medical records

Questions on how we spend our money and our time - consumer goods and services, home and vehicle, leisure and recreational activities
Post Reply
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

medical records

Post by rjbraun »

Just to be clear this post in no way seeks medical advice. It relates to maximizing return on something I've already paid for (medical tests, such as ultrasounds).

My understanding is that HIPAA requires healthcare providers to maintain records for seven years. After that, I guess the records can be purged.

I recently went for an ultrasound and was told that they had no record of any prior ones. This surprised me and when I went home and checked my records I found papers that indicated prior tests. They were done over 10 years ago and, sure enough, the provider has said they do not maintain records for that long. And while my paper records have some detail, apparently the doctor interpreting my results would likely want the actual electronic(?) records. I was told that had I requested these during the seven year maintenance period they would have been given to me.

Questions:

For people who have maintained their records in this fashion, do you do this consistently? How much time and effort is involved? Do you typically have to pay for anything (media, etc.)?

Also, I wonder if a doctor would even be willing to review records that were not accessible by them internally through their organization. In that case, it might even negate the benefit of trying to maintain this information.

Fortunately, I'm not overly concerned from a health standpoint in this particular case, but I do find it annoying that whatever baseline information I gathered over the years is now gone.

Thank you in advance!
tm3
Posts: 775
Joined: Wed Dec 24, 2014 6:16 pm

Re: medical records

Post by tm3 »

This reply is not medical advice.

Every radiologist that I have ever encountered loves to have prior records available for review, whether complete or partial (ie images and report or just report) when confronted with a study that has potentially significant findings -- it can be very helpful to know if said finding was present, say, 10 years ago. Non radiologists doing diagnostic imaging, maybe not so much.

I've never seen or heard of a charge associated with furnishing a patient with a copy of diagnostic imaging, whether report, CD, whatever.

End of the non-advice.
User avatar
samsoes
Posts: 2802
Joined: Tue Mar 05, 2013 8:12 am
Location: Northeast Rat Race

Re: medical records

Post by samsoes »

tm3 wrote: Mon Jul 26, 2021 7:48 pm I've never seen or heard of a charge associated with furnishing a patient with a copy of diagnostic imaging, whether report, CD, whatever.
Wow, that's not the case here in the Great State of Connecticut! The price for electronic records (on CD/DVD) will likely set one back about $25. (Report is free, however.)
"Happiness Is Not My Companion" - Gen. Gouverneur K. Warren. | (Avatar is the statue of Gen. Warren atop Little Round Top @ Gettysburg National Military Park.)
toofache32
Posts: 2349
Joined: Sun Mar 04, 2012 5:30 pm

Re: medical records

Post by toofache32 »

Once again the lay public tries to invoke HIPAA rules that don't exist.
HIPAA is merely a privacy rule governing who may view medical records, and has no requirements on the length of time records must be kept. This is determined by state medical boards and is commonly 7 years.
State boards allow for a nominal fee to be charged for duplication of records, but cannot withhold records due to non-payment of fees owed for medical services. The patient has a right to a copy of the records, although the medical practice owns the records.
mkc
Moderator
Posts: 3292
Joined: Wed Apr 17, 2013 2:59 pm

Re: medical records

Post by mkc »

I had no idea of the 7 year limit on retaining records, particularly imaging/test results... It explains a previous patient record at a specialist having a "no record of this patient" response my PCP received.

Thank you for sharing this - in the future I will be sure to request copies of diagnostic test results, including images.
User avatar
samsoes
Posts: 2802
Joined: Tue Mar 05, 2013 8:12 am
Location: Northeast Rat Race

Re: medical records

Post by samsoes »

toofache32 wrote: Mon Jul 26, 2021 7:59 pm Once again the lay public tries to invoke HIPAA rules that don't exist.
HIPAA is merely a privacy rule governing who may view medical records, and has no requirements on the length of time records must be kept. This is determined by state medical boards and is commonly 7 years.
State boards allow for a nominal fee to be charged for duplication of records, but cannot withhold records due to non-payment of fees owed for medical services. The patient has a right to a copy of the records, although the medical practice owns the records.
In my brief stint working for MegaHospital, one was said to be exempt from HIPAA privacy rules by knocking on the desk three times while saying "HIPAA, HIPAA, HIPAA" when looking at patient records one wasn't supposed to!

