Medical Records: What to Keep

If your office is anything like mine, you have too many medical records and too little storage space. And since the laws in your state require that old records be kept for only a finite amount of time, you may be tempted to get rid of your oldest charts.

Unfortunately, regardless of your state's retention laws (a list of which can be found at http://pcarchiver.com/statelaws.html

▸ According to one malpractice insurance carrier, GE Medical Protective, 10% of medical claims are filed at least 5 years after the incident, and 5% are brought at least 10 years after—regardless of state laws and statutes of limitation. Without a record, there is only the doctor's word against the patient's word: a treacherous situation.

▸ Statutes of limitation are often indefinite, or greatly extended, when the patient is a child, especially when birth defects, mental retardation, or parental disputes are involved.

▸ There is no time limitation on state medical board actions. Patients have been known to file complaints with state boards decades after alleged improprieties. Without the medical record, your ability to defend yourself against such a complaint is severely limited.

▸ In most states, if a patient alleges that a doctor said an outcome was not the one expected—even if this is only the patient's recollection, true or not—the destruction of the record can be considered hiding evidence, a criminal offense.

▸ Medicare and the IRS have a 7-year limit on pursuing billing errors, but there is no time limit if fraud is alleged.

▸ Regardless of any statutes, the Medical Liability Monitor (http://www.medicalliabilitymonitor.com

So as much as you would like to dispose of old charts, in general it's not a good idea. But office space is limited and expensive. Where should old charts be stored? You have several options:

▸ Self Storage. The most obvious option is to physically move old records to another location. While your attic might be an obvious and cheap option, those records are a fire hazard, and chances are your spouse will not be happy. For a monthly fee you can stash old charts in a commercial self-storage facility. This is the least expensive method, but finding a specific record when you need it can be a chore. In addition, make sure the storage company is reputable—and the roof doesn't leak.

▸ Archiving. You can hire an archival firm to keep your old records. They will pick them up periodically, store them, and when you need to see an archived file, they'll deliver it back to you within a day or two.

▸ Microfilm. This method allows you to keep the records on site, but in a much smaller space. A microfiche company performs the transfer, and you buy the equipment necessary to read the films. When you need a hard copy of an old file, you simply print it out.

▸ Computerization. Clearly, the wave of the future is digital archiving. The simplest method of doing this is scanning the old records onto a hard drive with backups on disk. Many large clinics already are using such systems, and turnkey programs are now available for smaller offices. One popular system is called PCArchiver (http://pcarchiver.com

Once you've found a home for your old medical records, what about all those other records—business documents of all kinds—you've been meaning to do something with? Which of those need to be kept, and for how long? I'll talk about that next month.

If your office is anything like mine, you have too many medical records and too little storage space. And since the laws in your state require that old records be kept for only a finite amount of time, you may be tempted to get rid of your oldest charts.

Unfortunately, regardless of your state's retention laws (a list of which can be found at http://pcarchiver.com/statelaws.html

▸ According to one malpractice insurance carrier, GE Medical Protective, 10% of medical claims are filed at least 5 years after the incident, and 5% are brought at least 10 years after—regardless of state laws and statutes of limitation. Without a record, there is only the doctor's word against the patient's word: a treacherous situation.

▸ Statutes of limitation are often indefinite, or greatly extended, when the patient is a child, especially when birth defects, mental retardation, or parental disputes are involved.

▸ There is no time limitation on state medical board actions. Patients have been known to file complaints with state boards decades after alleged improprieties. Without the medical record, your ability to defend yourself against such a complaint is severely limited.

▸ In most states, if a patient alleges that a doctor said an outcome was not the one expected—even if this is only the patient's recollection, true or not—the destruction of the record can be considered hiding evidence, a criminal offense.

▸ Medicare and the IRS have a 7-year limit on pursuing billing errors, but there is no time limit if fraud is alleged.

