George H. Ramsey

Integration of Health Department Records

DURING the first 6 years of its existence the Westchester County Department of Health accumulated more than 500,000 partially or fully completed medical and nursing record forms. Of these, approximately 175,000 were primary records, the remainder being duplicates, special summary forms, and index cards. This heterogeneous mass of records was kept without reference to integration and according to the general scheme of having separate files for each unit of the department and for each specific service rendered. Thus, if the divisions of tuberculosis and nursing needed the same data regarding a case, the original record form was filed with the tuberculosis division and in addition a duplicate was made and filed with the division of public health nursing. Originals and duplicates in each division were generally filed according to residence of the individual they referred to. When some other method of classification seemed desirable, new sets of duplicates, or summary forms were made. Nearly every file had its own crossindex, separate and distinct from other