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doorstep. However, it is in the CE’s best interest to partner with the BA, because the off-site storage company is an extension of the hospital’s own records library.


April D. Robertson, MPA, RHIA, CHPS, FAHIMA, is vice president, customer advocacy, HealthPort.


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Retrieval and retention drives need detailed inventory Secondly, CEs and BAs


also require inventories for effective record retention and retrieval. An example comes from a recently retired health information management (HIM) di- rector for a large, multi-location healthcare facility who recounts an incident when the facility’s tracking system crashed. With the system down, the facility did not know what was in storage, and the off-site storage vendor did not have a computerized list of all the charts. Shortly thereafter, a request was made for a chart, and the facility was unable to find it. This led to a lawsuit resulting in significant monetary damage to the facility. With regard to retention, a record may be subject to many different laws, with each law mandating a different length of storage. In California, for ex- ample, the MediCal Act and the Emergency Medical Services Fund require patient records be kept for a minimum of three years, whereas OSHA requires employee health records to be kept for the duration of an employees’ employment plus 30 years if an employee could potentially have been exposed to dangerous substances.


Important points for inventories and documentation management


• In the event of a lawsuit, the covered entities (CEs) must know who is in possession of a record in order to produce it within a mandated time.


• Retention requirements may be subject to a vari- ety of laws, such as length of storage or duration of employment. A detailed inventory makes the process more effi cient and less risky in regards to compliance.


• Knowing the location of records is critical and can only be ensured with a proper inventory system.


• Storage companies must spend the time to index the records. The CE will have to pay for the ad- ditional work that may have been waived during the initial transfer of records.


Clearly, the CE must know who is in possession of each specific record in order to produce the record in a timely manner and comply with record reten- tion laws.


Provider liability: Shifting risk is risky business Finally, the storage relationship is a collaborative one. There are benefits to partnership and dangers in failing to work together. Just as a CE would not undermine its on-site records library, it should not do so to its off-site library by attempting to unnecessarily shift risk to the BA. Shifting the risk unnecessarily from the CE to the BA does not foster high levels of patient service, security and privacy.


The need to store and manage physical records will continue for decades, even with the implementation of electronic health records.


However, with increased liability comes increased


cost. “For the storage vendor to accept more risk at the same negotiated prices denies the economic real- ity of the free-market system,” says Jim Booth, ex- ecutive director of PRISM International, a nonprofit professional trade association for the commercial information management industry. Providers should anticipate increased costs for paper record storage under the new HIPAA rules.


Going forward With the CE and BA equally responsible for the protection of PHI, it is incumbent upon both par- ties to establish the location of each unique record. Doing so will require that record storage companies spend the time to index the records and that CEs pay for the additional work that they likely waived during the initial transfer of records. The process will not be without cost, but legally both parties are accountable. Furthermore, the regulatory climate will not be- come more lax as it attempts to protect privacy in light of advances in technology. The need to store and manage physical records will continue for decades, even with the implementation of electronic health re- cords. Without a mutual effort to inventory records, there will be much finger pointing in court – and else- where – for many years to come.


HMT www.healthmgttech.com HEALTH MANAGEMENT TECHNOLOGY November 2010 27


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