ve been hard at work in the Clinco offices, processing cases and moving matters forward for our client firms.    We’ve been seeing a number of very complex high value cases which have made full use of our expertise.   These cases are likely to run for many years.  In most of them the patient has evolving needs under active ongoing clinical management, across many different specialties.

Updating the records and chronology is almost always needed in these long running, complex matters.  Usually there will be substantial updating records from a range of healthcare providers.  It’s easy over time for the fee earner to lose control of the updating process and for the records to get out of hand.  Duplication or overlap can start to proliferate.  The bundle can become disorganised, and hard to navigate.  The knock on effect is that it’s more difficult to spot gaps in disclosure and track developments in the condition and treatment of the patient.

We’re often asked to rectify a bundle where a fee earner has taken over conduct of a matter in which this sort of thing has happened.  We have seen some poorly prepared records which have been subject to various attempts to update them.  We can always make it right, by doing whatever is needed to resolve the issues and get the case back into a good state.

We advocate, however, getting a good grip on the records right from the outset; and then maintaining control throughout the life of the case by updating methodically across the board at intervals of around 12-18 months depending on where the case is in terms of the expert evidence and the timetable.   If you use our service from the beginning we will update efficiently – as the groundwork will have been properly and consistently carried out, so we can swiftly eliminate overlap and duplication.  We have cases we have updated eight times already and the bundle remains in excellent shape.

We tend to update by extending the index and pagination, rather than insert pages.  This prevents the rather unsatisfactory ‘point additions’ – 100.1. 100.2 etc, which only get worse as the years go by and the suffixes get longer.  A straightforward extension of page numbering is clear and keeps the index easy to read.  It is also more compatible with digital versions of the records in pdf format.   If your preference is for a simple prefix per provider – eg A100 –  to keep updates from that provider directly following on rather than later in the bundle, then that is easy to do and gives a good clear result.

It is important for updating to be done correctly and in an organised way.  We keep an electronic version of everything we collate so when the time comes to update, we only need the new records – not the whole set back again – to eliminate overlap and complete the update.  Our overall aims at Clinco are to bring clarity and help fee earners to progress their cases – updating the records is a significant part of our work on your behalf.

Success in Clinco’s third annual ISO27001 audit

At Clinco we have just undergone our third annual ISO27001 audit with our best ever results.  For those of you not familiar with ISO27001, it’s the international data protection standard which we have chosen to apply to all our systems and processes. 

This means that when medical records come to us for pagination, whether electronically or in hard copy, our clients can be sure that they are tracked, kept securely and strictly controlled to prevent a data breach.

We are dealing on a daily basis with highly confidential personal data.  So we see information security as an obligation both to the data subject and to our instructing firm – so that they can satisfy their own professional compliance requirements in relation to the outsourcing of sensitive client information.

We had excellent feedback from our external auditor.  We will make our audit report available to any client wishing to review it, whether for their own due diligence procedures or simply out of interest, to see the scope of the requirements.

Success in Clinco's third annual ISO27001 audit

Opening imaging CDs…Clinco is here to help!

Opening imaging discs is a constant bugbear for those involved in clinical negligence cases.   At a recent conference hosted by Inspire MediLaw, those who expressed their frustration included most of the experts and specialist solicitors present.

CDs are not a very suitable method of storing large complex graphic files, such as X rays and other imaging studies.   Elsewhere, use of discs is increasingly obsolete – but they are still routinely used for disclosure of radiology.

Help is at hand!

At Clinco, we have a tried and tested system for dealing with imaging on disc.  Sharon Philpott, our Records Manager, is an expert at getting into discs.  Sharon has various programmes at her disposal, as well as years of experience. We have never been defeated by an imaging disc! Thank you Sharon.

Passwords

Generally discs are password protected – by a password sent separately. Passwords can be frustrating but they are here to stay. Sharon checks all passwords as soon as the case reaches our office. This avoids any hold up once we start sorting the case.

Other imaging CD challenges

It can be difficult to access the imaging even if it is not a password issue.  This is a frequent problem experienced by solicitors and experts:

  • many PCs struggle to process large graphic files. This means files are slow to open. At Clinco we make sure our hardware is up to the job.
  • the operating system on which the disc was created might itself be out of out of date. In older cases the disc may well have been created on Windows 7 and not be fully compatible with later systems
  • the digital tools used to read files vary from disc to disc. Sharon constantly reviews our imaging software.

What happens once the CD has been opened and read?

Once the case is complete, we will send the  the radiology back to you scheduled, and cross-referenced in the chronology where relevant to the issues.

Free aftercare service

Passwords do occasionally get lost.We have a system at Clinco where, if we have been sent a password protected disc at any time over the last six years, we can provide the password to an authorised person within minutes.  This is part of our free aftercare service.

Opening imaging CDs...Clinco is here to help!