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.
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.
The case of Hanbury, which was reported recently in the Law Society Gazette, caught my eye. Click here to see the article in question.
It’s a salutary tale. If a fatal case is being investigated, and there has been a post mortem examination, make sure the medical expert sees the post mortem report and any associated test results, for example those relating to histology or toxicology. Where the death has occurred in a secondary care setting, the medical records usually clarify the contemporaneous thinking as to cause of death and make clear if the case has been referred to the coroner.
What should I expect from my collator?
If medical records in a fatal case are with Clinco for pagination, we will always flag up if we do not see a post mortem report (if one has been carried out) or death certificate. These documents are not always within the medical records but will need to be obtained if they are not present, so it is helpful to mention them for completeness. We would expect an experienced medical expert to do the same. This did not appear to happen in the Hanbury case. Consequently the family has had to spend many additional years waiting for a resolution of this very sad case.
At Clinco we have a lot to think about in our day-to-day work. Analysing medical records requires total concentration. However, we recently took some time out to carry out an environmental impact study on the green credentials of our workplace here at Discovery Park. In other words, just how green is our office? These are some of our findings.
Recycling and cutting down on waste
Medical records are very paper-heavy. Clinco produces up to 200kg of waste paper a week. This is clean, printed paper. The papers are confidential and therefore need to be securely destroyed. We use a shredding service that meets our ISO27001 data security requirements, but also recycles 100% of our waste paper produce. This service plants a tree per 500 sacks of paper collected.Our non-confidential waste from the office is also recycled with zero to landfill. Used printer cartridges are recycled, via our print supplier.
We are proud to say that at Discovery Park our energy comes entirely from renewable sources. All electrical systems including lighting, air-conditioning and heating are provided by Kent Renewable Energy Ltd, a local biomass plant, which in total saves 100,000 tons of carbon dioxide a year.
There is always more we can do to decrease our carbon footprint, in ways that are both big, and not so big. For example, we recently started to use refill bags for our office coffee, rather than buying a new jar each time we run out. On its own, this is a small change. However together…
Time has gone very fast but it’s 10 years since we opened the doors at Clinco and welcomed our first client (still with us today). In that time, we have seen big changes in litigation funding, costs and the serious injury landscape. Standards of medical care in our hard-pressed NHS continue to be variable. With pressure on NHS budgets and access to justice alike, the patient looks more vulnerable than ever. All the more need for the influential voice of AvMA, the experienced specialist lawyer, the authoritative medical expert and the knowledgeable ATE provider. It’s been our great privilege to work with all these over the years.
Constantly striving to improve
Clinco is now an international consultancy. We have been at the forefront of the move towards electronic working in the field of medicolegal practice. We have sought to improve our already high levels of data security. We analyse and process thousands of pages of medical evidence a week – to deadline. We have never lost sight of the need to provide a bespoke, independent, good quality but affordable service. That is what we are here to deliver.
A big thank you!
We’d like to thank our wonderful team of staff, all our friends, supporters, suppliers and most of all our clients. We look forward to the future.
Clinco has been at the forefront of digital documentation and data security in relation to pagination of medical records over the last few years. There are still lots of firms out there using hard copies of medical records; but more and more are turning to digital format to read and transfer the information. Several firms now are totally paperless. Others are paperlight – running at least one set of hard copy records alongside the electronic version. Enthusiasm varies from firm to firm (and fee earner to fee earner) but most say that, however daunting the prospect at the outset, they would not go back to pure hard copy working.
We have been able to deal with a couple of large urgent cases over the last few weeks by making the most of electronic transfer of records and documents. Transfer of documents is instant when using a secure file transfer system. Saving a day at each end will makes a big difference in an urgent case. With no physical packing or movement of boxes, there are fewer stages within the processing of the work.
If the matter is an update, it makes even more difference. If we have had the case before, under our new systems we will already have the previously collated set in digital format and all we need are the additional records to integrate, update and return complete. We completed and returned an update yesterday which had only arrived that morning.
