Clinical accuracy is not the same as linguistic accuracy
A medical record may be read by a doctor making a treatment decision. That raises the consequence of an error well above the usual, and it changes how the work is done.
Two principles govern it. First, clinical content is rendered precisely, never approximated. A dosage, a frequency, a laboratory value and its unit are transcribed exactly. Where a figure is ambiguous in the original, it is flagged as ambiguous rather than resolved by inference — a translator guessing at a decimal point in a dosage is a genuine hazard.
Second, drug names are handled by generic name. Indian brand names frequently do not exist in other markets, and a foreign clinician reading an unfamiliar brand cannot identify the molecule. We give the generic name, retaining the brand as written in the original so the record remains faithful to what was prescribed.
Handwriting
A substantial proportion of Indian clinical documentation is handwritten, and handwriting is where this work becomes difficult. Prescriptions and ward notes in particular are often abbreviated, written quickly, and use conventions that vary between practitioners.
We do not guess. Where a term cannot be read with confidence, the translation marks it as illegible at that point rather than supplying a plausible word. This occasionally frustrates customers who want a clean document, but an invented drug name on a record a doctor may act on is not an acceptable trade.
If you can obtain a typed discharge summary from the hospital records department, it is almost always worth doing. It produces a better translation, faster and more cheaply, and hospitals will usually provide one on request.
Investigation reports and reference ranges
Laboratory and imaging reports carry reference ranges, units and sometimes methodology notes. A value without its reference range is close to meaningless to a clinician working in a different system, where the normal range for the same test may be expressed differently.
Reference ranges, units and any note about the assay method are translated along with the values. Send the complete report rather than the page showing the numbers.
Who signed, and are they registered
Records carry the treating doctor’s name, qualifications, registration number and the institution’s details. Foreign authorities and insurers use these to confirm the record came from a qualified practitioner.
This is translated in full, including the registration authority. An insurer assessing a claim will check it, and a record whose author cannot be identified is a record they can decline to rely on.
Confidentiality
These are among the most sensitive documents anyone sends us. They are seen by the translator and the checker and nobody else, they are never used as samples in any form, and they are deleted on request. Our handling is set out in the privacy policy, which is worth reading before sending medical records to any agency.