▸ Regardless of any statutes, the Medical Liability Monitor (http://www.medicalliabilitymonitor.com

So as much as you would like to dispose of old charts, in general it's not a good idea. But office space is limited and expensive. Where should old charts be stored? You have several options:

▸ Self Storage. The most obvious option is to physically move old records to another location. While your attic might be an obvious and cheap option, those records are a fire hazard, and chances are your spouse will not be happy. For a monthly fee you can stash old charts in a commercial self-storage facility. This is the least expensive method, but finding a specific record when you need it can be a chore. In addition, make sure the storage company is reputable—and the roof doesn't leak.

▸ Archiving. You can hire an archival firm to keep your old records. They will pick them up periodically, store them, and when you need to see an archived file, they'll deliver it back to you within a day or two.

▸ Microfilm. This method allows you to keep the records on site, but in a much smaller space. A microfiche company performs the transfer, and you buy the equipment necessary to read the films. When you need a hard copy of an old file, you simply print it out.

▸ Computerization. Clearly, the wave of the future is digital archiving. The simplest method of doing this is scanning the old records onto a hard drive with backups on disk. Many large clinics already are using such systems, and turnkey programs are now available for smaller offices. One popular system is called PCArchiver (http://pcarchiver.com

Once you've found a home for your old medical records, what about all those other records—business documents of all kinds—you've been meaning to do something with? Which of those need to be kept, and for how long? I'll talk about that next month.

If your office is anything like mine, you have too many medical records and too little storage space. And since the laws in your state require that old records be kept for only a finite amount of time, you may be tempted to get rid of your oldest charts.

Unfortunately, regardless of your state's retention laws (a list of which can be found at http://pcarchiver.com/statelaws.html

▸ According to one malpractice insurance carrier, GE Medical Protective, 10% of medical claims are filed at least 5 years after the incident, and 5% are brought at least 10 years after—regardless of state laws and statutes of limitation. Without a record, there is only the doctor's word against the patient's word: a treacherous situation.

▸ Statutes of limitation are often indefinite, or greatly extended, when the patient is a child, especially when birth defects, mental retardation, or parental disputes are involved.

▸ There is no time limitation on state medical board actions. Patients have been known to file complaints with state boards decades after alleged improprieties. Without the medical record, your ability to defend yourself against such a complaint is severely limited.

▸ In most states, if a patient alleges that a doctor said an outcome was not the one expected—even if this is only the patient's recollection, true or not—the destruction of the record can be considered hiding evidence, a criminal offense.

▸ Medicare and the IRS have a 7-year limit on pursuing billing errors, but there is no time limit if fraud is alleged.

▸ Regardless of any statutes, the Medical Liability Monitor (http://www.medicalliabilitymonitor.com

So as much as you would like to dispose of old charts, in general it's not a good idea. But office space is limited and expensive. Where should old charts be stored? You have several options:

▸ Self Storage. The most obvious option is to physically move old records to another location. While your attic might be an obvious and cheap option, those records are a fire hazard, and chances are your spouse will not be happy. For a monthly fee you can stash old charts in a commercial self-storage facility. This is the least expensive method, but finding a specific record when you need it can be a chore. In addition, make sure the storage company is reputable—and the roof doesn't leak.

▸ Archiving. You can hire an archival firm to keep your old records. They will pick them up periodically, store them, and when you need to see an archived file, they'll deliver it back to you within a day or two.

▸ Microfilm. This method allows you to keep the records on site, but in a much smaller space. A microfiche company performs the transfer, and you buy the equipment necessary to read the films. When you need a hard copy of an old file, you simply print it out.

▸ Computerization. Clearly, the wave of the future is digital archiving. The simplest method of doing this is scanning the old records onto a hard drive with backups on disk. Many large clinics already are using such systems, and turnkey programs are now available for smaller offices. One popular system is called PCArchiver (http://pcarchiver.com

Once you've found a home for your old medical records, what about all those other records—business documents of all kinds—you've been meaning to do something with? Which of those need to be kept, and for how long? I'll talk about that next month.