Or so I was told, seriously. That, and the lack of regard for patient privacy (un-shredded documents in clear garbage bags destined for the dumpster, lost reports with patient data sent to a common printer, including name, DOB, and SSN, etc.) was frightening.
"Happiness Is Not My Companion" - Gen. Gouverneur K. Warren. | (Avatar is the statue of Gen. Warren atop Little Round Top @ Gettysburg National Military Park.)
Mr. Rumples
Posts: 2979
Joined: Sun Aug 25, 2019 7:16 am

Re: medical records

Post by Mr. Rumples »

Not sure about HIPPA, but my guess is state law follows federal guidelines. In VA, cost and retention are covered here:

https://law.lis.virginia.gov/vacode/8.01-413/

https://law.lis.virginia.gov/admincode/ ... ction1260/

https://www.msv.org/sites/default/files ... s_2018.pdf

I have all of my old records in a big canvas bag that I lug around to new physicians. My niece helped me at least organize it according to medical specialty.

The Code does not permit the medical provider to withhold records until payment is received, nor does the Code permit withholding of records until a patient's balance is paid. The Code also requires medical providers to provide account statements at least three times a year at no charge.

One issue is that old electronic data might not be readable now when going from one network to another. I found that in the case of one MRI.
"History is the memory of time, the life of the dead and the happiness of the living." Captain John Smith 1580-1631
User avatar
celia
Posts: 16774
Joined: Sun Mar 09, 2008 6:32 am
Location: SoCal

Re: medical records

Post by celia »

I think we need to keep in mind that digitization and sharing of records has been changing since the ACA started. I still find that different doctor offices can’t always read data from other providers since there is no universal format for data sharing.

I have been asked by doctors to bring in records from other doctors. If it is electronic, there is no charge (at least at my imaging centers). They will gladly give me a DVD and results printout with a few minutes’s wait. (They won’t do it unless you are there in person, since, I suppose, many people will request it, but then never pick it up—which could present HIPAA problems.)

I’ve also been asked if an X-ray film can be destroyed as they don’t have room to store them indefinitely. So I store it at home, but often it is never needed.


To put things in context here, I am over 65 and Medicare has an option where your billed services (but not the results) can be shared with other medical providers. The default is “ok to share” which DH has, while my setting is “don’t share”. I was very surprised when DH needed to see a doctor on vacation in another part of the country for something minor, but the urgent care doctor insisted on knowing his complete medical history and was able to see his Medicare billing history and billed meds.

So there are sharing options out there but they are not uniform at this time.
Last edited by celia on Mon Jul 26, 2021 8:34 pm, edited 2 times in total.
JPM
Posts: 586
Joined: Sun Aug 19, 2018 2:29 pm

Re: medical records

Post by JPM »

If you wish, you can ask for a personal copy of the medical images on a disc and can keep the disc as long as you like. A disc copy can usually be made after the interpretation is complete and contains a copy of the interpretation or at the time of service when the interpretation is not yet available. Most hospitals and larger integrated systems have the ability to transfer the images from the disc to their own current archiving system and then return your copy to you. Remote records can be valuable for future comparison.

It's possible that advances in imaging techniques and archiving systems may make comparisons difficult in the future if many years have elapsed between scans.
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

Thank you for the helpful comments. Gosh, I don’t want to exaggerate but I feel as if making sure I maintain my own copy of all my health records could be a part-time job. And I am healthy. Okay, I guess it’s the catchup work that I would have to start now that would be a fair amount of work. I suppose after that maybe I could after each appointment make a point to obtain the records. Still, I am in no position to evaluate what I got and whether it was complete; someone could hand me a blank or corrupt disk, and I would dutifully file it away. Or only a partial report, and I guess I would need to make the effort to chase down any omissions. Fun.

The radiology place I went to is affiliated with a large university and teaching hospital. I have been going there consistently (roughly annually) for well over 10 years. I am still surprised (and disappointed, but, hey, I suppose it’s not personal) that they would wipe out patient records - particularly patients who clearly are current and “active” - just like that.

