Home Forums Discussions General Discussion Fate of records in a closing office.

I am hoping that one more wise physicians or office managers on here can answer this question. I am very curious, because a pediatric office with about 2,000 patients is closing in about a week. Notice was given aobut three weeks ago.

The letter given out asked patients to pick up their records by the last day. They will be open for clerical things and the closing of the office for two more weeks. Many are transferring, and the records are being transferred. But, obviously, not all will be able to pick up his or her records in the next three weeks. I am hoping they mean pick up a copy of the records.

I believe the law states that they would have to keep a copy of the record for a certain period of time. I think in Maine it is six years past the 18th birthday. But, that isn't really the point of my question.

Given that patients will want copies of their records for awhile and, given that the records need to be kept and around for years, what is the responsibility of that physician? Is he responsible to maintain them and copy them until each patient is gone. Or does he have to keep the records until the law states? What if a patient asks for his or her record three years from now?

Just curious.

Bert,

I have wondered the same thing. I know there are docs here in my community that simply hand the chart over to the patient who then, if they transfer to me, hand the record over to me. I would be concerned if I were to be sued a year down the road for something and not even have the chart in my possession to use to defend myself! I suspect each state law is potentially different but I would venture to say we are responsible for the chart for the full 7 years (here in Indiana). This is one of my main motivations for going paperless. I figure it will be a lot easier to put the server in my house or wherever than the 4000 or so charts I now have. But then, one would have to maintain an accessible data base as technology changes over the years. Can you imagine having all your info on a beta VCR tape or an 8 track? So, that means one would have to be able to do continuous data conversions. These are questions to which we really need answers. When paper was king, this was never a problem.

Leslie

You mean none of my 8 tracks are any good. Here's a scary thought. My first song I ever had which was recorded was Tony Orlando and Dawn with Tie A Yellow Ribbon 'Round The Old Oak Tree on 8 track tape.

But, you said the exact same thing on my mind. So, the patient sues you, and the progress note that said, "If fever or patient gets worse, call or go to ED right away," is suddenly missing.

We have an old laptop that has XP Pro on it with the old EMR and our first year or so worth of records on it. As far as I'm concerned that old laptop is a mini-shrine to be bowed to every morning and we treat it like a god.

I say just the opposite, once you close and you have a workable format and you are the legal license holder of the OS or server software that the date can run on, freeze that machine in bronze and never mess with it again, take it off the net (virus protection) if need be, and just buy a new computer for your everyday needs. This machine and it's software are now your electronic archive and you need to treat it and care for it as such.... Forget it almost there except for reference.

And not to beat a dead horse but this is just another reason why I have been such a pain in the @$$ about you know what, the EULA.... Sorry Bert, but hey it fits....

PS: Bert do not under any circumstances accept any of his charts to care for... You will surely live to regret it. It is not worth the extra few patients. Many will chose to come to you anyway in such a small town set-up and those that don't want to now you have absorbed his problems and liabilities...

I'm sure you were not thinking of doing this, but just in case, stay far, far away my friend. This is his problem don't let him turf it to you. Let them transfere the old fashioned way, one at a time if they care to....

You nearly read my mind. I thought about it only as a thought. But, especially in pediatrics, I would be responsible forever. Then again, what a great business. Let's see 1,000 charts at $10.00 per first page and 35 cents thereafter. Hmmmm.

Now as to your first idea with the computer, my old records if they were just archived would be on a PC for easy manipulation, but they would also be burned to DVDs, one is a safety deposit box and one at home, etc. I mean if they were not changing daily.

Exactly, make them static once you are done with them forever as long as you own all the software needed in case of hard drive failure, that is the only real problem.

Now perhaps if this guy wants to move away you could start a separate company that handles all his issues for a nice fee, but be careful don't collect too much up front that then obligates you to do everything else for free.... I would just run like hell from this. They are now your patients for the most part anyway and some how he needs to get those records to you in a reasonable fashion or face the music. This is his cross to carry not yours. Seems like they have little other choice but to come to you anyway, so make him do the work and own the problems and say thank-you with a big smile everytime his does... One day this will be you holding on for dear life with AC and FAP hopefully. Or don't be too greedy and sell the practice even at a break even price, and now they new doc is on the hook.... Now that's the ticket. Pass the buck the correct way. "Check please" and leave....

In brief, my advice would be as follows (based on discussion with my wife/office manager who just completed a risk management seminar today from MICA, our physician owned malpractice insurer here in Arizona.)(Some of this will be the same as lstrouse's advice)

1. Never give up possession of the records. You have no recourse in case of malpractice suits, esp in pediatrics where your timelines are so long.

2. If the pediatrician is a friend of yours, have him contact the county (or state) medical society and see if they can help him set up a repository for record retrieval. Unless he dies, he is absolutely responsible for the records and their retrieval both by federal and state statute. Also, there are private companies that do this.

3. In Arizona you must have a written plan in place detailing disposition of your records if/when your practice closes. Under penalty of perjury you have to certify such a plan exists on your license renewal.

4. If in the end you decide to take possession of some of the records (which I wouldn't advise), you should execute written agreements with the other physician clearly detailing your obligations. I would contact your risk management/malpractice insurer for help in this area (MICA provides that type of advice free of charge for its members).

Best of luck.

Excellent post. That about sums it up. No, I am not really entertaining the idea of taking over possession of the records. The doctor may be leaving the country to retire, so it may become a mute point.

But we would all hope that he still has some sort of an access plan to his old records for the patients that will surely need them in the coming years... But again this is his problem, not yours. And don't make it yours either by assuming his....

I don't think the question was as much about worrying about him as I was just curious how it should be handled.