Is offshore outsourcing the future of medical record analysis? I certainly hope not. The purpose of a medical chronology is to isolate critical data for the attorney and his experts.

Attorneys need a focused chronology that isolates relevant facts with an explanation of why that fact is important. This allows them to formulate questionnaires and affidavits and prepare for depositions. They do not want hundreds of hours of billing.

The reason there are thousands of pages in record reviews is because facilities, hospitals and providers are asked to produce each and every EMR in their possession. An all-inclusive compilation of thousands of pages contains lengthy and irrelevant information, making it difficult for an attorney to find what s/he is looking for. Capturing this data requires only literacy, not discrimination on the part of the reviewer. An offshore reviewer can perform this task.

By contrast, nurses know hospital and office records, abbreviations and handwritten documentation, and we can weigh care delivered against known standards and guidelines. We are selective in the data extracted, and concentrate on the seminal event while noting pre-existing conditions and discrepancies in care. We do not skip pages that are difficult to decipher and we scan, choose and discard data rapidly. The merits or defense of a case take shape during this review, and those findings are shared immediately, as well as requests for missing documentation.

Without this informed review of records, the attorney is left with hundreds of pages of data that is a timeline, not a focused evaluation. The most thought-provoking data is always in the private Comments column (just remember to delete that column before sharing with a testifying expert).