Well, here goes. My completely uncaring different approach.
First, we get very few records through the mail. Mostly, they are faxed and a one page document takes up about as much space as a 250 page document. My staff labels it records, I import it, and that's that. I literally spend about five seconds on it. I do consults, and I would go through those, but I don't care at all what is in those records. I am assuming the patient's physician has already seen and dealt with those records. The responsibility is on parent or patient to let me know what is in the record. My MA and I ask them if there is anything in the record we should know about.
As far as if it is mailed, we scan it is, and shred the paper. We want the entire record.
When we send records, we usually send them via fax and scan if they are under 50 pages, otherwise we burn them to a disk and mail them. The way our software is set up, we can send all records, progress notes and vaccine record to the server, and it automatically makes a folder with their name. All of the information is automatically categorized so that when we combine them, it has the release on top, then the vaccine record, then the progress notes by date, then all records by category, i.e. cardiology, consults, demographics, discharge summaries, ED, Histories and so on up to orthopedics. On the very top of the PDF, is a sticky note with the number of pages and the charge for sending the record. The letter to the parent for the invoice is kept separate (if this is a transfer).
The record cannot be sent until an electronic stamp is stamped saying it is reviewed and OK for transfer. The front staff then burns the pdf to a CD (takes about 3 minutes after they stamp the date and time they sent it.
If it is simply a transfer for another reason, I just approve it via AC, and they do it. The whole process takes about 15 minutes from start to finish. The nice thing is that the record is always there when the other office calls and states they never got the record. If the patient wants a copy, it is on disk. We do NOT print the records. We never use a sheet of paper. The Xerox MFP has a huge hard drive also where these could be put.
We make a point not to send the messages as we think of these as work product. I wish I could get in the habit of not saying derogatory things in these comments. But, the receiving office never notices. When an attorney subpoenas it is it kind of embarrassing.
As to sending records for consults, we ask if they want the entire record. Most want the last progress note, etc. I find the histories and discharge summaries along with consults and labs, etc., are better than anything I type in five minutes in the room. If I know I am referring them, then I type a masterpieces. The crazy thing is that still in 2016 we have health facilities who do not receive records in a pdf. Massachusetts General Hospital still goes through reams of paper and yells at us if we send too much.
As to asking for certain records, personally I want the whole record. I really want to have all the information available, and it's not fair to the patient to have to ask for two or more offices to send records if they transfer again. It is completely legal for an office to send every page of their records, and if they don't after we call them, I contact the Board of Medicine. That works every time.
