In my previous post I talked about a few of the options related to shredding or archiving your paper charts after you’ve implemented an EMR and the paper charts aren’t being accessed.
Now let’s take a look at what’s just begun to come up in our clinic: EMR Data Archiving
Archiving Old EMR Records
Once you’ve been on an EMR for a number of years, you start to think about all of the data that’s stored in your EMR. Do you really want to store ALL of the information you’ve entered into an EMR in perpetuity? The answer as usual is maybe.
Quick Disclaimer: Before you do any EMR data archiving, you better talk to a good lawyer to make sure what you’re doing is legal in your state. I am not a lawyer and don’t even play one on TV. Just don’t be surprised if your lawyer say there’s no case law on this and so they’ll only be able to give you a best guess.
Now back to the point. The concepts in this are very similar to retention of paper charts. In fact, I’m guessing the laws for this will be similar to the laws on retention of paper charts.
On the one hand, it’s a great thing to be able to have years and years of a patient’s history available to you at the click of the button. In fact, in certain cases where you’re dealing with chronic conditions having all of the EMR data forever could be VERY valuable.
However, I see two possible problems with retaining all of your EMR data forever. First, there is a potential liability issue if you retain all of those records which are very old. If you’ve disposed of the data properly and according to state and federal laws, then you are no longer liable for the removed information that’s stored in the EMR. The second issue is that your EMR database grows larger and larger each year you use your EMR. Between all of the data that’s entered in the EMR and all the various scanned documents that are added to the EMR, the size of the database can be a huge issue after a number of years.
I’ll leave the first problem of liability to the lawyers. The second problem is really interesting. As your database grows, now database backups go from 5 minutes to sometimes hours (in some cases). Restoring all of that data will take a long time as well. At some point your server can run out of disk space for your database and will you even notice that it’s out of space before it’s too late and your server is in trouble? These are just a few of the issues related to storing all of your EMR data forever.
I don’t know of any EMR company that has implemented a solution for this problem. Although, it’s theoretically possible that you could extract the data from your EMR that was previous to a certain date. There could be multiple options with that data. For those concerned about liability, they could delete the extracted data and it would be gone forever. For those just concerned with the database size, you could move the extracted data onto another device or even just saved in a safe location (probably more than one location). In fact, you could even add it as its own database and your EMR company could give you a way to switch to the “archived EMR database” to see all of the archived data. Doing this will make your EMR database much smaller and much more manageable.
I have a feeling this post might have gotten a little too technical. Oh well, I guess sometimes the tech guy in me just comes out.
Also, lest someone starts typing a comment that the database will never get that big to matter. Be careful in saying never. Between scanned image files which are getting bigger and bigger as the quality improves and just the sheer length of time that people have owned an EMR this can happen. In fact, it has happened.