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By GRACE CORDOVANO, DEVEN McGRAW, and AARON MIRI
The HIPAA Privacy Rule gives patients the right to copies of their medical records, with rare exceptions. When patients need a copy of their medical records, most start the process by calling their doctor’s office and asking for how to get access. The receptionist or office staff point them in the right direction, whether it’s instructing them to write down their request and sending it to the office, pointing them to contact the medical records or radiology department (if the practice is large enough), or assisting them in setting up their patient portal, if the practice is using an electronic health record (EHR). Being able to connect with a person inside the four walls of medicine is often crucial for many patients and their carepartners who may be unsure of exactly how to request their records.
But what happens to those records when a doctor closes or leaves the practice?
Independent practices close for a variety of reasons. Physicians may merge with a large practice or health system, retire, they may sell or close their practice for personal reasons, they may file for bankruptcy, or they may get sick and die. The COVID19 pandemic has had devastating financial consequences on many small, independent, and rural practices, leading to their consequent closure, acquisition, or merger.
What should patients do when their doctor’s office closes, and they need a copy of their medical records? This is especially challenging when a doctor may not have had an EHR, as is the case with many independent practices as well as more rural settings. On September 26, 2020, a tweet from Cait DesRoches, Executive Director of OpenNotes, inquired about how a family member may get access to medical records from her physican’s practice that closed, triggering a robust conversation that led to the realization that patients and families are not well informed in these circumstances.
Prevention is Worth a Pound of Cure
It can be much more difficult to get copies of records after a practice has closed. Patients should get copies of their medical records as they are generated instead of waiting until they’re needed. HIPAA Privacy Rule guidance states that individuals can get digital copies of digital information (or even digital copies of records kept on paper, as long as the practice has a scanner). Companies are developing tools and services that enable individuals and their care partners to collect, use, and store health records. Request digital (or paper, if that is preferred) copies of blood work, imaging, discharge instructions, and corresponding reports before you leave the practice.
What Happens to Medical Records When Offices Close? The Law
The Health Insurance Portability and Accountability Act (HIPAA) does not require a physician to retain medical records for any particular period of time. (HIPAA covered entities – which include physicians who bill health insurers for care – are required to keep records demonstrating compliance with HIPAA for at least six years – but those records are distinct from medical records.
) However, if the physician still has those medical records – or has placed them in storage for safekeeping – the HIPAA requirements to produce them when a patient requests still apply.
State laws typically set medical record retention requirements for physicians and may also require the physician to take particular steps (such as notifying a patient) prior to or upon closure of a practice.
An example of some of these state laws:
During the record retention period, these records are considered to be still “available” and subject to the HIPAA right of access. Consult the medical board or the state medical society in the state where the physician has practiced for further information about physician requirements in the event of closure of a practice. The Medical Board should also have information about how to file a complaint if the physician’s practice has closed without any notice or information about how to obtain records.
Irrespective of legal requirements, the American Academy of Family Physicians recommend that patients be notified by a letter that the office is closing, giving them the opportunity to obtain a copy of their medical records or have records forwarded to a physician of their choosing. The office may post an update on their website or social media page(s), if ones exist or run an ad in the local newspaper.
Patients should be notified who will be the custodian of the medical records and their contact information.
Sorry! The Office Is Closed
Unfortunately, the reality is that most individuals do not get copies of their medical records throughout their care journey. This leaves patients and carepartners in need of records facing significant uncertainty, stress, and frustration when they unexpectedly find out that their doctor’s office has closed. Here are a number of critical tips to assist patients in gathering their medical records, directly and indirectly, in the event their doctor’s office has closed.
(As noted above, state laws may allow for them to be destroyed even sooner than 10 years.)
Social media managers are often very responsive and may be an additional avenue for connecting individuals to the information they need if it is perceived that delays in response may be detrimental to their company’s reputation.
Consequently, the specific state’s county probate court may be contacted to confirm if there is a designated executor of estate that has authority over records retention processes. Alternatively, an obituary may list surviving next of kin which may also be contacted for more information on records retention.
Individuals may also file a complaint with the Office of Civil Rights (OCR) at the Department of Health and Human Services (HHS) if all efforts have been exhausted and the needed medical records have not been obtained.
A closed practice does not need to be a dead end for patient access. Proactively requesting copies of medical records throughout one’s care journey can prevent encountering such patient access barriers. Continuing to share best practices for navigating patient access barriers, from legal, regulatory, and practical standpoints, is in the best interest of all patients.
Grace Cordovano, PhD, BCPA is a board-certified patient advocate specializing in the oncology space, a patient experience enhancer, and information unblocker.
Deven McGraw , JD, MPH, LLM (@healthprivacy) is the Chief Regulatory Officer at Ciitizen (and former official at OCR and ONC).