Live and learn :annoyed

ETA: I posted my reply before reading all the prior ones. I must have neglected to refresh my browser.
Last edited by rjbraun on Mon Jul 26, 2021 8:40 pm, edited 2 times in total.
toofache32
Posts: 2349
Joined: Sun Mar 04, 2012 5:30 pm

Re: medical records

Post by toofache32 »

On the other hand, don't be that patient that shows up in my office with a 3-ring binder with years of encounters and thinks I'm actually gonna weed through all that. I ask for specific information from your history that helps me formulate a diagnosis and plan. If you cannot tell me, hand me the page from you binder that answers the question. Just handing me the entire binder with your Cheshire Grin is a red flag that we are not a good fit and your case will suddenly be too complex for my meager skills.
toofache32
Posts: 2349
Joined: Sun Mar 04, 2012 5:30 pm

Re: medical records

Post by toofache32 »

rjbraun wrote: Mon Jul 26, 2021 8:31 pm
The radiology place I went to is affiliated with a large university and teaching hospital. I have been going there consistently (roughly annually) for well over 10 years. I am still surprised (and disappointed, but, hey, I suppose it’s not personal) that they would wipe out patient records - particularly patients who clearly seem to be current and “active” - just like that.
How long does a CPA keep your tax records?
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

JPM wrote: Mon Jul 26, 2021 8:29 pm If you wish, you can ask for a personal copy of the medical images on a disc and can keep the disc as long as you like. A disc copy can usually be made after the interpretation is complete and contains a copy of the interpretation or at the time of service when the interpretation is not yet available. Most hospitals and larger integrated systems have the ability to transfer the images from the disc to their own current archiving system and then return your copy to you. Remote records can be valuable for future comparison.

It's possible that advances in imaging techniques and archiving systems may make comparisons difficult in the future if many years have elapsed between scans.
Thank you. I just included a a reminder note in my calendar for my upcoming radiology appointments to request personal copies. :sharebeer

I also wondered about potential system incompatibilities, but I guess something is better than nothing and it’s worth a try!
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

toofache32 wrote: Mon Jul 26, 2021 8:40 pm
rjbraun wrote: Mon Jul 26, 2021 8:31 pm
The radiology place I went to is affiliated with a large university and teaching hospital. I have been going there consistently (roughly annually) for well over 10 years. I am still surprised (and disappointed, but, hey, I suppose it’s not personal) that they would wipe out patient records - particularly patients who clearly seem to be current and “active” - just like that.
How long does a CPA keep your tax records?
I don’t know, but I have always retained my own copies (in those instances where I have used a tax preparer). As I know that I will need the prior year’s info when I do my return next time I want to be sure to have access.

Not sure exactly what you mean by “tax records”, but if you mean receipts, security transaction records, etc. that I gave to a CPA, I wouldn’t rely on them for access at a future date. If you mean worksheets that they used to prepare my tax returns, I guess / hope that would be included in the materials they give me and I retain. If it’s the tax return itself, worst case I presumably could get a copy from the government (fortunately, I’ve never been in that situation).

In the case of my “trusted medical provider” :wink: I can’t recreate the baseline ultrasounds performed over my lifetime. It would have been nice to have been notified of the purge beforehand so I had a chance to obtain my health history. But, now I know and will start contacting all of my doctors’ offices tomorrow to assemble as complete a history of my medical records as possible.
User avatar
ram
Posts: 2281
Joined: Tue Jan 01, 2008 9:47 pm
Location: Midwest

Re: medical records

Post by ram »

rjbraun wrote: Mon Jul 26, 2021 2:24 pm Do you typically have to pay for anything (media, etc.)?
Medical facilities are allowed to charge a "reasonable" fee for this. At my institution it is 25 cents/ page ( $50 for 200 pages)

Also, I wonder if a doctor would even be willing to review records that were not accessible by them internally through their organization.

