Home Forums Discussions Problems Transfer patient records

I will need to transfer multiple patient's Amazing Chart (version 5.0.29) records soon as I'm retiring this summer. I've used Updox for lab data, Word Documents for consult letters, and Excel spreadsheet for allergy vial data all under the patient's Import items tab.

My Plan A
All this can be fairly easily exported into a desktop folder designated for the patient, though it's from multiple sources. Then using Adobe Acrobat the contents of that folder can with one click be combined into one long PDF file. I anticipate sending this final PDF as an e-mail attachment, through Updox sent as a fax, or print it out for a patient to hand carry. A group located elsewhere has purchased my practice so it is anticipated most would transfer to them. They do not use EHR but, of course, have e-mail or fax capability.

Question 1
Is there an easier/simpler/better Plan B?

Question 2
Is there a quick way to total up the number of "active" patients? (after others have been designated inactive. Thinking of stamps her for mailing re closing practice, release forms)

Thanks

You could give them one computer with AC and your data on it - they could then print out the files as needed. You can also keep an inactive copy of data and AC on a computer for you to have....just a thought.

I strongly favor you keeping your records somewhere. You may need them for legal reasons down the road. You could upload your data to a service that will store them for you, along with a working version of AC.

Thanks Steven

At the practice closing date in June they will take possession of the computer with AC and data base. Their password would give limited access and a backup database will be maintained. That will make transition easy. One of the reasons I started with AC a few years ago was anticipating this transfer, namely avoiding handwritten scrawl, but I digress.

Legally the doctor-patient relationship ends at the closing date. Going forward after that date refills of previous prescriptions, allergy vials, etc are technically no longer valid. Therefore I am encouraging many patients to transfer and establish a new doctor-patient relationship before the closing date. It's during this 4+ month interval that legally the records should physically stay in my possession, though I'm sorely tempted to give them a cloned AC and data base now. Of course some patients will just want their records for themselves or another physician. The PDF conversion to fax, e-mail,or print out was the only solution I can come up with. Those transferring to the purchasing group would only need a "just the facts fax", so to speak, now since ultimately their whole AC chart will end up with there new physician.

Thanks Leslie

For sure the contract spells out the purchasers obligation to maintain said records and permission for my access re statue of limitations, wishes of my malpractice carrier, and State of Ohio regulations. As further safeguard I plan to keep a clone of AC and it's database securely locked away in my possession. When the statue of limitations runs out then the protocol to wipe hard drive, shred paper records etc is in place.

Another question

My first thought was the purchasing physician would access AC by setting them up as a user at Mid-level or medium security level. Only drawback is when something is printed from the chart a message is sent to the Provider for documentation. Since I won't be logging on the messages would pile up. No big deal but maybe not necessary at all and just set up the purchaser as highest level Provider. Am I correct in thinking there couldn't be any changes made to the original records I hand over? Anything added or subtracted would be under their user name. (Not paranoid, just want to be accurate)

With regard to your initial question #2: you could run a report on all patients seen during the past 1,2,3 years-whatever you think is appropriate- and use that for the mailing.

If your practice is being purchased, then after you leave, I agree with the above that you want to keep a version of AC for yourself; one that only you can access.
I like Stephen's idea that you give them a version of AC with a copy of your database. I see no reason to make their access limited; if they want to make changes (additions, etc) then they can do so. All will be documented in AC as changes made AFTER you stopped practicing.
My understanding is that generally when a practice is purchased, the buyer takes over the records and responsibility for managing those records. That is true with paper charts and should be equally true with an EMR. So patients that stay in the practice, they will have the record. For patients that leave the practice, as legal guardians of the medical records, THEY are responsible for sending out copies and otherwise managing the records. (In fact, one could argue that once they take possession, their version of the record is now the "official" version, and yours is just an out-of-date copy). What do you think?

Yes, mailing letters to all "active patients", i.e. those seen over past three years, is required and made easier in AC by selecting a patient, letter writer to patient, template "I am retiring...etc" and print. Not a big deal but it would be nice to instantly bring up a number who actually have been seen over say the three year period. AC assigns each patient an identifying number as they are logged in for the first time. One can't go by that absolute number as some came in once 4 years ago and never again. Others had data logged, a number assigned, and then were "no shows" as new patients. (the latter a not infrequent happening for a specialist). It looks like I'll just guess and buy a bunch of "Forever Stamps" The way postal rates go up any extras will "pay" better than a money market over time.



