f. Access and Audit Trail. Access must be given to ITRs on file or to cases
having register numbers. In addition, a record audit trail must be kept. Two indexes will be
kept for this purpose, the nominal index and the register number index.
(1) Nominal index. The nominal index will include a card for each patient
assigned a register number. Each card will list the patient's name, SSN with FMP, and
register number. The cards will be filed alphabetically by last name. If the patient is
transferred, the date of transfer and the name of the receiving MTF will be noted on the
card. A manual nominal index is not required for those MTFs using AQCESS (Automated
Quality of Care Evaluation Support System), CHCS (Composite Health Care System), or
other automated patient data systems.
(2) Register number index. A MEDCEN does not need to maintain this index,
because the ITRs are maintained for 5 years. A MEDDAC (Medical Department Activity)
will maintain a register number index for 5 years. The register number index will include a
copy of DA Form 3647 for each patient assigned a register number. A copy of SF 502
(when prepared) may be attached to the DA Form 3647. This index will be kept in register
number sequence. For transfer cases, a copy of the transmittal form will be attached to
DA Form 3647.