Let’s talk about the always controversial and intriguing topic of purging EHR data. It’s something that’s no doubt talked about in every healthcare organization, but I honestly see very few people talking about it publicly. So, let me get the discussion started.
I find that most people are on two sides of the aisle when it comes to EHR data. You have the quality of care and research folks on one side of the aisle that say that they need all of the EHR data from throughout an entire person’s life in order to do their job at the highest level possible. Basically, they want all of the healthcare data collected for an individual available at any time any where.
On the other side of the aisle are the risk management folks who say that keeping the EHR data around opens up an institution to be liable for that data. Instead, if that EHR data is appropriately purged per state and federal record retention guidelines, then the healthcare organization is no longer liable. At least that’s the theory I’ve heard many argue when it comes to retention of health records.
The issue of record retention is not a new one. Many of these discussions happened with paper charts in the past. Do we store the old patient charts or do we shred them? I imagine whatever policy your hospital institution has for old patient charts is how you’re likely to approach EHR record retention as well. Although, the shift to electronic does pose some interesting changes to the dynamics.
For example, many hospitals likely chose to purge paper charts partially based on the cost of storing a large quantity of patient charts that will likely rarely get used. The cost of long term storage of an electronic patient chart is much less than storing a paper chart. Not to mention the cost of electronic storage is going down every day.
Another difference is the accessibility of an old paper chart stored in some offsite storage location. Even if you needed the chart it takes a lot of time to go and retrieve the old paper chart. This is not an issue with old electronic patient charts which can be easily pulled up on any computer.
The challenge for EHR purging is that most EHR vendors don’t provide an EHR chart archive or purge capability. EHR vendors should probably look to PACS and vendor neutral archive vendors for examples of how they do it. They’ve been doing this for a while since the size of the files are so large. Should the EHR data be purged from the main EHR and pushed to more of a document management type of software? These aren’t easy questions to answer.
I’m also reminded of a rural hospital who commented on a previous post I did about purging EHR data. They suggested that in the rural environment where you have deep relationships with all of the patients, it’s unacceptable for them to purge any EHR data. I thought this was an interesting commentary. No doubt the relationship between a rural healthcare provider and their patients has unique features that aren’t experienced in a large city.
What’s your approach to purging EHR data? Which features do you wish were available?