Medical record automation and child abuse/neglect

Medical records may be important for family violence case management and for quality control in medical systems. Problems include conflict about record sharing within the health system and with outside agencies. Automating medical records will make that conflict more visible. Sharing the issue of family violence in medical systems may damage a patient or family with negative responses from medical staff or public disclosure of allegations. Failure to share these records in house or with out side agencies may leave a victims unprotected. Sharing records is particularly important and problematic with records for young children. A statewide network in California to address nonfatal severe child injury and possible abuse will provide some focus on the issue of record sharing and the need for automation to share or to hide information. The California system includes contacts in 50+ hospitals that serve more than 80% of all children under age three hospitalized for injury. The population is monitored with hospital discharge data including some data on child death and on injuries coded as abuse related.. Hospital data to be collected includes a match of injury records with internal records of child. The initial record match is necessary for case management and for quality control. Medical records may have enough automation to be collected but child abuse report are not Automation of these records will help call the question of what can and should be shared.