Long after a patient leaves your clinic, you are required to keep their X-ray records in storage.
The films themselves are heavy and take up valuable space, so many chiropractors store the records digitally. Either way, federal and state standards dictate that clinics maintain X-rays for at least a few years after the last patient encounter.
Staying in compliance with these regulations will help you protect your patients and your clinic. By taking simple steps to store and protect your X-ray records, your clinic will be able to make use of this key diagnostic tool.
X-ray storage basics
Since the 1950s, most X-ray films are made from polyester and are fairly tolerant of different environmental conditions and temperatures. Kept together in files, X-rays are fairly heavy and may require heavy-duty cabinets to hold and store them.
As with other types of physical records containing patient information, X-rays are protected by HIPAA, so they must be guarded against potential security breaches. Digital X-ray storage saves space and may be easier to secure.¹
X-rays must be stored for several years, regardless of how you choose to store them. The exact length of time you must keep X-rays depends. Right now, there is no universal federal standard for healthcare X-ray retention and state requirements differ tremendously, so the American Health Information Management Association (AHIMA) suggests researching the standards that apply to your clinic from your state, the federal government, and industry associations such as AHIMA.
Review each standard and choose the longest from your list. For example, if federal recommendations, the state and industry say 4 years, 6 and 10 respectively, you should retain records for 10 years. Complying with the patchwork of laws is easier if your own clinic’s standards are higher than the minimum requirements.²
Integrated X-ray systems
By integrating your X-ray imaging with your EHR, you can access patient records quickly, efficiently and securely with x-rays and patient data all in one place. You can reduce the physical space in your office dedicated to storing X-ray films and make it easier to retain records from former patients.
Software is available that enables you to store and access these records from a computer, with some programs even supporting use with a mobile device such as a cell phone or tablet. From there, diagnostic apps that help physicians read X-rays, share results with patients by making their records accessible directly and other imaging apps are available.
These systems are becoming increasingly common and may allow chiropractors to review and use patient data more efficiently.³
Digital radiography may expose patients to less radiation, offers more options when reviewing images and is more easily transmitted than traditional, film-based systems. While viewing images, you can magnify details, change lighting and make other manipulations to x-rays. These features may help you provide more accurate interpretations and enable you to share these suggestions to patients.
Because digital images do not require developing chemicals or special storage, patients can quickly receive copies and you do not need special equipment and supplies to provide these records. Retaining old x-rays is simply a matter of storing the digital records.⁴
Retaining records does not have to be complicated or costly, but you may need to invest in new software and equipment for digital radiography. Be sure to ask plenty of questions to ensure that everything is fully compatible with your EHR.
¹National Archives. “Managing X-Ray Films as Federal Records.” http://www.archives.gov/records-mgmt/publications/managing-xray-films.html. Accessed July 2016.
²AHIMA. “Retention and Destruction of Health Information (2013 Update).” http://library.ahima.org/doc?oid=107114#.V42k05BHarW. Published 2013. Accessed July 2016.
³Bolan, C. “Tools for enhanced radiology workflow in an EHR environment.” Applied Radiology. http://appliedradiology.com/articles/tools-for-enhanced-radiology-workflow-in-an-ehr-environment. Published November 2012. Accessed July 2016.
⁴Sherman College of Chiropractic. “Advantages of Digital Radiography for Chiropractors.” http://www.sherman.edu/?p=8710. Accessed July 2016.