Nursing

Clear up confusion over paper record retention

Nurse Leader Insider, July 6, 2007

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As more organizations choose to store patient charts electronically, the question arises of what to do with all of those old paper records.
The answer depends on your state's statutes, says William Roach Jr., Esq., partner at McDermott Will & Emery in Chicago. After you scan or enter records, "unless there's a very specific statute involving paper records, which is increasingly not the case," your organization can essentially destroy those paper records at its convenience, says Roach. You're not actually destroying the record, he says. Instead, you're destroying the record's initial medium. As long as access is available, you haven't destroyed the record.

Watch mismanagement

Mismanagement of record retention and destruction can lead to serious consequences, says Roach. Healthcare facilities need to know how long to keep all records-not just paper records they have converted to another medium-and must follow physical destruction requirements so that they maintain patient confidentiality. State statutes address destruction-related confidentiality requirements, he notes. They also indicate the time at which organizations can destroy records.

Be sure to check out the e-Discovery Law, implemented December 1, 2006, says Beth Hjort, RHIA, CHPS, professional practice manager at the American Health Information Management Association in Chicago. "[The e-Discovery Law] requires organizations to comply with legal requests for electronic information in new and challenging ways," Hjort says. "Organizations should ensure they can produce electronic records in fulfillment of the new law, just as they can for paper medical records, before they destroy the paper."

Once you have a retention and destruction plan, be sure to follow it. "Organizations are wise to follow through and destroy records on schedule according to the retention plan," she says. If a record shouldn't exist according to your retention policy, but it does, a judge can issue a subpoena, and a lawyer can use the record against your organization. This could happen in lieu of a better outcome-the explanation of retention practices and production of documents showing that the record no longer exists, says Hjort.

Maintain patient confidentiality when disposing of old records

Recycling old records sounds like an appealing, earth-friendly idea, but recycling doesn't guarantee confidentiality.

Organizations should accomplish record destruction via confetti shredding or chemicals rather than recycling, says Rose T. Dunn, RHIA, CPA, FACHE, FHFMA, chief operating officer of Maryland Heights, MO-based consulting firm First Class Solutions. Some recycling plants sort paper by like types to allow the creation of new paper.

"In the process, [the plants] use emulsification solvents to raise the ink off the paper." But they may not lift some of the print, which may still be slightly visible on new recycled paper, she says.

Source: Electronic Health Records Briefing, June 2007, HCPro, Inc.



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