What Are the Disadvantages of Alphabetical Filing of Medical Records?

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Alphabetical filing is one method of managing medical records. Files are organised by surname and further broken down by first name. While alphabetical filing has the advantage of being one of the easiest filing methods for new employees to learn, this system of organisation also has some disadvantages.


Names that are misspelled or misread may be inadvertently filed in the wrong location. Another potential cause of misfiling is that different employees may have different interpretations of the way a patient's record should be filed. Foreign names---especially names beginning with Mac or Mc---are frequently misfiled.

Locating a misfiled record increases file retrieval time. If a file isn't found, a file-by-file search may be necessary, costing substantial time and resources.

Duplicate Names

In a large medical office or facility, there is the potential for more than one patient to have the same name. A file clerk may have to look at more than one file to determine which one is the one needed. If a duplicate name results in the wrong file being retrieved for a patient, the patient's doctor may end up prescribing treatment or medications based on the information in the medical record. A patient may potentially be harmed by this mistake.


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The potential for a breach in patient confidentiality is one of the most serious disadvantages of the alphabetical filing system. Names listed on file folders may be seen by anyone working in a medical office. If the office provides only a specific type of care, then someone seeing a patient's name will know his medical issue.

An alphabetical system also increases the risk that unauthorised personnel can find a patient's file. Unlike numerical systems, in which the person retrieving the file needs to know a patient's number, finding a record in an alphabetical filing system requires only the patient's name.

Name Changes

If a patient's name changes after her initial file is generated, it could cause confusion on her future visits. Names may change due to marriage, divorce, adoption or legal name change. If the name on the file folder isn't updated, clerks must cross-reference the current name to find the folder with the old name.

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