Not all cases are urgent, but the use of electronic resources raises efficiency generally. We are here to put those resources to work on your behalf and are also available to advise on electronic file transfer, records management and data security should that be required. Get in touch if you would like to know more – firstname.lastname@example.org
Happy New Year! This year we will be celebrating 10 years of Clinco being in business. Over that time we have processed tens of thousands of cases – that is millions of pages of medical evidence accurately assessed for ordering and relevance. We’ll be marking the anniversary in March but for the moment, it’s back to work as usual and delivering on our deadlines. We wish all our clients, supporters, friends and suppliers a successful and prosperous 2019.
As we come to the end of 2018 we would like to thank all our clients, suppliers, supporters and friends. We have had a busy and productive time, with an office move to a more central location on our site, successful renewal of our data protection credentials by the ISO27001 auditors and streamlining of procedures to keep workflow efficient.
We have a broader client case than ever before. 2018 has seen us welcome a number of new firms and organisations who are seeking best value, but won’t compromise on quality. Clinco is increasingly a technological hub. We still receive plenty of hardcopy instructions, but are receiving an increasing amount of work via electronic transfer too. Our partnership with Inspire MediLaw led to us attending conferences in obstetrics and gynaecology, brain and spine injury, where talented medical and legal speakers provided invaluable continuing education to our team.
We continue to watch quality and deadlines on a daily basis. Our training and systems drive efficient delivery of both.
We wish everyone a Happy Christmas and a successful New Year!
This week our largest ever case and our smallest ever case were both, by complete coincidence, with us at the same time. Both were sent out on the same day. The small one was only 18 pages. Behind every set of medical records we see, there is a person going through a dreadful time and deserving of our best efforts.
One thing these cases had in common was that they were both urgent and the large one in particular has taken up a lot of resources. It’s good to see them going out on time, and those matters being progressed swiftly as a result. Thank you to our clients for entrusting us with their medical records, which will always have our full attention whatever the size of case.
We’ve had a busy Autumn so far at Clinco. Not much time to enjoy the beautiful sunshine outside! But it’s been a productive and interesting period. We’ll soon be getting in touch with our clients to report to them on activity over the year, to check their preferences are up to date, and offer to assist them in whatever way they require. We like to innovate and streamline, so we’ll also be reporting on new practices in the office, all designed with efficiency and service in mind.
We’ve also been attending to some scheduled ‘housekeeping’ matters, staff reviews and equipment updates…staying on top of the timetable for our internal processes. Feels good to have made time for these things. We’re processing thousands of pages of evidence a week and need to be sure our systems are sound.
One piece of good news for clinical negligence practitioners is that their requests for medical records from healthcare providers should now be met free of charge, and more quickly than was sometimes the case pre-GDPR. Whilst the previous statutory charge of £50.00 (which applied except where the patient was deceased) was generally considered reasonable and had not been increased over the years, it could add up where there were large numbers of providers.
Authority for the change is at Chapter 3, Article 12 of the GDPR. Paragraph 5 reads: “Information provided under Articles 13 and 14…shall be provided free of charge”. Article 13 relates to personal data originating from the data subject and Article 14 to personal data originating elsewhere – medical records arguably could be both, but there is no need to go into this for the purpose of Article 12.
There is an exception to the free of charge principle, but only in the event of unfounded or excessive requests – effectively ‘nuisance’ or malicious approaches. Even then the burden is placed on the data controller to demonstrate that a (limited, administrative) fee is appropriate under the regulations so this looks unlikely to be sought in the context of a professional access request.
I have read that under GDPR, disclosure must be made within 30 days of the request being made. This would represent a considerable improvement on the previous position, in many cases. However when looking at the raw regulations they do not actually require substantive 30 day compliance. They say (Article 12, para 3) “The controller shall provide information on action taken on a request [including access to data] without undue delay and in any event within one month of receipt of the request”. This is not the same thing as providing the data itself within one month. Furthermore the same paragraph allows for a two month extension “where necessary” , again to provide information on action taken rather than provision of the data itself. In the absence of any meaningful deadline, it remains to be seen whether requests will actually be processed faster as appears to be the intention of the GDPR.