Question Software Vendor withholding access to medical records

Walker22

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My employer recently (Sept 2019) switched EHR vendors. Consequently, we no longer have login access to the old software. We recently had a legal request for a copy of the medical records for a patient we saw one time back in 2018. We contacted the old vendor to see about getting a copy, and we were told we would have to pay $1500.00 for a copy! This seems outrageous, and possibly illegal. Has anyone experienced this situation before? Are they within their rights to make us pay that fee? If they are in the wrong, who should we complain to? The OIG?

Thoughts?
 

sls314

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My employer recently (Sept 2019) switched EHR vendors. Consequently, we no longer have login access to the old software. We recently had a legal request for a copy of the medical records for a patient we saw one time back in 2018. We contacted the old vendor to see about getting a copy, and we were told we would have to pay $1500.00 for a copy! This seems outrageous, and possibly illegal. Has anyone experienced this situation before? Are they within their rights to make us pay that fee? If they are in the wrong, who should we complain to? The OIG?

Thoughts?

The first place I'd look is the contract between your organization and that EHR vendor. There should have been some sort of clause in the contractual agreement about how archived records would be retrieved after the agreement ended.
 

SharonCollachi

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This very scenario is why my staff has spent hundreds of hours downloading reports from our old EHR vendor, on over 8000 patients. When we were thinking about leaving, I asked if we would have access to a read-only copy of the program, and they said no. The contract was over 20 years old at that point and nowhere to be found. We have to be able to produce medical records, and they were being uncooperative with giving us information (came down to, "download it yourself"), hence the hundreds of man-hours.
 

csperoni

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When you terminate your previous EHR contract, you have a few options I can think of:
1) Continue to pay a fee to have access to the old records. Depending on the vendor, this could be almost the same as you were paying previously for that portion.
2) Do as Sharon did and download the records. It does not need to be printed on paper or anything. It can be data files you store in whatever secure way you prefer. I agree this is extremely time consuming.
3) Your old EHR vendor will gladly charge you way more than you ever thought possible to develop a way to transfer the data.
4) Sometimes your new EHR vendor is so excited about having you as a client (and maybe had another client with the same previous EHR) that they may be able to assist with the download, or have a way to transfer data. Your old vendor will charge you for any work/time they spend on this.

Try to think of it like this when everyone was on paper. Let's say you paid a storage facility to keep your old records. You decide to start using a new storage facility. It is your responsibility to either keep paying the old storage company, or move the charts to the new facility. If you no longer pay the old facility, they are not obligated to keep storing your records.

I would imagine the $1500 fee is not just to access this one record, but will give you access to additional information. I would immediately get on whichever option above is your best solution, as you are required to have access to past records for a certain number of years depending on your state. I have seen practices usually do a combination of options 1 & 2. They may keep the old system running for a year or two. Patients seen in that time frame have their records manually individually uploaded to the new system. During that time, the practice may hire some high school or college students to come work on weekends, over the summer, etc to complete option 2 if your current staff is unable.

My personal opinion is that EHR companies realize this, and once they have you as a client, they know how difficult and expensive it can be to change due to the legal wording of their contracts. Unfortunately, they do hold the cards (and the charts).

Good luck whichever option you choose!
 
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Hi, you would file a complaint with the HHS Office for Civil Rights. This may be a violation of the recent interoperability rules that I believe specifically forbid the practice you describe. Good luck.

Update - a colleague informs me you should go straight to ONC with your complaint. You can read about information blocking and file a compliant here: https://www.healthit.gov/topic/information-blocking
 
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csperoni

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I personally don't think you have a leg to stand on, but I hope I'm wrong. The previous EHR vendor is simply stating you have to pay a fee to continue to use their service. Your company chose not to transfer the records while you did have access. There is specifically a "fees exception" in the information blocking link provided by jkyles. I go back to the paper chart example in my first post about this. If you cancel your storage facility and no longer pay them store your old paper charts, and don't move them out of the storage facility before cancelling, that company is not restricting or blocking your access. If the storage facility happened to keep your records there, and you wanted them a year and a half later, they would require you to pay the rent for the past year and a half to gain access.
In fact, here's an article by the same ONC explaining that unless it's in your contract (and I can't imagine it is), your old EHR vendor doesn't need to give you access once the contract is terminated. https://www.healthit.gov/sites/default/files/playbook/pdf/ehr-contract-guide-chapter-9.pdf There's actually a lot of great advice in there about what to ask for when you are signing an initial EHR contract.
 
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