IT'S ALL FREE! How Long Will it Take?

"How long will it take?"  When it comes to record reviews, attorneys ask this question all the time.  If you're a new legal nurse consultant, you may be unsure how to answer.  I don't have a magic answer, but I CAN help you respond to attorneys who ask this question.

If there WERE a magic answer to this question, it would be, "It depends."  That's because every case is different and every LNC is different.  Here are some questions that you should ask to get an idea of the work involved.

Ask yourself if your clinical experience is similar to the type of case you'll be reviewing.  For example, if it's a critical care case and your experience is OB, it will probably take you longer to review the case.  That's because you may need to review the patient's clinical condition as well as critical care guidelines.

Also, take into consideration your experience as an LNC.  If you're new to the field, it will take you longer to review the case because the process is unfamiliar.  The amount of time needed to review cases lessens with experience reviewing medical records.

Ask yourself about competing responsibilities.  If you're about to work five 12-hour shifts, you may not have time to tackle a new case.

Ask the attorney, "How many pages of medical records are there?"  I'm not a proponent of charging by the inch, but there's a big difference in the time needed to review 10,000 pages of records versus 100 pages of records.

Another question to ask about medical records is whether the records are typed, computer generated, handwritten, or hybrid.  Handwritten records take more time to review than typed records due to legibility issues.  Typed reports (discharge summaries, consultations, histories and physicals, etc.) take the least amount of time to review.  Computer generated records (progress notes, orders, nursing notes, etc. that are entered into a computer by the health care provider) are typed, which makes them easy to read.  However, sometimes these records are duplicative.  They may repeat the same information with every visit with updates that are difficult to locate on the page.  Or information that used to be on a four-page flowsheet uses 20 pages of computer generated records to convey the same information.  Hybrid medical records are a combination of the other types of medical records.

Ask the attorney if a written report is required.  It takes much less time to provide a verbal report to an attorney than it does to create a written report.  For a verbal report, you can jot down your thoughts on sticky notes or a piece of paper as you review the records.  Then you can look at the records and notes as you relay your thoughts and findings to the attorney.  A written report requires a grammatically correct, formally structured summary of your review.  This obviously requires more time than a verbal report.

After you gather this information, the most important question to ask is, "When do you need the results of my review?"  If the attorney needs a written report in two days, there are a large number of handwritten records, and you have other commitments, you may not be able to meet that deadline.  On the other hand, it may be easy for you to review the records if the deadline for the review is a month or two away.

As you can see, the length of time it takes to review medical records depends on many variables.  Maybe the sentence, "It depends" IS the magic answer to the question, "How long will it take?"

...Katy Jones