Friday, July 31, 2015

This Is An Area That Can Get Very Complex But Needs To Be Properly Addressed. Why No Discussion Of The Fate Of Electronic Records?

This appeared a few days ago:

Practice closure caution

Charlotte Mitchell
Monday, 20 July, 2015
AWARENESS and careful planning are key to avoiding legal trouble over medical records when a practice closes, according to legal and management experts.
An “Ethics and law” article in the MJA outlines enforceable regulatory requirements governing the management of medical records for doctors when they close their practice. (1)
David Carter, lecturer in health services management at the University of Technology Sydney, wrote that in the ACT, NSW and Victoria there were specific laws regarding records management, while in other jurisdictions, privacy and information management laws affected records.
The Medical Board of Australia code of conduct also advised careful health information management at all times, particularly at practice closure.
Mr Carter said that despite the overlapping and complex nature of legal and professional requirements, health practitioners had immediate and continuing obligations to their patients’ care when closing a practice.
He suggested Primary Health Networks, which replaced Medicare Locals, could be well placed to facilitate record transfer or custody when practices closed without transfer arrangements in place.
Georgie Haysom, head of advocacy at Avant, told MJA InSight that there was a complex set of legal obligations in each jurisdiction in Australia that doctors needed to be aware of well before closing their practice.
Anthony Mennillo, senior solicitor at medical defence organisation MIGA, said responsible medical records maintenance served a number of functions in delivering good patient care, as well as allowing efficient continuity of care if another doctor had to take over patient care.
Ms Haysom said about a quarter of all the phone calls Avant received from doctors were about records management, including practice closure.
The full article is found here:
There is the full article from the MJA is found here:
Ethics and law

Records access and management on closure of a medical practice

David J Carter
Med J Aust 2015; 203 (2): 109-110.
doi: 10.5694/mja15.00258
  • Despite uneven regulation, health practitioners registered with the Australian Health Practitioner Regulation Agency have immediate and continuing obligations to patients when contemplating practice closure.
  • Recent enforcement actions by regulators highlight the importance of knowledge and compliance with requirements relating to record management.
In July 2014, a Melbourne general practice made headlines when the Australian Privacy Commissioner found that it had breached the Privacy Act 1988 (Cwlth) by failing to properly secure patient medical records.1 The practice had relocated, leaving its records behind in a garden shed; when a thief broke in, the records became accessible to the public. The case raises the question of how patient medical records should be stored and transferred at the time of a practice closure or other change in operations, such as physical relocation or retirement of a practitioner. Significant changes to practice operations occur frequently in Australia due to corporatisation, relocation or retirement. This article outlines the legal and regulatory requirements that govern how patient records are to be managed in such circumstances.
Lots more here:
As far as the article and commentary go it is both important and relevant. However given many practices keep electronic records - why are these not mentioned and discussed?
There are some really difficult issues regarding access and so on to an electronic record when the practice closes or whatever?
Maybe we need an article that reflects the 21st Century?

Late Addition:

Spotted this yesterday - very pertinent to the discussion above:

Keeping Old Patient Data from Causing HIPAA Headache

JUL 28, 2015 7:29am ET

The electronic health records meaningful use program substantially increased the number of providers adopting the technology, and fostered an explosion in the past half-decade of buying additional ancillary systems to augment EHRs.

Just think about how many providers bought a new practice management system and health information management system when they got the new EHR. More recently, mobile devices, often bought by the organization, are everywhere in a care setting.

But, what happened to the old servers, personal digital devices, pagers, copiers, fax machines, printers, floppies and disks, tape reels and other technologies that held protected health information and are no longer used?

Here is the link:


1 comment:

Terry Hannan said...

David, a critically important topic. I am pleased you have posted this documentation. We need urgent, clear and precise legislation (where and if possible) on this matter. I recall the complexity of issues and often the limited understanding of what is required when I was on a committee for the NSW governmentt (via the AMA) looking at the storage of all medical records -predominantly paper based then.
It would be great to have suggestions as to how such legislation could be formulated and who should be the on the committee formulating the recommendations.