She blogs at ciitizen.com.
Aaron Miri is the Chief Information Officer for The University of Texas at Austin comprising of the Dell Medical School, UT Health Austin clinical enterprise, research, and community impact missions.
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Categories: Uncategorized
Tagged as: Aaron Miri, Deven McGraw, Grace Cordovano, Health Data, HIPAA, Medical Records
The Health Insurance Portability and Accountability Act (HIPAA) gives you control over your medical records. That means you can obtain your medical records when you need to and you can shield them from others. This includes paper records and charts as well as electronic health records.
It is a good idea to review your records periodically, such as each time you visit the doctor. By doing so, you learn what information is out there about you and can keep tabs on your health.
Because you know your body better than anyone, keeping tabs on your health data over time can alert you to any changes that you should bring up with your physician.
If you believe you have been a victim of medical negligence, you will need to obtain your medical records before you file for medical malpractice. This includes diagnoses, lab results, doctor’s notes, billing information, and other health data.
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The fastest and easiest way to get copies of your medical records is to contact your provider. For instance, if you are seeking orthodontic records, contact your orthodontist’s office. If you want to look at the lab values from your latest thyroid screening, get in touch with the office of your endocrinologist or internist.
Most providers have an easy, straightforward form you can fill out to request access to your medical records. They can provide you with a copy of this form in person or via email, mail, or fax.
You simply fill out the form with the requested information, provide proof of your identity, and you should receive immediate access to your records.
If your provider does not have a standard form, you can receive access to your records by making a written request. Include in the letter your identifying information, proof of identity, and the specific records you want to access.
A common challenge for patients is attempting to obtain medical records from doctors or healthcare providers who have retired, moved, or are no longer at the same practice.
If the practice where you received care is still open, you should be able to retrieve your records there even if your specific physician has moved on. You would simply contact the practice and fill out a records request the same as if your doctor still practiced there. As long as you can provide proof of your identity, the practice should still have your records on file.
If the practice itself is no longer in business, obtaining your records becomes slightly more challenging, but in most cases, you can obtain them by taking the following steps.
Tell them the name of your doctor and the name of the practice and see if they know where your records are being stored.
If that does not lead you to your records, get in touch with the state medical association. They can often help you track down records from doctors or practices no longer in operation.
Finally, if you are still having issues, make a list of the hospitals in the area and call them one by one. At some point, your doctor might have registered to treat patients through a local hospital, and if so, the doctor likely went through an extensive formal process to receive permission. The hospital then likely knows where the records of patients treated by that doctor are located.
In rare cases, a doctor can legally deny access to certain medical records. This situation occurs most commonly with mental health records. By law, your doctor can deny access to certain mental health records if they believe that letting you view your records might endanger your physical health or well-being.
If a healthcare professional decides to deny you access to your medical records for any reason, they must provide you with a written record detailing their decision.
If a doctor or facility tries to deny you access in an attempt to conceal altered hospital records, you could have grounds to file a malpractice claim.
The medical malpractice lawyers at Medical Malpractice Help can help you defend your rights as a patient. If you have any questions or concerns about the care you have received or the accuracy of your medical records, we want to help.
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To the question: “How to get a medical book for work?” you can either answer briefly, or consider several options for solving it.
If you are in a hurry to get the answer , then you need the fastest solution - issuing a medical book in a commercial medical center that has the necessary valid licenses for medical services and meets the requirements of the law for medical centers. This will give you a guarantee that the issued medical book will not cause any trouble for you or your employer. nine0003
This medical center is MedProf, which has sites in St. Petersburg and Moscow. You can read more about the medical book registration service at MedProf on its page.
If you are someone who carefully collects information , considers different options for solving your pressing issue, weighs all the pros and cons, and then makes a deliberate choice, then we are ready to help you with this and provide the necessary information about how to apply for a medical book to get the job of your dreams. nine0003
You can do it yourself or through a commercial organization, as we mentioned earlier.
Making a health book or the so-called health minimum is a multi-stage process:
First, you need to pass a medical examination , in which you need to visit several medical specialists and pass tests.
listen to a short theoretical course.
Thirdly, pass certification on the basis of the completed course.
Fourthly, draw up a form of personal medical book , enter there marks on the certification passed, the conclusions of all medical specialists and the results of the tests. Of course, you can't bring it all in with your own hands :)
Fifthly, register a medical book with Rospotrebnadzor. nine0008
Now that you understand the whole process of obtaining a medical book, you can consider it in the context of different options for solving this issue.
Let's say you have a great sense of adventure.
In this case, you should do the independent registration of a medical book.