Most doctors would be. Do not expect it to be a free read.
Ram
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

ram wrote: Mon Jul 26, 2021 9:12 pm
rjbraun wrote: Mon Jul 26, 2021 2:24 pm Do you typically have to pay for anything (media, etc.)?
Medical facilities are allowed to charge a "reasonable" fee for this. At my institution it is 25 cents/ page ( $50 for 200 pages)

Also, I wonder if a doctor would even be willing to review records that were not accessible by them internally through their organization.

Most doctors would be. Do not expect it to be a free read.
Thank you. In the case I posted about, the records I don’t have but wished I did originated from the organization I would be asking to read them. So, it would be something if they charged me (‘extra’) to read their own records, as part of a routine annual diagnostic radiology visit. Had they not elected to purge my records they would have been able to retrieve them from their own system. But I realize that anything is possible.
User avatar
ResearchMed
Posts: 16795
Joined: Fri Dec 26, 2008 10:25 pm

Re: medical records

Post by ResearchMed »

ram wrote: Mon Jul 26, 2021 9:12 pm
rjbraun wrote: Mon Jul 26, 2021 2:24 pm Do you typically have to pay for anything (media, etc.)?
Medical facilities are allowed to charge a "reasonable" fee for this. At my institution it is 25 cents/ page ( $50 for 200 pages)

Also, I wonder if a doctor would even be willing to review records that were not accessible by them internally through their organization.

Most doctors would be. Do not expect it to be a free read.
At our major medical center/teaching hospital, there is a chsrge if a patient wants copies of "records". However, if another medical provider requests those same records, there is no charge.

(I think there is a single charge for media instead of paper, such as for copies of scans.)

RM
This signature is a placebo. You are in the control group.
Marylander1
Posts: 583
Joined: Sat Jan 04, 2014 2:18 pm
Location: Baltimore & DC

Re: medical records

Post by Marylander1 »

rjbraun wrote: Mon Jul 26, 2021 8:31 pm Thank you for the helpful comments. Gosh, I don’t want to exaggerate but I feel as if making sure I maintain my own copy of all my health records could be a part-time job. And I am healthy.
All of those discs from scans I've received are self-contained viewer systems that let you browse through a scan and review the radiologist's notes. I recommend you try it: put the disc in your computer and run the startup script or executable. Electronic x-rays are usually just plain old image files.

I get a (free, so far) disc of every scan and use PowerISO to save a mountable .iso or equivalent on my computer, which enables me to either burn a new disc at a provider's request, or let them browse through the scans on my laptop. I don't need as many scans, my doctors love it, and I do what I can to make their jobs easier. I also save PDF copies of lab reports and visit summaries, mostly for my own reference.

Unfortunately, I have enough medical care to make this a worthwhile effort: scans from 2 decades and a number of physicians among whom I coordinate care. I also have enough computer skills that it's easy for me to help medical staff access and copy my electronic records into their own siloed EHR repositories.

I understand other countries with better medical systems don't put this burden on patients, but this is what we have.

Marylander1
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

Marylander1 wrote: Mon Jul 26, 2021 10:27 pm
rjbraun wrote: Mon Jul 26, 2021 8:31 pm Thank you for the helpful comments. Gosh, I don’t want to exaggerate but I feel as if making sure I maintain my own copy of all my health records could be a part-time job. And I am healthy.
All of those discs from scans I've received are self-contained viewer systems that let you browse through a scan and review the radiologist's notes. I recommend you try it: put the disc in your computer and run the startup script or executable. Electronic x-rays are usually just plain old image files.

I get a (free, so far) disc of every scan and use PowerISO to save a mountable .iso or equivalent on my computer, which enables me to either burn a new disc at a provider's request, or let them browse through the scans on my laptop. I don't need as many scans, my doctors love it, and I do what I can to make their jobs easier. I also save PDF copies of lab reports and visit summaries, mostly for my own reference.

Unfortunately, I have enough medical care to make this a worthwhile effort: scans from 2 decades and a number of physicians among whom I coordinate care. I also have enough computer skills that it's easy for me to help medical staff access and copy my electronic records into their own siloed EHR repositories.

I understand other countries with better medical systems don't put this burden on patients, but this is what we have.

Marylander1
Wow, thank you so much for helping to make this daunting (to me) new item on my to-do list a bit less so.

