NAME OF SYSTEM: Medical Record Storage ORIGINATOR: Armed Forces Institute of Pathology 6826 16th Street, Washington, D.C. 20012

A special device enables the operator to semiautomatically insert from one to as many as 15 page images in one operation. This insertion technique permits new documents to be added to a patient's jacket record after each period of hospitalization or treatment. The microfilm jacket used by the Institute is transparent and measures 5 x 8 inches. It is formed by joining two sheets of plastic to provide six rows of horizontal slots for inserting up to 15 image strips of roll microfilm per slot. Each jacket may thus hold up to 90 images with additional jackets established when a patient's record exceeds 90 pages. An opaque stripe is provided on the top of each jacket for showing identifying data in normal size print, and the jackets are maintained in paper folders for ease of withdrawal from the file and for control purposes. The microfilm jackets are stored in motorized rotary files. When a researcher wishes to retrieve a particular patient's records, the appropriate jacket is temporarily removed from the file, and a duplicate microfiche copy is made for his personal use and disposition. The doctors and other professional people view the filmed images on a microfilm reader located in their individual work areas. The user may position the jacket in the reader through use of control knobs and identification markings. Whenever desired, a paper enlargement of a particular image is made by the central file unit and sent to the user. R E M A R K S . The conversion of the former large and bulky conventional document storage system to this miniaturized Medical Record Storage System has resulted in numerous benefits, such as the great reduction in space committed to document storage; the preservation of valuable records and improvement in control over the document files due to the fact that the master film record never leaves the control unit; the relatively easy method of adding new material to the established jacket file; and the capability for making individual patient's records available to more than one user at the same time.

O B J E C T I V E . To develop a document storage system that will reduce the total space committed to the Institute's voluminous medical history case file and to improve the overall efficiency of the document handling function. BACKGROUND. The Armed Forces Institute of Pathology is responsible for basic research in all areas of pathology. Over the years it has accumulated a medical history case file containing over one million cases from all parts of the world. New case material is received daily while many onhand cases continue to remain active and to require periodic updating actions. This continuing document file expansion created space problems and reduced search effectiveness. To better insure that the professional staff's document needs are properly met and that individual patient's records can be made simultaneously available to more than one user, a study group recommended adoption of a microfilm jacket method to solve the space and document retrieval problem. T H E N E W M E T H O D . The first action in converting to the microfilm jacket system consisted of screening the patient medical records, arranging the papers in chronological order, and preparing a log sheet. These medical history documents included such matter as typed reports, charts, graphs, and forms. After other minor actions to insure proper order and control over individual patient records, the documents were microfilmed on a portable, rotary type microfilm camera. After developing, the exposed film was inspected, cut, and inserted into the microfilm jacket slots in a single operation.

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MEDICAL RECORD STORAGE
I N P U T PROCESSING

STORAGE

SEARCH AND RETRIEVAL

Individual Medical Record

Microfilm Jacket File

Search Request

Film Processor ,

Individual Microfilm Jacket

16-mm Microfilm

Film Duplicator j

Microfilm Jacket

Microfiche Copy

Reader

1. R e c o r d s a r e b a t c h e d , m i c r o f i l m e d , d e v e l o p e d , and cut into f i l m s t r i p s of 15 i n c h e s o r l e s s . 2. F i l m s t r i p s a r e i n s e r t e d into p l a s t i c 5 x 8 inch m i c r o f i l m j a c k e t s holding up to 90 i m a g e s .

M a s t e r file c o n s i s t s of o v e r one m i l l i o n individual c a s e s s t o r e d in m o t o r i z e d r o t a r y files in c e n t r a l file unit.

1. M e d i c a l p e r s o n n e l and o t h e r u s e r s request patient documents by n a m e . 2. F i l e request to-film u s e and c l e r k t e m p o r a r i l y removes) j a c k e t and d u p l i c a t e f i l m i s m a d e for u s e r s p e r s o n a l | disposition.

3. U s e r h a s option of viewing m i c r o f i c h e copy on r e a d e r or obtaining p a p e r e n l a r g e m e n t f r o m c e n t r a l file u n i t .

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