The hours before
Orders, medications, vitals and notes from the shift before, so the first warning sign shows up with its time.
cited timelineNewMissing Records Detection: flags every visit, provider, and date missing from the file. See how →
- Solutions
- Hospital risk management
Hospital risk management chart review services
The adverse event, minute by minute, from the chart your team already has.
Hospital risk management chart review for the risk manager and patient safety team after an adverse event. Medrecords AI reads the chart and builds 1 page-cited timeline of orders, results, medications, vitals and notes. It flags the gaps in charting, late entries and conflicting notes your root cause analysis has to explain. Your team makes the call.
Updated 3 Nov 2026
At a glance
| Built for | Hospital risk managers, patient safety officers, quality directors and peer review committees |
| The first job | The adverse event chart in strict order, hours after upload |
| Records it reads | EHR printouts, MAR, flowsheets, nursing and physician notes, orders, results, outside records |
| What you get | 1 timeline, every entry cited to its page, gaps and late entries flagged |
| Sentinel events | The timeline your comprehensive systematic analysis starts from |
| Speed | About 1 hour per case |
| Price | From 10 cents per deduplicated page, as low as 5 cents with volume |
| Security | SOC 2 and HIPAA, BAA signed at signup |
| Trial | First case is free on us |
| What it does not do | It does not judge care, assign blame, set reserves or decide privilege |
In a sample 342-page, 2-packet production, Medrecords AI found 11 duplicate pages. You pay for unique pages only.
- HIPAA, under a BAA
- SOC 2
- About 1 hour per case
- First case is free on us
1 inpatient fall on an anticoagulant, 1 nighttap a point
Nursing and vitals
Orders and medications
15 Feb 2025, 06:20Neuro checkNursing and vitals
Drowsy. New left arm weakness. No neuro check charted since 03:00.
Illustrative case. The patient, times and pages are fictional.
45business days
To finish a comprehensive systematic analysis and action plan after a sentinel event.
The Joint Commission, Sentinel Event Policy5requirements
Every hospital chart entry must be legible, complete, dated, timed and authenticated.
42 CFR §482.24(c)(1)1 hourper case, on average
How long a typical case takes after upload.
Medrecords AI11duplicate pages
Found in a sample 342-page, 2-packet production before billing.
Medrecords AIWho should use hospital risk management chart review?
Risk managers, patient safety officers and quality teams who rebuild an event from the chart, and peer review committees who need the packet before the meeting. If your RCA team spends the first week printing and highlighting, start here. If the event is 1 short ED visit with 20 pages, you probably do not need it.
Does Medrecords AI decide what caused an adverse event?
No. It rebuilds the event from the chart in strict order, with pages, and flags the gaps, late entries and conflicting notes. The root cause analysis, the peer review finding and any judgment on the care belong to your team and your committee.
What should hospital risk management review the chart for after an adverse event?
The first read of an adverse event chart is the slowest part of the review: 3 shifts, 4 kinds of notes and a MAR that runs on its own clock. These are the 6 things Medrecords AI pulls out of it, each flagged with its page.
The gap in charting
Every stretch without the ordered vitals or neuro checks, with the entry on either side and the length of the gap.
gap in chartingNotes that disagree
A nursing note and a physician note that describe the same minute differently, side by side with both pages.
contradictionLate entries
Notes written after the event for an earlier time, flagged by the time stamp in the note. The EHR audit trail is listed as a record to request.
late entryOrder to result
Each order beside the time it was carried out, so the delay from an order to a scan is a number.
order to resultWhat the file does not have
Monitor strips, MAR pages or consult notes the chart refers to but the file does not contain, listed by date.
missing recordsHow does an incident report line up with the chart?
The incident report is written after the shift by the people involved. The chart was written during it. Side by side, the fall above shows where they agree and where they do not.
| Date | Source | Finding | Page | Flag |
|---|---|---|---|---|
| 15 Feb 2025, 00:15 | Nursing flowsheet | Fall risk score high. Bed alarm on. Hourly rounding. | p. 231 | cited |
| 15 Feb 2025, 02:10 | Nursing note | Found on floor beside bed. No head strike noted. | p. 238 | conflicts with p. 241 |
| 15 Feb 2025, 02:50 | Incident report | Unwitnessed fall. Bed alarm found off. No injury. | IR p. 2 | conflicts with p. 231 |
| 15 Feb 2025, 06:20 | Neuro check | Drowsy. New left arm weakness. Last check 03:00. | p. 247 | gap in charting |
| 15 Feb 2025, 07:30 | Nursing note, late entry | Late entry for 04:00: sleeping, easily arousable. | p. 249 | late entry |
| Date | Source | Finding | Page | Flag |
|---|---|---|---|---|
| 14 Feb 2025, 23:30 | Medication administration record | Apixaban 5 mg given. | p. 214 | cited |
| 15 Feb 2025, 02:35 | Covering physician note | Patient states she hit her head. Head CT and hourly neuro checks ordered. | p. 241 | conflicts with p. 238 |
| 15 Feb 2025, 06:55 | Head CT report | Acute right subdural hematoma, 9 mm. | p. 262 | order to result 4 h 20 min |
Fictional case built for this page. Real output has the same columns, and every page links to the source PDF.
Rerun 1 closed chart review your team already knows.
Send 1 closed adverse event or claim chart your team already reviewed. You get the chart chronology and a list of gaps on the standard-of-care timeline, each cited to its page. We review it with you on a call, next to your own findings.
