(2) The health care provider is responsible for the day-to-day supervision
and maintenance of the inpatient record and for its completion, to include preparation of
the professional data on the ITRCS. The information provided on the ITRCS must be
adequate for medical, legal, and administrative purposes.
(3) The Chief, Patient Administration Division (P AD), is jointly responsible
with the health care provider for the preparation of the ITRCS and for other
administrative aspects of the ITRCS.
(a) The Medical Records Administration Branch acts for the Chief,
Patient Administration Division, in completing the administrative aspects of the ITRCS.
(b) While each medical treatment facility establishes the procedures for
processing the ITRCS, the Medical Records Administration Branch must ensure that the
ITRCS is accurate, coded, and complete and that the completed ITRCS is distributed in
accordance with AR 40-66 and AR 40-400 upon disposition of the patient.
a. Preparation. The ITRCS (DA Form 3647) is one of the forms initiated by
Admissions and Dispositions (AAD) at the time a patient is admitted to an MTF. It is
completed when the patient is transferred, is discharged, is returned to duty, dies, or is
a CRO case. The ITRCS comes in single or continuous form as a four-part carbon
pack. Usually, the last copy is used as a worksheet by the attending health care
provider. At the time of disposition, the information on the worksheet is transcribed onto
the remaining three forms.
b. Distribution of ITRCS. The ITRCS is distributed for completed or transferred
cases. The original and copies are distributed as follows:
(1) The original copy is placed in the ITR.
(2) The first carbon copy is placed in the patient's Health Record or
Outpatient Treatment Record, as appropriate.
(3) The second carbon copy is placed in the register number index, in
register number sequence.
(4) The third (or last) carbon copy (doctor's handwritten worksheet) is placed
after the original typewritten copy in the ITR.
NOTE: MEDDACs will maintain a register number index for 5 years. MEDCENs do
not need to maintain this index because the ITRs are maintained at the MEDCEN for 5
years. In facilities using the Composite Health Care System (CHCS) or Automated
Quality of Care Evaluation Support System (AQCESS), an automated version of DA
Form 3647 will be printed. The worksheet copy will not be provided.