Clinic being slow to produce medical records.

[Treasure]

Howdy! I'm curious if anyone else has had a difficult time getting their medical records from their dialysis center.

A year ago I was going to visit California for my son's wedding and requested some of my medical records to take with me on my trip. I noticed a mistake in my original diagnosis (which was FSGS, and not hypertension, as the records stated). It took a while, but I got that diagnosis corrected. But that had me thinking about other incorrect information in my records. In January of this year, I began verbally requesting my records from clinic (hint: part of the world's largest dialysis treatment provider). I was told that they were trying to retrieve my records from storage. When I was going to make a trip to Chicago for a transplant evaluation in April, I once again asked for access to my records. That didn't happen before my trip.

When I returned from Chicago I decided to put my request in writing (I had previously asked for a request form and was told that such a form didn't exist-- which I didn't buy, especially since I'm well aware of HIPAA requirements. I just typed up a letter, as per the suggestions on the HIPAA website). I gave my clinic 30 days to produce my records or offer an explanation about when they would be available. Instead of producing them, I was told that my medical records were with F's legal department. I asked for one piece of information from my records (as opposed to the any and all written request) and was told that my clinic had absolutely none of my file present in the clinic because it was all with legal (which was, of course, a lie. I knew this, but I had an employee go back and retrieve a physical file with some of my records in it, for verification that that was a lie. Not to mention that a lot of the data is in electronic form and could have been accessed).

Several employees at my current center told me that there had been piles of patient filing that had gone untouched for awhile, and I'm sure that's an issue regarding this clinic's poor record of records management. Interestingly, when F figured out I was serious about getting my records, they sent two managers over to "clean" up the files. Did they get a memo from the legal department to rush out and do that? We may never know!

I can tell you that F's delaying tactics have only served to fuel my resolve to gain access to my records. I am now going to request an index of my records, information about the organization and management of the records, and whether anything has been omitted or redacted-- especially by their legal department.

I am ever an advocate for my care (been doing this for twelve years now). I have filed a complaint with the state health services board and will be following up with other agencies. I also had my primary care doc request all of my records (F hasn't sent them all to her, either). I've also talked to a couple of attorneys. I know this will be resolved soon, but hopefully I won't have a stroke from worrying over this issue for several months now.

I am curious, though, if there are systemic problems with F and other dialysis treatment facilities handing over records as requested. Has anyone else experienced these sorts of problems getting their records?

Treasure

[iolaire]

Regarding legal it sounds like they worry that you are going to sue them.  Personally I doubt the fact that the documents are with legal changes any rules on how quickly they should provide them.   

Did they respond your written request (within 30 days) or did they request additional time (within 30 days) in writing?  If neither then I'd file a complaint.

Carrying Out the Denial

If the covered entity denies access, in whole or in part, to PHI requested by the individual, the covered entity must provide a denial in writing to the individual no later than within 30 calendar days of the request (or no later than within 60 calendar days if the covered entity notified the individual of an extension). See 45 CFR 164.524(b)(2). The denial must be in plain language and describe the basis for denial; if applicable, the individual’s right to have the decision reviewed and how to request such a review; and how the individual may submit a complaint to the covered entity or the HHS Office for Civil Rights. See 45 CFR 164.524(d).

This seems to be a good guide:
http://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access

[Michael Murphy]

Tell them if you are not provided yor records by the end of the week you will be contacting the CMS (Center for Medicare Medicaid Services) and report the inability of the clinic to provide access to your health records.  Access to these records is required in HIPA,.

[Treasure]

My clinic did not provide my records within 30 days. I did file a report with a state agency. IIRC, when I looked at the CMS process, it just referred me to my state agencies. We'll see what develops.