For sexual assault victims, it means the crime lab may be able to test their kits faster. For investigators, it means faster and easier access to secure files. And all for $50,000.
On July 1, Utah became the first state to implement an electronic forensic medical record system that spans all 29 counties, said Susan Chasson, a sexual assault nurse examiner with the Utah Coalition Against Sexual Assault.
A similar system has been in use since 2017 in Salt Lake and Utah counties, accessible by the Wasatch Forensic Nurses, said Julie Valentine, a forensic nurse with the group. But an annual $50,000 grant funded by the Utah Legislature allowed the system to expand across the state.
"Now, every nurse who does a medical forensic exam for an adolescent or adult patient has access to this record,” Chasson said. "We’re all using the same form. It’s all stored in the same place.”
Sexual assault nurse examiners, or SANEs, are registered nurses who have specialized training to assist patients who have experienced sexual assault or abuse. In addition to treating a patient, these nurse examiners collect evidence that could be used in a court case.
SANEs throughout Utah now have access to an electronic system, called FeMR, that was developed by the husband of one of these nurses in Arizona, according to Chasson, Utah’s statewide SANE program manager. The system is encrypted and compliant with federal health care privacy provisions, she said.
When SANEs perform a sexual assault exam, sometimes referred to as a rape kit, they take three photos of every injury, Valentine said. One is taken from far away to show which body part is in the picture, another is close up and the third is a close view with a ruler, she said.
“That’s always been a concern, is where do you store these very sensitive pictures?” Chasson said.
Camden Caifa, program director of Southwest SANE II in Washington County, said her team used to burn the photos onto two discs using a computer that was not connected to the internet. One was stored with a patient’s file in a fireproof cabinet at a hospital, while the second was put in a security deposit box at a bank.
Having a secure electronic system "really makes me, as a program director, happy to know that maybe I can sleep a little easier knowing my records are safe,” Caifa said.
All SANE teams had their own ways of securing their paper and photo records in the past, Chasson said, but the new system will prevent records from getting lost if a program closes or if there’s a natural disaster.
The system also helps the state crime lab and law enforcement get quicker access to the reports, Chasson said. If the state crime lab has a kit but no report yet, “all testing on that kit stops” until the lab gets a copy of the report, “which can result in days/weeks of needless delay," Jay Henry, laboratory director of the Utah Department of Public Safety, said in an email. The new system can help the lab process a kit faster.
The electronic records will also provide continuity among SANEs and their records across the state, according to Valentine. They can use the system to conduct peer reviews to help improve the work of smaller programs in rural areas that may not get as much practice as other regions, Chasson said. While nurse examiners in the Salt Lake City area may do hundreds of exams a year, those in Sanpete County probably do a handful, she said.
“You just don’t get the same level of skill," Chasson said, “but through peer review, you can improve what you’re doing.”
With the electronic system, Chasson said, “we can get on the computer, look at their charting, look at their pictures and say, ‘Listen. You could’ve done this a little differently. You could’ve worded this differently. Is there a reason you didn’t document that?'"
Caifa said her team has 10 nurses who handle about 70 cases a year. They do their own peer review within their team, she said, but reviewing their cases with other teams “can help us identify things that we may not have identified before."