ROLES AND RESPONSIBILITIES OF MEDICAL RECORDS STAFF IN HEALTHCARE SETTINGS

Abstract

Medical records staff play an important role in healthcare operations. The objectives of this essay were: to identify the roles and responsibilities of professional medical records staff; to describe various qualifications required for employment in a medical records department; to explain the use of, and need for, medical records in a variety of healthcare settings; and to describe the increasingly important field of electronic health records. The essay found that there are many roles and responsibilities that medical records professionals are, or can be, involved in. This blend of tasks undertaken has a significant impact on the efficiency and effectiveness of patient care and treatment. There is also a significant need for staff, and staff in a position of authority, to have the knowledge and skills required to carry out their roles safely, accurately, and consistently. (Nwosu, 2024)

Accurate, legible, and organized medical records are essential components of patient care. It is crucial that all healthcare professionals take an interest in the electronic or paper medical records which they generate. In order to be effective, they must be trained and retrained on how to comply with their medical records responsibilities. Compliance with a variety of medical records-related legislation is required. Many documents are retained, and destruction of medical records must be monitored and executed using secure and ethical yet cost-effective methods. The healthcare system predominantly operates to encompass the provision of care and treatment for individuals, and to prevent ill health on a community level. These roles are carried out with the use of legible, accurate, and complete medical records. Failure to utilize such a documented paper or photographic-based tool can result in litigation, inadequate resources, and/or a substandard level of knowledge of healthcare professionals. Ultimately, this paper-based essay will identify and define the required levels of competence of medical records professionals, the techniques used to assess such competencies, and some strategies which can be used to teach and maintain the necessary levels of medical records knowledge and skill that the working healthcare professional needs. (Wager et al., 2021)