It is the new calendar year and time to update the patient files. The office manager explains that the law in this state requires that all medical offices maintain patient records, or charts, for seven years from the last medical treatment or consult. The charts of current patients, of patients who have contacted the office within the last year, or of patients who have an unpaid balance are kept in the front of the office for easy access. Added to the front of each current chart will be a new sticker that indicates the new calendar year; the new sticker is placed directly on top of the previous year's sticker. All other charts will be moved to a separate chart storage room, organized alphabetically, and grouped according to the last year in which there was contact with the patient. These older charts must remain readily available in case: The patient returns to the practice Records are subpoenaed by a court of law Records are requested for a medical history The office manager reminds the staff that all original charts belong to the physician who owns the practice. Copies can be made only when the patient signs a release authorizing the distribution to another party. When copies are made, a notation must be added to the chart that copying occurred and the date. In this state, even with a subpoena, physicians must have patient permission to release records to the court. Originals are never taken out of the medical office. At this same time, the staff will purge the chart room and shred the oldest charts. All charts that have had no activity in the last eight years will be either pulled apart and shredded in a shredding machine in the office or picked up by a local company that will shred the documents for the physician. It is essential, the office manager points out, that all documents be shredded, not just thrown away, in order to guard the confidential content of the documents.

As you read this chapter, consider the following questions:

1			What are advantages and disadvantages of different file systems?
2			What security measures might be used to protect patient files?
3			What is a tickler system and how is it set up?
4			Identify several storage options for closed charts. Which is the most secure? The easiest? The most cost-efficient?