June 7, 2016


Question:


Hello Jennifer,
 
In New York State, we must keep written records for 6 years and x-rays for 3 years or to the age of 22, whichever is longer. These laws have been around for a while, long before electronic record keeping. My questions are: 1) How long do EMR records have to be kept for?  2) How long do digital x-ray images have to be kept for?  3) How long do non-health care related records (paper) like insurance EOBs have to be kept for?  4) What about digital testing records like EMGs, Range of Motion studies, digital orthotic scans and the like?  
 
Almost all of these are stored on hard drives which, over time, take up precious space not only on the server's hard drive, but also on a back-up medium whether it is on an in office back up system or a cloud system (which charges a higher rate for more storage).  Thanks for your input.
 
Dr. L 


Answer:

You are absolutely correct that record retention is governed by State law.  Check out OCR HIPAA reference here.   You are also correct about the time frames.  In New York, a doctor is required to maintain records for six (6) years after the patient's last visit, or 1 year after the patient's 21st birthday (whichever is longer). Check http://www.op.nysed.gov/title8/part29.htm. Where I disagree is the time frame for x-rays.  I recommend maintain x-rays and other elements of the patient record also for the 6 year or 22nd birthday, whichever is longer, requirement.  For the insurance payment records - EOBs - unless you regularly maintain and incorporate into the patient's chart, those are recoverable from the respective payor.  

EMR is the same deal.  EMR is the patient record.  The electronic record should be maintained for the full statutory period, and in fact, I am very comfortable with you converting your paper or other records stored into electronic and maintaining electronically for the complete statutory period.  Please make sure you have arrangements for backup and safeguards required under HIPAA prior to migrating over the remainder of your records. If you are going to have a shredding company destroy your originals, please make sure you have a BAA in place AND confirm you have properly converted the records to electronic format.  Yes, there are benefits to maintaining an original, but you may not believe same outweigh the benefit of the potential for available space.  **Important!  If at any point you suffer a loss, possibly due to weather or acts unforeseeable and beyond your control, please make a legal record at that time - police report, insurance report, etc.  Also, please be sure to abide by your breach notification rule requirements, if any.   

Also, please be advised that Medicare Managed Care requires records to be maintained for 10 years.



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