Search results
Results from the WOW.Com Content Network
The classroom as documentation (reflections and documentation of the physical environment of a classroom). [13] Documentation is certainly a process in and of itself, and it is also a process within the educator. The following is the development of documentation as it progresses for and in the educator themselves: Develop(s) habits of documentation
Electronic nursing documentation is an electronic format of nursing documentation an increasingly used by nurses. Electronic nursing documentation systems have been implemented in health care organizations to bring in the benefits of increasing access to more complete, accurate and up-to-date data and reducing redundancy, improving ...
An inactive record is a record that is no longer needed to conduct current business but is being preserved until it meets the end of its retention period, such as when a project ends, a product line is retired, or the end of a fiscal reporting period is reached. These records may hold business, legal, fiscal, or historical value for the entity ...
A document management system (DMS) is usually a computerized system used to store, share, track and manage files or documents. Some systems include history tracking where a log of the various versions created and modified by different users is recorded.
These vendors have historically provided electronic document management systems and have acquired smaller records management system companies. The seamlessness of the integration and the original intention of the records-management component to manage electronic records typically sets the complexity of deploying and potentially of using the ...
Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
Internal control, as defined by accounting and auditing, is a process for assuring of an organization's objectives in operational effectiveness and efficiency, reliable financial reporting, and compliance with laws, regulations and policies. A broad concept, internal control involves everything that controls risks to an organization.
The information contained in the medical record allows health care providers to determine the patient's medical history and provide informed care. The medical record serves as the central repository for planning patient care and documenting communication among patient and health care provider and professionals contributing to the patient's care.