Record Retention Roulette

How many obsolete or otherwise flawed documents do bureaucracies fail to remove or revise? I found this one still online today. Less than 3 years old, and the “Program Manager” contact no longer works in that position. Their attorney told me by telephone that the Commission may revise or remove the document and that no statutory penalties attach to failure to comply with what only consists of guidelines. Nevertheless, the document could mislead and fails to acknowledge realities of medical records. To wit:

  • “A physician should make sure that the transition to another provider is done with a minimum of disruption to the patient’s care[.]” Given the shortage of physicians increasing the tendency of physicians to refuse to contract with payers and even to refuse to treat patients with over-regulated payers such as Medicaid and Medicare, this requirement is unrealistic.

  • “Notice in the practice’s local newspaper.” (Most practices do not publish newspapers.) This might have made sense as recently as 20 years ago, but who would look for such a notice in a newspaper today? Now the notice should appear on the practice Website.

  • “Cost of recovering records” Recovering records? What does that mean?

  • “The Medical Commission concurs with the Washington State Medical Association recommendation.” No particular professional association deserves special mention by a government agency.

  • “Patient records should be retained... Indefinitely, if the patient is incompetent, if the physician is aware of any problems with a patient’s care, or has any reason to believe the patient may be involved in litigation.” Surely the state can find an attorney who can tell them there are several kinds of incompetence and indicate which apply here. This still begs the question of how the physician knows these facts unless the patient has remained in regular treatment.

  • “A physician should consider whether it is feasible to retain patients’ medical records indefinitely.” Gladly: It is not feasible (depending on what “indefinitely” means).

  • “Records should be stored to allow for lawful access and in a place that maintains confidentiality.” How can “a place” maintain confidentiality? Did they mean security?

  • “Post Office boxes and drop boxes are not acceptable addresses for the storage of patient records.” Physicians should never have to provide their home addresses to patients. A post office box or even a fax number or email address should be acceptable.

  • “The system must be capable of generating a paper copy at the request of the patient.” Electronic medical records cannot be copied to paper. How can you print an audio file or digital signature? They should be made available for viewing in their native format, as intended, on a computer screen.

  • “Paper records may be destroyed only if electronically stored records can be reproduced without alteration from the original record.” Can anyone explain what this means?

Ill conceived and poorly written policy from incompetent and/or negligent bureaucracy confuses and even endangers, possibly even more than no government at all.

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