The patient medical record is a valuable medical and legal document that has to be maintained safely by medical record custodians. When required for a legal use, attorneys employ medical record retrieval companies to collect all the relevant records. To ensure safety and compliance with regulations, many doctors assign the task of storing their patients’ medical records to reliable service providers.
Recent news in The ChronicleHerald highlighted how Nova Scotia doctors are increasingly entrusting their patients’ medical records to out-of-province storage companies. This trend is increasingly evident as doctors retire or close their practice for some reason or other. Nova Scotia doctors have to retain the original medical records even after their practice closes. The retention period is 10 years for adult patients and for children it is 10 years after the patient turns 19. A spokeswoman for Doctors Nova Scotia says that doctors are choosing this way of record storage to ensure that the files are stored on a secure, outside entity. The responsibility of the records is transferred to the outside agency instead of the doctor’s spouse, in case the doctor dies before the mandatory 10 years have passed.
The problem patients perceive is the high cost of retrieval involved when medical records are stored out of province. They are unhappy that they have to pay so much for their own medical information. Such complaints have been common in recent years, according to Nova Scotia officials. They give the following advice to patients:
- If they are making a request for their medical records, whether from a doctor/custodian/records management company, they should have a clear understanding of what they are looking for and trying to get a copy of.
- Obtain a fee estimate before going ahead. The medical record custodian is required to give the patient an estimate before charging them anything.
- If the patient is not happy with that estimate or cannot afford to pay the amount, the Office of the Information and Privacy Commissioner for Nova Scotia can help them with fee waivers that are possible under the Personal Health Information Act.
The above-mentioned Act allows peoples’ medical records to be secured outside of Nova Scotia. However, the physician or healthcare entity who is custodian of the medical record must ensure that their contract company has strong security and privacy safeguards as required under the legislation. Most storage companies affirm that they are committed to the principles of security, accessibility, and accuracy. Moreover, they say that before releasing a medical record, they check the record to make sure that every page of that record belongs to the concerned patient and that there are no mix-ups of any kind. The fees charged by these companies may vary and could be higher depending on the complexity and length of the medical record.
When doctors have been in practice for many years, the number of patients who have been with them is also huge. In such cases, the medical records could be in two and three volumes, with each volume running to more than hundred pages. That is what adds to the fee amount.
The provincial Health Department officials also receive many inquiries regarding private medical record storage companies and their retrieval fees. They point out that charging a fee is at the discretion of the storage company and some companies may waive the fees if they believe the person requesting the record cannot afford to pay it. Nova Scotians can request their provincially held hospital records from the Provincial Electronic Health Record (SHARE) and this could include prescription information, blood work, X-rays, and other hospital events.
In the United States, medical records are typically stored in doctors’ offices, hospitals, pharmacies, and care facilities. Patients have certain rights regarding access to their medical records. Medical record retrieval fees may vary from one state to another, and patients, doctors, lawyers, and medical record retrieval companies all need to be aware of the legislation in this regard.