Medical Record Review and Retrieval in Mass Tort Cases: What Attorneys Need to Know

If any aspect of a mass tort case can be characterized as fast, fun, or friendly, it’s not the process of retrieving and reviewing medical records. Firms handling mass tort cases may have a client list in the hundreds or even thousands, requiring them to identify, obtain, and review a staggering amount of pages, scouring them for key facts and connections. 

Though we’re no longer in the days of bandaging paper cuts after culling through boxes of blurry photocopies, poring through massive amounts of electronic medical data can still pose a resource shock. 

Attorneys need tools and strategies that provide faster and more cost-effective medical record review and retrieval for mass tort litigation. This starts with understanding the challenges involved and following best practices that maximize your access to actionable summary information as it develops.

Challenges in Medical Record Retrieval at Scale

Understanding the issues that arise with mass medical record retrieval can help you plan for the resources and time required.

Volume and Timelines

Mass tort cases include multiple deadlines, from client expectations to court dates. Often the most critical, however, are the discovery stages that guide case strategy and set the stage for pre-trial negotiations. 

You can’t wave a wand and have a stack of multiple medical records appear simultaneously, or even have all records for a single individual show up at once. Records will arrive over time frames affected by: 

• Organizational efficiency – Records management practices differ widely across institutions, each with its own request format requirements and language. Some may still require faxes or mailed requests vs. utilizing a streamlined electronic system.

• Prioritization – Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), healthcare providers have 30 days to respond to a written records request, with an additional 30 days if they run into difficulties doing so.¹ Regardless of the urgency of your need, outside requests may be given lower priority than record handling related to internal medical or bureaucratic needs.

• Discovery – Clients can rarely produce a comprehensive list of their health care records. A single event can involve different records from a healthcare facility, one or more physician practices, lab results, an ambulance provider, and more. One record request may unveil the need for additional requests to be submitted to other agencies.

• Client involvement – Records can be requested directly by clients, with their consent via signed releases or limited power of attorney, or without consent through subpoena or court order.² Each option can pose steps and paperwork that delay casework.

The volume of complex records needed to establish patterns of complaints, diagnoses, and treatments over time—especially for the number of clients in a mass tort case—makes record retrieval a layered and complex challenge.

HIPAA Compliance

The American Bar Association recommends that attorneys follow HIPAA guidelines (and any relevant state-specific healthcare data protection laws) when handling medical records, whether or not they’re currently acting as a business associate to a covered entity^3,4.

Law firm HIPAA compliance includes: 

• Selecting records retrieval and analysis partners who guarantee HIPAA compliance
• Staff training and HIPAA-consistent practices for anyone who handles records
• Limited, single-user access to a system that tracks file views and changes
• Security procedures for paper files and hardware storage, access, and disposal
• Adhering to protocols such as SOC 2 Type 2 and NIST Cybersecurity Framework

Common Bottlenecks and How to Avoid Them

Between human nature, bureaucratic practices, and legal standards, there are speed bumps to records retrieval that you’ll encounter in most mass tort cases. Look out for: 

• Client reluctance, confusion, or inefficiency
• Record departments not accepting standardized request forms
• Multiple rounds of requests after identifying missing information, results, or notes
• Delays for older files related to off-site and outdated media format storage

Actions that can help you avoid predictable delays include: 

• Adapt your intake and communication processes to facilitate client involvement
• Work with records retrieval specialists who follow and follow up on finicky processes
• Begin records retrieval early in your case timeline
• Leverage partners who can access and convert all media to optimal digital formats

Best Practices for Record Retrieval in Mass Tort Cases

Like most professional workflows, investing time to review and refine your record handling will pay off. Improve results and efficiency that support positive case outcomes with the following best practices.

Choosing the Right Retrieval Partner

Working with a medical records retrieval partner is a must for mass tort cases. Handling record retrieval just for a single client can be cumbersome, with multiple care providers necessitating lengthy records requests from facilities that have unique (and often inefficient) records departments. 

When you multiply that factor by hundreds or thousands, you need to identify a retrieval partner with: 

• A deep network of provider relationships
• The ability to deliver paper, x-ray, and digital records across multiple formats
• A HIPAA- and cybersecurity-compliant retrieval process  
• Hubs in multiple time zones
• Secure ordering, delivery, review, collaboration, and unlimited download
• Process serving capability

Streamlining Authorization and Follow-Up

If your medical records workflow includes a patchwork of different mediums and manual entries to handle authorization and follow-up, there’s room for improvement. Aim to: 

• Include medical records authorization as part of client intake
• Feed data directly into a secure and central client management system
• Use required fields and answer options that don’t allow clients to bypass them
• Have your retrieval partners review your forms and data collection for gaps

Include a collection plan for each set of identified records to track: 

• Origin with consent – Client/patient direct, signed release, limited power of attorney
• Origin without consent – Subpoena, court order 
• Request – Who, when, where, including confirmation tracking

Select a record retrieval process with detailed pursuit tracking, with automated project management tools to stay on top of communication, including immediate follow-up when:

• Records or responses from records departments are received
• Due dates are missed
• Files received are incomplete
• Additional forms and steps are needed by medical records departments

Conducting a Strategic Medical Record Review

Once you have a full deck of medical records, you need to untangle and make sense of them. 