I actually sent the hard copies of the notes from my prior ultrasounds to the radiology medical records department to request inclusion in the files (the ones they had purged from their systems). I mentioned in the note that the ultrasound technician found no history for me, and that the interpreting radiologist (therefore) recommended a six-month follow-up.

When Medical Records called me to say that they could not find the corresponding images, they added that, in their experience, the radiologist would need these (for any additional interpretative work). So, I guess I am just out of luck. I also sent the historical notes to the radiologist, but she hasn't contact me for now.
camden
Posts: 414
Joined: Sun Sep 27, 2009 12:22 pm

Re: medical records

Post by camden »

Radiologist here. Although it is true state specific regulations determine how long a medical facility is required to keep medical records (imaging studies in this case), nothing prevents the facility from keeping them longer. At the medical center where I work all studies are kept for 7 years, but if an individual has any any medical interaction with any of our MDs or non-MD providers in the last 5 years, the records are retained indefinitely. I routinely have occasion to look at old studies dating back to the early 2000s. I suspect many institutions have similar policies.
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

camden wrote: Tue Jul 27, 2021 8:45 am Radiologist here. Although it is true state specific regulations determine how long a medical facility is required to keep medical records (imaging studies in this case), nothing prevents the facility from keeping them longer. At the medical center where I work all studies are kept for 7 years, but if an individual has any any medical interaction with any of our MDs or non-MD providers in the last 5 years, the records are retained indefinitely. I routinely have occasion to look at old studies dating back to the early 2000s. I suspect many institutions have similar policies.
Thank you! Maybe I should reconsider my medical center. I say that somewhat in jest, particularly as a number of my doctors happen to be affiliated with it. I am truly surprised that having been a consistent patient in their system for over two decades now, they would just purge records as they did - and with no prior notice to the patient.

I realize that an institution's record keeping policy need not highly correlate with the quality of its program, but this university system is highly-ranked (as a general matter -- I am not in the healthcare field and only follow informally). Geographically, I am referring to NYC (Manhattan), which has several top-tier medical facilities (I assume -- you may know more and disagree).

Thanks again for taking the time to post.
Topic Author
rjbraun
Posts: 2271
Joined: Sun Sep 09, 2012 8:22 pm

Re: medical records

Post by rjbraun »

rjbraun wrote: Tue Jul 27, 2021 6:47 am
Marylander1 wrote: Mon Jul 26, 2021 10:27 pm
rjbraun wrote: Mon Jul 26, 2021 8:31 pm Thank you for the helpful comments. Gosh, I don’t want to exaggerate but I feel as if making sure I maintain my own copy of all my health records could be a part-time job. And I am healthy.
All of those discs from scans I've received are self-contained viewer systems that let you browse through a scan and review the radiologist's notes. I recommend you try it: put the disc in your computer and run the startup script or executable. Electronic x-rays are usually just plain old image files.

I get a (free, so far) disc of every scan and use PowerISO to save a mountable .iso or equivalent on my computer, which enables me to either burn a new disc at a provider's request, or let them browse through the scans on my laptop. I don't need as many scans, my doctors love it, and I do what I can to make their jobs easier. I also save PDF copies of lab reports and visit summaries, mostly for my own reference.

Unfortunately, I have enough medical care to make this a worthwhile effort: scans from 2 decades and a number of physicians among whom I coordinate care. I also have enough computer skills that it's easy for me to help medical staff access and copy my electronic records into their own siloed EHR repositories.

I understand other countries with better medical systems don't put this burden on patients, but this is what we have.

Marylander1
Wow, thank you so much for helping to make this daunting (to me) new item on my to-do list a bit less so.

I actually sent the hard copies of the notes from my prior ultrasounds to the radiology medical records department to request inclusion in the files (the ones they had purged from their systems). I mentioned in the note that the ultrasound technician found no history for me, and that the interpreting radiologist (therefore) recommended a six-month follow-up.

