Home Forums Discussions General Discussion inactivating patients

As I do Pediatrics, and I have been using AC for a long time, there are many patients that no longer see me.

I have considered inactivating them. I should know the answer to these answers, but:
1) What are the advantages to deactivating them?
I do understand they will not show up on the main screen and will not show up most reports that include active patients,
but are there any other benefits I am not considering?

2) How could I do this in bulk (i.e deactivate all patients not seen in 5 years or > 22 years of age)?

Wendell,

Best way to do this in bulk is to run a report for the patients you want to inactivate. Once the report runs, right click on the patient in the generated list and select "Inactivate Patient".

You cannot inactivate multiple at once, but this is the fastest way IMO to inactivate a group of them.

OK, great. That I did not know, but other than the advantages I put forth above, are there any other reasons to inactivate patients?

Besides what you already stated, there is no real reason to inactivate a patient.

I may have a heightened sense of risk aversion, but I feel like we need to close the loop on patients. If a patient is active on the chart system, they are "active" in my practice. If they are active in the practice, they need to be followed. If someone has not been in for 3 years, they should have a letter (probably much sooner than that) letting them know they are due for a wellness exam or well-child check. (We try to set people up for their NEXT wellness at each exam every year). If they do not respond, then I inactivate them. What if someone has a problem that you wanted to address in time, but they never came back in? Do you have any record that you reached out to them and tried to follow up? What if they just don't show up for 3 years, but then come down with a breast cancer? There have been court cases lost where the primary doctor did not recommend adequate and timely screening tests for such things.

I'm no lawyer, so ask your own for advice. But, I say you don't want inactive patients sitting active on your books. Ask them to come in. If they do not, tell them you are closing their file and they need to follow up with a primary doctor. I regularly run a search of all patients not seen in the last 3 years and send letters. I deactivate people who leave or who are discharged. If you go into my admin options you will see how many patients are active in my practice. That is very useful for evaluation the health and growth of the practice.
In addition, you HAVE to do this if you are going to do meaningful searches, for instance: a search for all ACTIVE patients with an A1c >8.0. Keep accurate books is one of the keys to having a successfully managed practice.

I agree with Chris. Plus, my CMA drills me daily about this. Well, weekly. It screws up her vaccine inventory. I am not sure how it works with importing files, as we use a 3rd party program, but if the patient left the practice even six months ago, and we get a consult note or lab, etc., if they are still active I will review it and may, embarrassingly call the patient to have them come in or do something like a follow-up lab. With the patient inactive, it won't name the file or import it. Therefore, I check demographics and see the transfer.

Generally, it is easiest to notify Health Information Systems and ask them to remove us as the primary. We send the consult note back to the consultant. We call the lab to let them know they were sent to the wrong doctor.

We could just forward everything to the new provider, but we have no way of knowing if they are still there, and it could cause HIPAA issues.

If anyone, especially Chris, has some ideas as to what to do with records coming in after a patient is no longer in his or her practice, please add your thoughts to the thread.

Thanks.

I agree with both Bert and Chris. Let me give you the thinking that went into the question .

Some years ago Indy merged my 2 databases of patients. There were inevitable duplicates although most of them were merged. There are also a fair number of patient who were never seen under 1 patient ID and put under another (no visits). We have been inactivating them as we go along.

One day I was on a spree of inactivating. I would click on one patient and see that the next patient had no visits and had insurance information from 2012 or so, thus I started inactivating them as well. But then, I looked at patients who had not been in the office in > 5,7,or even 14 years. Some of them were in their 30's.

I will not take a new patient from the age of 18 on, although I will generally keep my patients through the age of 22. A 17 year old not here in 10 years is not coming back. I started to consider at what point I should consider deactivating them.

So I did start to deactivate patients > 5 years who were over 23 years old. I came up with over 700 patients. That's when I began to wonder whether I could bulk deactivate. Since it could not be done, I dropped the idea to deactivate by bulk and still plink off a chart that I will see on the main screen that is very long not used.

Now once a patient has been deactivated, all you have to do is click on the "ALL" button to the right of the DOB field and they will show up. If you go to demographics on the right side there is a check box that is clicked (on a deactivated patient) that states inactivate with a drop down below giving the reason (which will be red if it is deactivated from the main screen as nothing has been selected). By unclicking this box you can reactivate a patient.

So they are not really "lost", they just don't show up under the regular active button. You can include them in searches, or look for them by the same measure. They are not overwritten.