Prioritizing Key Data for Legal Relevance

What exactly are you looking for? Medical records review starts by: 

• Confirming identification is correct (name, birthdate, etc.)
• Chronologically organizing records 
• Tagging records by key data, including providers, visit type, etc.

In addition, you may prioritize certain: 

• Practitioners or facilities
• Conditions, injuries, diseases, surgeries, and other health events
• Symptoms, diagnoses, misdiagnoses, tests, and treatments related to the above
• Keywords
• Billing and costs

Finally, medical record summaries can offer: 

• A succinct overview of a patient’s health history 
• Summarization of specific conditions, facilities, or other prioritized areas of concern
• Discrete sections and record extracts
• A hyperlinked table of contents 
• Identification of potential connections, missed opportunities, malpractice, etc.

Leveraging Nurse Reviewers and Legal Support Teams

You don’t hire a gardener to give you a haircut or a professor to fix your car. Assigning specialized work to those with the training and tools to get it done is job one for records retrieval and review. 

Legal support providers who specialize in medical records have the systems and knowledge to fulfill your needs as efficiently as possible. That’s partly built on experience, but their effectiveness also comes down to:

• Long-term, cordial relationships with major healthcare providers and insurers
• Enterprise software customized to track and move requests to completion
• Client delivery systems that incorporate user-friendly access and usage options
• Compliance officers who know HIPAA and other security frameworks inside out

Medical records review is a career field open to nurses and other healthcare practitioners. While it doesn’t take a registered nursing degree to handle the basics of organizing and tagging records, having access to medical professionals to fine-tune the interpretation of complex findings is critical. 

Using AI and Automation to Accelerate Review

Some of the major challenges of medical records review line up beautifully with AI strengths, making it an ideal use of artificial intelligence and automation. Particularly with mass tort litigation, consider: 

• An enormous volume of records
• Specialized terminology and industry practices
• Widely inconsistent organization of information from record to record
• Differing language and practices over time and between type and scale of provider
• Integration of handwriting, x-rays, photos, diagrams, audio files, and other formats

Leveraging AI trained specifically on medical records summarization and review can meet these challenges while overcoming the weaknesses of manual records review—too much time, too high a cost, misinterpretation, and even eye strain. 

Final Thoughts: Making Medical Records Work for Your Mass Tort Strategy

Securing and organizing medical records is a high hurdle for mass tort litigation, but the right practices and partners can expedite and streamline the process. Accurate and timely summaries and timelines allow your team to focus on case strategy and improve outcomes.

For nearly 30 years, U.S. Legal Support has provided top-notch, inclusive litigation support, including medical records retrieval, organization, and analysis. Our experienced team, 1.1M+ established provider relationships, and multi-time-zone hubs help us fulfill more than 400,000 requests each year. 

Additionally, we offer RecordSummary Pro™, an AI-powered tool that generates thorough medical record summaries organized into key sections with actionable intel in less time and for less cost than manual record summarization. 

Ready to learn more? Reach out today to connect with us on your medical records and other litigation support needs.

Sources: 

1. U.S. Department of Health and Human Services. How timely must a covered entity be in responding to individuals’ requests for access to their PHI? https://www.hhs.gov/hipaa/for-professionals/faq/2050/how-timely-must-a-covered-entity-be/index.html
2. American Bar Association. Collection of Medical Records: A Primer for Attorneys. https://www.americanbar.org/groups/litigation/resources/newsletters/products-liability/collection-medical-records-primer-attorneys/
3. LitPro. Mass Tort Compliance: A Guide for Attorneys. https://litprollc.com/mass-tort-compliance-a-guide-for-attorneys/
4. American Bar Association. HIPAA for the Family Law Attorney. https://www.americanbar.org/groups/family_law/publications/family-advocate/2023/winter/hipaa-family-law-attorney/

Julie Feller

Julie Feller is the Vice President of Marketing at U.S. Legal Support where she leads innovative marketing initiatives. With a proven track record in the legal industry, Juie previously served at Abacus Data Systems (now Caret Legal) where she played a pivotal role in providing cutting-edge technology platforms and services to legal professionals nationwide.