Types of Medical Records

Question 1

What are the four types of medical records that can be used?

Answer 1

• Source-Oriented Medical Records (SOMR)
• SOAP documentation
• CHEDDAR Format
• Six C’s of Charting

Question 2

What are Source-Oriented Medical Records (SOMR)? And how is information collected and documented?

Answer 2

• Creating and preparing medical records

Information should be grouped by types:
* Progress Notes
* Laboratory
* Radiology
* Correspondence

Forms and progress notes are filled in reverse chronologic order (newest on top)