Request for treatment records at an old job

[Psych19]

Hey all--looking to see how this sort of thing might be handled by others.
I left an inpatient job with a hospital system in July 2022.
I just got a fax from the medical records department at the hospital asking if I would release the records to a patient I treated during my stint with this hospital. They only gave me the name and MRN for the patient. I don't even have access to the EMR any longer. So I don't know or remember anything about this patient or his treatment history.

Frankly I'm surprised this is the first time i'm getting one of these requests since leaving my former employer. I used to get these requests to release records a few times per year when I was working there. I almost never (and maybe actually never) refused to release the records. The hospital system gives two choices: release records or do not release and I need to check one of two boxes about why I am not releasing the records that are approved reasons to deny to release the records. It would be legitimate to deny release if I believe the request could endanger the life of the patient or someone else, basically.

Without being able to see the treatment records or hospital notes, I don't know how I can say if I am okay releasing the records. Would the medical director or current head of the psychiatry department be the one to review these requests after former staff has left?

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[Bartelby]

If it were me I would authorize release unless I remembered a clear reason not it. It's pretty rare to deny that kind of permission.

And they probably still want your input because you know the patient / wrote the notes.

 

[comp1]

Sure you could call the medical director to review the notes over the phone. I agree this is awkward. There are a tiny minority of patients whose records might pose a risk to others, mostly staff, but I would be hard pressed to remember them from years ago without access to the EMR.

 

[Sushirolls]

You no longer work there.
The patient isn't yours anymore.
Tell them to leave you alone and bother the Medical Director. It is there job to field these.

 

[Stagg737]

Without being able to see the treatment records or hospital notes, I don't know how I can say if I am okay releasing the records. Would the medical director or current head of the psychiatry department be the one to review these requests after former staff has left?

Agree with Sushi. You don't work there anymore. You presumably don't have access to these records. This is not your responsibility unless your state has a law specifically outlining it is specifically the treating physician's responsibility, which I've never heard of. The medical director or some other higher up should deal with this. Not your problem.

I also thought that this would be irrelevant d/t the open notes rule in the 21st Century Cures Act anyway. EHRs must be released to patients if they request it unless there is something that would cause direct harm by releasing the info. Sounds like the hospital is just trying to pass on potential liability.

 

[allantois]

You forgot that in the US, corporations have more rights than people - they can make these demands of the corporation they were a patient of

 

[mistafab]

Dude you don’t work there.

Not sure why you are overthinking this.

 

[comp1]

The OP is overthinking it because the termination of doctor/patient relationships from an inpatient unit is complicated. It's often incorrectly complicated, but still complicated. I still get refill requests months after patients leave. I think we can kind of split down the middle and say that the OP literally can't respond to the request because responding to it requires EMR access to review. As such, the OP should politely call the medical director and leave a VM saying that you received this request, but you can't respond to it for the reasons above. Also, make sure medical records is aware that you can't respond to it. This also gives you a chance to educate them on the fact that you no longer work there (which they may very well not know) and that they should, in the future, address these requests to the medical director or staff that do actually work there. And this isn't irrelevant, even with our massively dangerous swing from paternalism to autonomy, someone with some clinical experience still has to decide if releasing the notes could pose a direct harm to someone else. In this case, I do believe it would be the unit or hospital medical director.

 

[splik]

Hey all--looking to see how this sort of thing might be handled by others.
I left an inpatient job with a hospital system in July 2022.
I just got a fax from the medical records department at the hospital asking if I would release the records to a patient I treated during my stint with this hospital. They only gave me the name and MRN for the patient. I don't even have access to the EMR any longer. So I don't know or remember anything about this patient or his treatment history.

Frankly I'm surprised this is the first time i'm getting one of these requests since leaving my former employer. I used to get these requests to release records a few times per year when I was working there. I almost never (and maybe actually never) refused to release the records. The hospital system gives two choices: release records or do not release and I need to check one of two boxes about why I am not releasing the records that are approved reasons to deny to release the records. It would be legitimate to deny release if I believe the request could endanger the life of the patient or someone else, basically.

Without being able to see the treatment records or hospital notes, I don't know how I can say if I am okay releasing the records. Would the medical director or current head of the psychiatry department be the one to review these requests after former staff has left?

I was in this situation when I left my last job. the medical records people kept calling me about releasing records because they had a policy about all psych records reviewed by the psychiatrist before release (which is a bit discriminatory). They even did for records the pt could already seen in mychart lol.

I just told them to stop calling me and release all pt records unless there really was something that might be concerning. The patient has the right to their medical records with vanishingly few exceptions.

Actually, there was one pt who had a factitious disorder. I told them not to release any records directly to the pt because he had a habit of doctoring them. I said they could release them to any treating clinicians.

 

[michaelrack]

Do you still have privileges at the hospital- if not, tell the hospital that the records request needs to be dealt with by a doctor with current privileges. IF you do have privileges, deal with the request yourself.

 

[Psych19]

Very helpful responses. I do not have privileges at this facility any longer. Consensus seems to be this isn't my problem to address. Thanks all.