Chief Compliance and Ethics Officer Health Care

Falsified Medical Records

  • 1.  Falsified Medical Records

    Posted 9 days ago

    Falsifying a medical record is a crime no doubt. However, what do you do when a medical record has been submitted to you and it clearly has been altered by the patient outside of the EHR system? What would you do if this record was altered by an employee for a personal matter? Its not related to work, and it wasn't altered at work. Any thoughts and comments are greatly appreciated.

    Thank you 


    Rebekah Gilden
    Compliance and Privacy Coordinator
    Marietta Memorial Hospital

  • 2.  RE: Falsified Medical Records

    Posted 9 days ago

    Hi Rebekah!


    Do you know it's altered because the "original" document is in your system?  Or because the alteration was done so poorly? 


    I would think about contacting whomever the record originated from, and getting a copy of the original to compare it. If you can confirm it was altered, I would talk to the patient about their dishonesty, why it's important to have a truthful medical record, and why you're dismissing them from your practice (if applicable).  I would do the same thing if it was an employee who is a patient.


    Not saying this is what you are required to do, it's just what I think I would do in this situation.



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