Clinic records evolved to keep track of 1 million patients
History tells us that Dr. Will Mayo said "the best day’s work I ever did was the day I hired Henry Plummer."
Dr. Plummer came from the little community of Hamilton in Mower County, about 4 miles southeast of Racine. His father, Dr. Albert Plummer, was a country doctor.
The young Plummer joined Will and Charlie Mayo about the turn of the century and was on staff for the new Saint Marys Hospital, a 27- to 30-bed facility built in 1889. This was before a clinic was built. Dr. William Worrall Mayo, father of Drs. Will and Charlie, had an office in the Cook Hotel with any record-keeping certainly a "struggle."
Henry Plummer was painfully aware of their social responsibility and that most of the records in use did not meet that responsibility. This is taken from "The Doctors Mayo" by Helen Clapesattle written in about 1941 after their deaths in 1939.
According to this historical page shared by Matt Dacy of the Mayo Heritage Division, Dr. Plummer set out to devise a system for numbering and record-keeping. He traveled to other hospitals to see what they were doing. He just didn’t receive much assistance from medical men. But Drs. Will and Charlie agreed there was a need for better record-keeping.
Until the time in 1907 the system was following individual ledger "jottings" for individual patients.
The dossier system Plummer evolved has become a model for medical records. Each patient upon arriving at Mayo Clinic was given a number, and ongoing visits were put together for record-keeping. Until the computer system took over record-keeping, many of us remember visiting our doctor as he called by phone to send over the patient’s records.
You saw a glass cylinder filled with all the hand-written history. These came through a pneumatic tube to the doctor’s desk. When the patient’s visit was concluded that day, the records were updated and sent back.
As Dr. Plummer studied the record-keeping situation, he received approval to hire Mabel Root, of Rocheste,r to assist him. According to notes by Clark W. Nelson, who was long involved in the Mayo Historical Unit, Mayo Foundation, Mabel and Plummer put together the "Plummer-Root" medical file, which started with six wooden cabinets, originally kept in the Masonic Temple building.
Mabel and staff kept updating and card-filing and cross-indexing. Numbers were "batched" together originally after they reached 100,000. Dr. Plummer felt for this reason early registration numbers would be prefixed by the letter "A." They intended to do the next 100,000 prefixed with the letter "B" and so on. Clark Nelson wrote in "Mayo Roots: Profiling the Origins of Mayo Clinic" it was later decided that this would cause confusion.
A decision was made to let the numbers grow in simple numerical sequence. Today Mayo Clinic has expanded nationwide.
Nelson spent considerable time at Mayo Clinic working historically. He often explained the "Mayo story" which is really too big for one person. He told me "the success of Mayo shows tremendous dedication to the care of each patient and family and the fact that employees have a chance to grow and move up to the next position, if desired."
This goes back to that statement by Dr. Will Mayo: "The best interest of the patient is the only interest to be considered."
Dr. Will Mayo next saw the need for better financial control and record-keeping. He hired a young banker, Harry J. Harwick, from First National Bank. He began his work in 1908 to keep their payroll without crowding it on the back page of a single checkbook.
Many doctors were ordering their own medicines and collecting from some patients. According to Clapesattle in "The Doctors Mayo," doctors would come in at the end of the day and dump cash and coins on Mr. Graham’s desk. Harwick took over purchasing and everything financial and had things running smoothly by 1910.
Matt Dacy says Mayo has more than 7 million records, paper and electronics, on file. In 2011, the approximate patient count of all Mayo campuses was 1,113,000.
Next week’s Back and Forth column will have another Mayo Clinic story, and the numbers are astonishing.