When Medical Records called me to say that they could not find the corresponding images, they added that, in their experience, the radiologist would need these (for any additional interpretative work). So, I guess I am just out of luck. I also sent the historical notes to the radiologist, but she hasn't contact me for now.
rjbraun wrote: Tue Jul 27, 2021 9:24 am
camden wrote: Tue Jul 27, 2021 8:45 am Radiologist here. Although it is true state specific regulations determine how long a medical facility is required to keep medical records (imaging studies in this case), nothing prevents the facility from keeping them longer. At the medical center where I work all studies are kept for 7 years, but if an individual has any any medical interaction with any of our MDs or non-MD providers in the last 5 years, the records are retained indefinitely. I routinely have occasion to look at old studies dating back to the early 2000s. I suspect many institutions have similar policies.
Thank you! Maybe I should reconsider my medical center. I say that somewhat in jest, particularly as a number of my doctors happen to be affiliated with it. I am truly surprised that having been a consistent patient in their system for over two decades now, they would just purge records as they did - and with no prior notice to the patient.

I realize that an institution's record keeping policy need not highly correlate with the quality of its program, but this university system is highly-ranked (as a general matter -- I am not in the healthcare field and only follow informally). Geographically, I am referring to NYC (Manhattan), which has several top-tier medical facilities (I assume -- you may know more and disagree).

Thanks again for taking the time to post.
Well, I have some good news to report and figured I would provide an update here.

As noted above, the facility's Medical Records department couldn't help me based on the historical information I had dug up at home and mailed to them. I had separately mailed those records to the interpreting radiologist. When she called me maybe a week or so later, I was appreciative but figured there was nothing left to try to do. I bit my tongue when she said something about trying to get the old ultrasounds to review and held off on saying that Medical Records had already told me they couldn't find them.

Lo and behold, the radiologist called me a few days ago. Not only did she find the images (from 2008-09, I believe) but she said my situation was stable and actually even slightly improved (if that's the correct word usage). So, her interpretation was that I no longer will need to go through the 2-years of semi-annual ultrasounds as previously advised (unless my doctor thinks differently).

Excellent news on several fronts. 1) my health situation is good (I wasn't overly concerned about an issue, but it's certainly nice to have the confirmation), 2) my health records on file at the institution have been updated (I hope), 3) I have 4 ultrasound appts I can skip (particularly nice given ongoing pandemic conditions), and 4) I and my insurer avoid unnecessary charges. :D

I suppose a downside is that said medical facility will not be able to charge a patient for unnecessary work. I mean, it seemed like an interesting business model: discard prior tests for patients so the facility can then order new ones for the same patients whose records they have wiped out. :wink:
Last edited by rjbraun on Mon Aug 16, 2021 8:36 am, edited 1 time in total.
egrets
Posts: 888
Joined: Sun Jul 05, 2020 2:56 pm
Location: Rhode Island

Re: medical records

Post by egrets »

tm3 wrote: Mon Jul 26, 2021 7:48 pm This reply is not medical advice.

Every radiologist that I have ever encountered loves to have prior records available for review, whether complete or partial (ie images and report or just report) when confronted with a study that has potentially significant findings -- it can be very helpful to know if said finding was present, say, 10 years ago. Non radiologists doing diagnostic imaging, maybe not so much.

I've never seen or heard of a charge associated with furnishing a patient with a copy of diagnostic imaging, whether report, CD, whatever.

End of the non-advice.
+1

No charge for cds, paper in RI as far as I have experienced. The local hospital keeps images maybe forever, they have ones 10-15 years old for me. On the other hand when I lived in another state I ran into the seven years records wiped thing with an internist.
hvaclorax
Posts: 598
Joined: Mon Nov 21, 2016 5:01 pm

Re: medical records

Post by hvaclorax »

I didn’t read all the threads,
The various medical record programs are not mutually compatible. They are proprietary. They come to your new provider as paper or scanned documents. They aren’t in categories like radiology, cardiology etc. Just one big lump of data. Also the process of getting them scanned into your e-record is left to a limited number of staff. This creates a bottleneck because so many records come in from recent transfer patients. So one has to look around for the right packet.
An arduous task and thankless. Maybe ones reward will come in heaven or better karma.
Sorry if this is a rant or off topic too far.

PS: BTW specialist records are generally better


Thanks,HVAC.
Post Reply