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Wednesday
Apr212010

« Records Retention »

Q: According to WAC 246-817-310, dentists are required to maintain treatment records for patients treated. How long are we required to maintain them?
A: The short answer is five years, the time stated in the regulation.  But the question really depends on all circumstances and laws beyond the regulation.  For example, under HIPAA, dentists are required to maintain records of disclosures of information for at least six years.  No doubt many dentists have found it expedient to keep all records indefinitely rather than to establish a records retention policy. 
Old and dusty records aren’t generally a source of liability.  This is because negligence claims associated with treatment provided are usually subject to specific statutes of limitation.  Generally, these limitations are three years for competent, adult patients.  For minor patients, the limiting period may extend to age twenty-one (3 years after adulthood).  The actual application of statutes of limitation have some exceptions and special rules, but this is the general idea.
Apart from the direct liability issue, a records retention policy makes sense for these reasons:
Expense and inconvenience of storing old records;
Expense of handling and reviewing records in responding to discovery 
requests in the event of litigation from other patients; and
Potential burden of adapting old records to electronic health record 
systems (EHR).
The second reason is speculative and would require a case where the treatment or products used for patients generally had some relevance to the claimant patient’s case.  It could happen, but may not be likely.
The third reason is more likely.  One of the goals for the country is an interoperable health records system.  To be useful, EHR is likely to include existing records as well as new records.  This may well establish definitions, codes and standards which could be at odds with the content of old records. 
Transferring old style records to a new system may be difficult. A reasonable records retention policy might reduce the expense and workload of establishing a conforming digital record system when that is required.
A general retention policy of six years could be workable.  But if practical experience tells you eight or ten years is better, use that time frame.
You may find it easier to do the culling of files once each year, so some records would be over your policy target age.
It is reasonable to keep records longer for ongoing patient relationships because of the greater likelihood of referring back to prior services and health history.
For minor patients, consider retaining records to age twenty-one or perhaps a couple years more than that.
Note:  Whenever you go to the trouble of looking at the old records, try to label them by year of services and as to persons not currently a patient.  This will allow for faster processing when you repeat the culling process every year or two.
It is a good idea to keep a systematic record of the files destroyed each year.  This will help you establish whether or not an individual was ever your patient.  Also, there may be an implied duty to keep some record of the file destruction under the regulation referred to above. 
Records retention policies have been a good idea for many years.  Now it may be an even better idea.

Records Retention
Q: According to WAC 246-817-310, dentists are required to maintain  treatment records for patients treated. How long are we required to  maintain them?

A: The short answer is five years, the time stated in the regulation.  But the question really depends on all circumstances and laws beyond the regulation.  For example, under HIPAA, dentists are required to maintain records of disclosures of information for at least six years.  No doubt many dentists have found it expedient to keep all records indefinitely rather than to establish a records retention policy.  Old and dusty records aren’t generally a source of liability.  This is because negligence claims associated with treatment provided are usually subject to specific statutes of limitation.  Generally, these limitations are three years for competent, adult patients.  For minor patients, the limiting period may extend to age twenty-one (3 years after adulthood).  The actual application of statutes of limitation have some exceptions and special rules, but this is the general idea. Apart from the direct liability issue, a records retention policy makes sense for these reasons: Expense and inconvenience of storing old records;
Expense of handling and reviewing records in responding to discovery  requests in the event of litigation from other patients; and
Potential burden of adapting old records to electronic health record  systems (EHR).
The second reason is speculative and would require a case where the treatment or products used for patients generally had some relevance to the claimant patient’s case.  It could happen, but may not be likely. The third reason is more likely.  One of the goals for the country is an interoperable health records system.  To be useful, EHR is likely to include existing records as well as new records.  This may well establish definitions, codes and standards which could be at odds with the content of old records.  Transferring old style records to a new system may be difficult. A reasonable records retention policy might reduce the expense and workload of establishing a conforming digital record system when that is required. A general retention policy of six years could be workable.  But if practical experience tells you eight or ten years is better, use that time frame. You may find it easier to do the culling of files once each year, so some records would be over your policy target age. It is reasonable to keep records longer for ongoing patient relationships because of the greater likelihood of referring back to prior services and health history. For minor patients, consider retaining records to age twenty-one or perhaps a couple years more than that.
Note:  Whenever you go to the trouble of looking at the old records, try to label them by year of services and as to persons not currently a patient.  This will allow for faster processing when you repeat the culling process every year or two. It is a good idea to keep a systematic record of the files destroyed each year.  This will help you establish whether or not an individual was ever your patient.  Also, there may be an implied duty to keep some record of the file destruction under the regulation referred to above.  Records retention policies have been a good idea for many years.  Now it may be an even better idea.