What goes into a claim file and a peer review packet?
What you send
- The EHR printout or export for the admission
- MAR, flowsheets and nursing notes
- Orders, results and imaging reports
- Your incident report, if you want it on the timeline
- Prior admissions and outside records
- Any format: PDFs, scans, faxes
What you get
- 1 timeline merged across every source, down to the minute
- Gaps in charting with their length
- Late entries and conflicting notes, both pages shown
- Order to result times
- A missing-records list
- A packet the reviewing physician reads before the committee meets
We rebuild the chart. Your committee judges the care.
Medrecords AI does not decide the root cause, whether care met the standard, whether a claim has merit, what to reserve or what is privileged. Your team makes the call, and the reviewing physician signs any opinion.
BAA signed at signupCharts are handled under our Business Associate Agreement from the first upload.
SOC 2Encryption in transit and at rest. Every access to PHI is logged.
Never trains a modelYour charts never train any AI model.
Retention you setDeletion on request, with an access log you can review.
What does a sentinel event review and root cause analysis need from the chart?
The Joint Commission defines a sentinel event as a patient safety event that reaches the patient and results in death, permanent harm or severe temporary harm, and is not primarily related to the natural course of the illness or underlying condition. Its Sentinel Event Policy expects a comprehensive systematic analysis and an action plan within 45 business days, and reporting the event to the Joint Commission is voluntary. Medicare's QAPI rule, 42 CFR 482.21, already requires hospitals to track adverse patient events, analyze their causes and put preventive actions in place. Every method, including the one in the AHRQ primer on root cause analysis, starts from what happened, in order. Medrecords AI builds that sequence. Why it happened, and what changes, is your team's analysis.
Who reads the timeline after it is built?
The same cited timeline serves each reader. None of them has to start from the raw chart.
Early claim assessment
When a records request or a claim arrives, the timeline shows on day 1 what the chart documents and what it lacks.
missing-records listThe RCA team
The team starts its first meeting with the sequence agreed, and spends the time on why.
cited timelineThe peer reviewer
The reviewing physician gets the packet before the committee meets, with every entry linked to its page.
page-citedTrend review
Gaps in charting and late entries from each event, in the same format, so a pattern across units can be seen.
flagsHospital risk management chart review: common questions
Does Medrecords AI decide what caused an adverse event?
No. It rebuilds the event from the chart in strict order, with pages, and flags the gaps, late entries and conflicting notes. The root cause analysis, the peer review finding and any judgment on the care belong to your team and your committee.
Is the timeline protected as patient safety work product?
That depends on how your organization collects and reports it under the Patient Safety and Quality Improvement Act and 42 CFR part 3, and on your state's peer review statute. Medrecords AI does not decide privilege. Your team and counsel do.
Can it handle an EHR printout of several thousand pages?
Yes. A case takes about 1 hour on average.
Does it read flowsheets and the MAR?
Yes. Flowsheet vitals, neuro checks and MAR entries are placed by their own time stamps beside orders and notes.
Does it find late entries?
It flags notes whose time stamp shows they were written after the time they describe. The EHR audit trail is listed as a record to request. It is not analyzed.
Can it build the packet for peer review?
Yes. The cited timeline and the missing-records list go to the reviewing physician before the committee meets. The peer review finding is the committee's. Whether HCQIA protections apply, and any required National Practitioner Data Bank report, are for your organization and counsel.
Do you retrieve records from other facilities?
No. Medrecords AI does not retrieve records. You upload what you have, outside records included, and they are merged into the same timeline.
Is it HIPAA compliant?
Yes. Charts are handled under a BAA signed at signup, with SOC 2 controls. Records never train an AI model, and deletion is on request.
What does it cost?
From 10 cents per deduplicated page, as low as 5 cents with volume. Duplicate pages are free, and the first case is free on us.
Does it replace our root cause analysis?
No. It replaces the week of printing and highlighting before the RCA. The analysis, the action plan and the findings stay with your team.
Send 1 adverse event chart. The first case is free on us.
Book a short demo. After it we open trial access on one of your own charts, the first case free on us, with the timeline back page-cited.
Further reading
- Medical chronology for physiciansDated events, page citations and a clinician who signs, for standard-of-care review and the IME report.
- Evaluating Medrecords AI: FAQ16 answers on SOC 2 and HIPAA, the BAA, citations, who signs and price per page, each with its source.
- What 1,000 pages of review costs10 AI vendors with a public price: $19 to $299 for 1 file of 1,000 pages, median $154.50.
Sources
Every rule, regulation, statute and published standard named on this page is linked below to the text the body that issues it puts out, read on the date shown. Where a standard is sold rather than published, the link goes to its publisher's page for it.
- The Joint Commission Sentinel Event Policy: The Joint Commission, read 3 Nov 2026
- AHRQ PSNet primer on root cause analysis: Agency for Healthcare Research and Quality, read 3 Nov 2026
- 42 CFR 482.21, quality assessment and performance improvement: eCFR, read 3 Nov 2026
- 42 CFR 482.24, medical record services: eCFR, read 3 Nov 2026
- 42 CFR part 3, patient safety work product: eCFR, read 3 Nov 2026
- 42 U.S.C. 11101, Health Care Quality Improvement Act: Legal Information Institute, read 3 Nov 2026
- National Practitioner Data Bank: HRSA, read 3 Nov 2026
Related guide: Medical chart audit: how to run one that holds up