Practices ask us every day, ‘I want to turn off my legacy EMR system. How long should a doctor keep medical records?‘.
For long term medical record retention, from a legacy EMR system, time is just the beginning. State laws, tail liability coverage and costs are more reasons to keep records.
To reduce costs, create an archive
Legacy EMR system record storage
To obtain the best long term savings, decommission a legacy EMR system with an archive. Create 1 record per patient.
Single user, read only access to a legacy EMR system, can cost a few thousand dollars per year. Keeping data on a server means securing to HIPAA standards. Maybe not appropriate for including in a home network.
The output of an archive needs to work with many operating systems and hosting environments. Adobe PDF based systems are a popular solution and typically do not need to be licensed every year.
And, Adobe PDF systems have been around for a long time, with a good track record.
Access to records is important too. Patients will want their records forwarded at some point. Searching for records needs to be just as easy as in the legacy EMR system. Name, record number, date of service are all good search options.
Additionally, searching multiple records for CMS audits by date or treatment code is an important function.
Where to store a patient records archive
It is worth repeating, an archive is still covered by HIPAA rules. PHI information must be compliant with current and future standards. Professional hosting is not an expensive option with many vendors that can securely host medical records.
Here again, is where the choice of output is important. Most hosting vendors have no problems with a directory of PDF files. A very simple way to store data.
Using a database as an archive, like MS Access, is a more challenging hosting task. Often, a more costly, ‘private’ or ‘virtual private’ server is needed.
Another expense is the cost to license the database or other application.
Can I just keep my current server & legacy EMR system?
Sure, for a while. Servers work with specific server operating systems. Operating systems are expensive and well known for being obsolete in a few years. This means HIPAA compliance becomes an issue.
Why try and hack the latest and greatest? New OS systems have regular updates to prevent (hopefully) hackers gaining access. Old OS systems no longer have updates and are much easier to defeat.
Legacy EMR systems and newer OS systems tend to have issues as well. Software applications are written for existing and near term environments. Major updates help to smooth out the increasing complexity and performance of new hardware.
It is likely, a legacy EMR system, created years ago, and not updated, will not install on a new server. Practices that have legacy EMR systems tend to not purchase support for the updates.
Considerations for clinical, financial, imaging & scheduling data
Clinical, imaging and scheduling data becomes static on the last day of use for the legacy EMR system. Practices should wind down financial data in the legacy EMR system. This is due to the complexity of how most EMR systems store financial data.
The best practice for financial data is to speed up claims processing and clearing. Same for patient balances with increased communications to patients. We recommend a 5 day interval for communications to patients that have balances over 30 days.
Not only does A/R lose value fast, its costing more with a legacy EMR system that has to remain open.
Starting with clinical data first, we can start the archive process on the last day of the legacy EMR system’s operation. Testing of the output is a collaboration with the practice and takes some time. Generally, once the testing step has been completed, the financial data has stabilized and is ready for archiving.
So, how long should a doctor keep medical records from a legacy EMR system?
The best answer is to ask your attorney. Likewise, laws vary among states, time limits vary among specialties, and courts need their say too. There are even separate CMS rules.
Groups like the AMA, MGMA & NSCHBC have guides and experts that can help.
Unfortunately, there is no single answer as to how long a doctor needs to keep records from a legacy EMR system.