Yes, very true once they are in physical possession of the records. They can access, so to speak, the contents of the records but only after they have received a medical release of information form from the patient directing them or establishing a doctor-physician relationship. The rub is only one entity can physically possess said records at a time (we are not partners or members of an association/group). So their responsibility and, one might say, ability starts on my stop date (5 months hence).

As to their making changes after possession not being a problem that's reassuring.

Thanks Jon

I don't mean to belabor this but I suspect a number of AC users are solo practitioners and perhaps information gleaned here will help in the future. We all retire eventually except, of course, for Bert.

Just curious.
Any one hear of a situation in which the Admin PW holder (solo MD?), say, dies (or worse), and the records are effectively locked in the EMR?

Usually every company has a backdoor into the database. AC has the SA Password (also JB Has a hidden account on everyone's database) for the database if something of that nature were to happen, allowing them to extract all the records. Other web-based EMR companies have the ability to issue password resets also.

Sandeep, that presuposes that survivors know to contact vendor.
Just curious if anyone knew of a real world worst case.

Bob, this is exactly what I am talking about. Go to the reports section of AC and run a report of all patients seen in the past 3 years. Not only will that give you the number of patients, but you can use it to create a spreadsheet of addresses, then do a "mail merge" in Excel and print all of the letters at once (instead of one-by-one). Should be far less time and labor intensive that way.
That is what you would do sometime in the next few months, while it is still your practice.
If you have sent the above letters in the next few months, after they take over, management of charts and old records is THEIR responsibility, not yours.

I totally agree.

Jon

re using AC Report

Aha, I see what you mean. That really helps! Using AC report I was able to determine number of unique households and number of inactives. Thus I calculated total active patients which nails it for number of "Forever Stamps" to buy.

re mail merge and AC Report

I exported the AC Rolodex file of referring physicians as CSV file which works great with mail merge for envelope labels and "Dear Dr..." part of letters. Using Unique Households with the AC report would eliminate having to guard against duplicate mailings using my original thought of mailing individual patient letters using the AC letter writer. Of course the batch printing would be great too. If I use Unique Households and less than three years as the search criteria and then go to export is there a type of file it should be exported as for use in mail merge? My only experience with mail merge is "use existing file" and, as I mentioned, linking to a CSV file.

Thanks for your advice

Bob,
This is not my area of expertise (I would probably ask one of my kids for help ) but I think you can just export the list as a csv file and use that to do a mail merge in Excel that will send the whole stack of letters.

Jon

Can export as Excel file. My first attempts at using this Excel file itself, or after converting it to a CSV file, didn't go smoothly with mail merge. In label mode the names/addresses are populated randomly throughout the label sheet with many labels left blank or partially filled. Will sleuth and get back to forums if I find the solution.

Thanks again Jon, very helpful

Since they are buying the practice I would suspect that they would be, in effect, buying the license to AC. As such, they should be able to write orders and such, so they would need an administrative password.

The prior records are locked with a log of any changes maintaining the ability to document when changes are made. This should provide legal protection. I would certainly keep a copy of the database with AC. (I suppose it could be argued that you sold the license, but at some level I don't think this would be a problem, since you are retired and in good standing.)

Disclaimer: All of this, of course is from my "legal" standpoint of common sense, and the law is not always logical. Actual mileage may vary......

Check the excel sheet to see that the names are in a logical progression. Sometimes a comma may be missed and you get a string of letters in new columns which screw up everything.

Also look for hidden text (there is a setting to show hidden text) as it may expand a cell that is not visible to the eye ordinarily.

Finally, try a different avery setting and test print to a blank sheet of regular paper printing only 1 page and see if perhaps it's the wrong setting for the particular type of labels you are using.

These are all common issues I have run into in the past.

Thanks Wendell, will do

Wendell

Just when I thought all was lost, your post spurred me on to try again. Yes, there is a way to make the unique households report into an orderly Excel file for mail merge. (Jon, you said probably ask the kids for help. Well, a pediatrician's close)

In AC Report bring up unique households and export as Excel file. Delete blank columns. Then select all remaining columns and in Merge Center drop down menu select unmerge. Next under data tab choose Sort A-Z for names column. The latter choice leaves flotsam and jetsam isolated at bottom of long spreadsheet.

Each name field includes children etc. as well. Though a 7 year old may like getting mail, no reason to confuse the postperson. In the Excel file go to Data then Text to Columns. Use a delimiter to eliminate others in the household from the mailing address of labels. Also use Text to columns and a delimiter to make a column of just first names to use in the Greeting Line on mass mailing letters.

Then, of course, on to MS Word and mail merge.

Thanks....a real time saver