Closing a Practice
Back in 2011, this office issued an Advisory to address concerns we had at the time regarding abandoned patient records. That resource was titled, Advisory for Saskatchewan Trustees for Record Disposition. This office now again is looking to provide some advice to trustees that are winding up his or her practice as additional cases of abandoned patient records come to our attention.
In one recent case, a physician left the country leaving behind both paper and digital patient records in two different locations. Section 22 of The Health Information Protection Act (HIPA) requires trustees that are closing up his or her practice to transfer custody/control of patient records to another trustee or an Information Management Service Provider (IMSP) that is a designated archive. This physician did not do this. Instead an IMSP was left with physical possession of patient records. The full Investigation Report 214-2017 is available on our website here.
So what needs to be done in order to wrap up a practice without leaving loose ends? The Saskatchewan College of Physicians and Surgeons has a helpful resource, Leaving Practice – A guide for physicians and surgeons. In addition to HIPA obligations, this resource addresses other issues such as continuity of care and discharging patients. The Ontario Information and Privacy Commissioner published How to Avoid Abandoned Records: Guidelines on the Treatment of Personal Health Information, in the Event of a Change in Practice considering obligations under its Personal Health Information Protection Act, 2004. HIPA is of course similar but not identical and applies to a wide assortment of trustees (i.e. affiliates, Saskatchewan Health Authority) with custody or control of personal health information, not just physicians.
In terms of HIPA compliance, some of the most important steps to take before closing a practice are as follows:
- If you have not done so already, create an inventory of all records (paper and digital) in your custody or control;
- If you do not have one, create a record retention/disposition schedule for all records;
- Custody or control of patient records must be clearly established before taking action;
- Before transferring patient records, enter into a written agreement with the successor trustee or IMSP (that is a designated archive, see HIPA Regs s. 4);
- Ensure that any multi-function devices that may contain personal health information are sufficiently wiped/erased or hard-drives are destroyed;
- Provide advance, adequate notice (letters to patients, notice on doors, voicemail message and details in the newspaper and/or online) to patients and others;
- Securely transfer patient records; and
- Leave no records behind including securely destroying any records that are up for disposition.
If a member of a regulated profession, the trustee can also seek advice from its health professional body which also happens to be prescribed as designated archives in the HIPA Regs. Do you have more questions? If so, let us know.