As storage space becomes more limited, healthcare providers often wonder when they can begin disposing of old patient records. The recommended time for retaining medical records depends on a number of factors, including:
- State regulations.
- Medicare and third-party payor requirements.
- Standards set by accreditation organizations
- The statute of limitations for bringing medical malpractice claims or other legal action against the healthcare provider.
The safest approach is to retain medical records for adult patients at least 10 years; longer if the patient was a minor or incompetent at the time of treatment.
State regulations tend to vary widely, and often depend on how the provider is licensed. Physicians are less likely to be subject to state regulations regarding retention of medical records than hospitals and other institutional providers which usually are governed by specific state licensure requirements. State licensing agencies may impose longer retention periods for X-rays and similar documents than for other types of medical records.
Under Medicare, the retention periods range from five to seven years, depending on the particular coverage program or type of document. Other third-party payors generally impose similar requirements, although the contractual terms of the agreement may need to be reviewed. The American Hospital Association and American Health Information Management Association both recommend retaining medical records for at least 10 years after a patient's most recent treatment. Longer periods are recommended if the patient received experimental treatment since the records could be needed for future medical research.
Healthcare providers also need to retain medical records for the full period during which an injured patient can sue. State laws generally impose a specific time limit – the statute of limitations – for bringing a malpractice action against a healthcare provider. Statutes of limitations for adult patients usually range from one to five years following the injury. Sometimes this time period can be extended, however, if the patient was continuing to receive treatment or could not have discovered the injury until later.
Retention times become even more complicated if the patient was a minor or was not mentally competent at the time of treatment. In most states, the statute of limitations does not start running while the patient is a minor or is otherwise incapable of suing. Therefore, medical records for such patients should be retained for several years after the patient reaches the age of majority; indefinitely if the patient is incompetent.
Fortunately, it is not usually necessary to retain the records in paper form for the entire time. Most states allow the records to be stored either electronically or by microfilm, as long as they are readily retrievable.
Once the healthcare provider is ready to dispose of old medical records, care must be taken to dispose of them so patient confidentiality is not compromised. Some states have specific requirements regarding the appropriate method of disposal, such as burning or shredding. Documentation of proper destruction should be maintained.
If an outside firm is hired to dispose of the records, the firm should be required to acknowledge the confidentiality requirements. The firm also should certify the records have been destroyed properly and agree to indemnify the provider if patient confidentiality rights are breached.