The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1880-778X
Print ISSN : 0034-351X
ISSN-L : 0034-351X
Short Note
A Survey of the Medical Record Data Fields used for Cerebral Infarction Patients in the course of designing a Liaison-critical Pathway
Makoto TOKUNAGASusumu WATANABETeruyuki HIRANOYoshifumi HIRATAYoichiro HASHIMOTOHiroaki YAMANAGA
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2006 Volume 43 Issue 12 Pages 834-838

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Abstract

In order to improve medical record sharing between 5 acute phase hospitals (APHs) and 13 rehabilitation hospitals (RHs) in the course of designing a liaison-critical pathway for cerebral infarction, we sent out a questionnaire targeting APHs and RHs concerning the description items requested for medical records by each. The number of hospitals requesting description items was significantly greater amongst the RHs than the APHs in 4 items out of 14 common questions which were asked to both the APHs and RHs. Although most of the description items requested were already recorded, some items, such as the “itemized Barthel Index score” requested by the APHs, and the “explanation to the patient and family members” and “modified Rankin Scale” requested by the RHs, are recorded in fewer than half of the hospitals at present. We need to improve medical record usage and sharing between APHs and RHs, and to accomplish this we first need to know the specific data fields required by each. Designing and implementing a liaison-critical pathway may be the best way to solve this problem for our entire region.

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© 2006 by The Japanese Association of Rehabilitation Medicine
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