First you need to contact the Center for Hygiene and Epidemiology in order to officially purchase a form of a personal medical book. nine0003
After you have a form or just a medical book (sanitary book) in your hands, you need to undergo a medical examination in accordance with the requirements for its volume.
You will be assisted in visiting doctors, getting the results of laboratory tests and functional diagnostics:
Yes, get ready, the program will be extensive and incredibly exciting :)
Epidemiology, in order to register a medical book with Rospotrebnadzor. It will take 1-3 working days, after which you can pick it up and solemnly hand it over to your future employer.
Theoretically, everything is very easy, but in practice there are different nuances.
1. The whole process is completely under your control. The better you understand the issue, the less the risk of making a mistake - to go through an incomplete examination, skip an error when processing documents, not notice that somewhere they forgot to put the necessary stamp, etc.
2. The final cost of the medical book will be known only after receiving it. It is very likely that in the end the savings will not work or the savings will be negligible. nine0003
3. In public clinics, very often the staff of doctors is not 100% staffed. In practice, this may mean the following:
4.
You will need to additionally look for a photo studio in order to take the correct photo for the medical book.
5. Not all public clinics do fluorography, so there is a chance that you will have to go to the nearest fluorography station.
6. CHI covers tests and functional studies for health reasons, that is, you still have to incur financial costs to apply for a medical book. nine0003
But all this, of course, can be endured if you are an avid fan of standing in lines, listening to the latest news from the members of the “over 65” club, watching and maybe even participating in the RUDE creative impulse of all those gathered here :)
Registration of a health book in MedProf is an outrageously simple way to get a medical book registered with Rospotrebnadzor in the shortest possible time for a legal document. Without the need for your own immersion in the topic of the issue and its personal control.
nine0003
Namely:
Still have questions? We will be happy to answer them by phone: +7 (812) 443-86-93.
1. Visit honey. center
3. Getting Personal medical book
When a driver is hired by an organization, an employee of the personnel department is obliged to accept from him a standard package of documents established by Article 65 of the Labor Code of the Russian Federation. Such documents include a passport, a work book, an insurance certificate of state pension insurance, a document on education, etc. Also, in accordance with Article 328 of the Labor Code of the Russian Federation, an employee whose activities will be directly related to the movement of the vehicle is hired only after he has passed the mandatory preliminary medical examination. However, this is not the only medical document according to the Labor Code of the Russian Federation that a driver may need for employment.
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According to Article 213 of the Labor Code, if a person gets a job in a food industry, catering and trade organization, medical and children's institutions, water supply facilities and some other employers, he must undergo a medical examination to issue a personal medical book (LMK). This document must be obtained in order to protect public health, prevent the occurrence and spread of diseases. We add that the requirements of the Labor Code of the Russian Federation are supplemented by the Letter of the Ministry of Health of the Russian Federation of 08/07/2000 No. №1100/2196-0-117. On the basis of this document, those involved in the production, storage, transportation and sale of food products and drinking water will also have to issue a sanitary book; communal and consumer services to the population, as well as persons working in transport enterprises and engaged in the transportation of people. Summarizing, we can say that a health book (medical book) is equally necessary for a refrigerator driver transporting food; forwarding driver of the laboratory performing the transportation of medical tests; driver-courier for the delivery of bottled drinking water; taxi driver or driver of city, intercity and international buses.
About what kind of examination these workers need to pass and what is its price, read on. nine0003
The profession of a driver is not a criterion that affects the scope of the survey. The list of specialist doctors, laboratory and functional studies, which is required by the driver's health book, is determined by the area of \u200b\u200bhis activity. In accordance with it and on the basis of the Order of the Ministry of Health and Social Development of 12.04.2011. No. 302n, each driver will find out in a medical institution the scope of the upcoming examination. This means that a forwarding driver from one field of activity and his colleague, but from another field of activity, will issue a medical book in different ways - they will need to take slightly different tests and go through different doctors. nine0003
If a woman works as a vehicle driver, then this increases the scope of the survey.
The driver's license is valid for 12 months.
After this period, the employee of the taxi service or the transport department of any other organization will need to undergo the examination again in the amount prescribed by law in order to be able to continue working as a driver.
When the necessary document needs to be issued quickly, each of us will consider all possible options for resolving the issue. In this regard, we hasten to warn you. Offers to buy a personal medical book with delivery to the door of the house in 1 day should be rejected. The procedure for issuing and renewing a medical book does not involve the purchase and sale of a finished document in absentia.
Be careful, acquiring LMC in this way is illegal and punishable by law for all parties to the transaction. nine0003
Where to make for the first time and extend the medical book for the driver urgently? To undergo an examination and enter its results in the LMC, you should personally contact medical institutions with state permission for this type of activity.
