- 4 weergaves
Lead Statement
Medical records and health information technicians compile, maintain and implement health records processing, storage and retrieval systems in medical facilities and other health care settings to meet the legal professional, ethical and administrative records-keeping requirements of health services delivery.
Task statement
- planning, developing, maintaining and operating a variety of health record indexes and storage and retrieval systems to collect, classify, store and analyze information;
- processing patient admission and discharge documents;
- reviewing records for completeness, accuracy and compliance with regulations;
- compiling and maintain patients’ medical records to document condition and treatment and to provide data for research, billing, cost control and care improvement;
- transcribing medical reports and entering data, such as demographic characteristics, history and extent of disease, diagnostic procedures and treatment into records-keeping systems;
- translating narrative descriptions and numeric information about patients’ characteristics, conditions and procedures performed into codes associated with standard classification systems;
- protecting the security of medical records to ensure that confidentiality is maintained and releasing information to authorized persons and agencies;
- supervising clerical and administrative workers involved in the maintenance of medical records.
Included occupations
- Clinical coder
- Disease registry technician
- Health information clerk
- Medical records analyst
- Medical records clerk
- Medical records technician
Excluded occupations
- Data entry clerk - 4132
- Filing clerk - 4132
- Medical secretary - 3344
Notes
Occupations included in this category normally require knowledge of medical terminology, legal aspects of health information, health data standards, and computer- or paper-based data management as obtained through formal education and/or on-the-job training.
Comments
(NCvB; Maart 2010)