Like business breakups in any field, when a medical practice loses a partner or dissolves to spawn new and separate businesses, the inevitable division of assets can often lead to disagreements between the separating parties. One area that is particularly susceptible to such disputes is patient medical records. Deciding who gets what patient information at the time of a practice break up will often present very difficult issues and can drive a driver of costly litigation.
To avoid this scenario, physician partners should plan ahead. This requires devising and implementing consistent, workable procedures that can be incorporated into the day-to-day operations of your practice and into your practice management and EMR systems. Work with your partners, with your IT/EMR providers, and with your system users to create patient distribution and allocation protocols that ensure that everyone responsible for generating, managing and ultimately sorting through patient records is on the same page.
The first step is to determine a method for allocating patients. Whether a partner is coming in with a book of existing, established patients, or whether physicians are determining how to assign fairly new patients among members of a group, the key is to have a system to which all the partners agree and which can be clearly tracked through your EMR/practice management system.
Consider allocating each patient to a particular physician by a searchable and commonly-used statistical/demographic or other “key” recognizable and sortable by your EMR system. Then, at the time of separation, when a departing physician wants “his” or “her” patient records, the practice will be able to call upon the EMR provider to sort the data base and provide only the records that physician is entitled as a matter of law and practice. Applicable regulations may also require that the practice provide records to which actually generated by the departing physician; so using “encounters” or “physician name” as the “key” used for later sorting may be advisable.
Incorporating a system for allocating patients, and a universal means to assign patients or patient encounters with particular physicians into your practice is step one. Step two is to make reference to that protocol in binding agreements. Implementing these protocols will do little good; there is no obligation to comply with those protocols upon a dissolution of or departure from a practice group. In your agreement, consider making direct reference to the protocol, identifying how patient data will be distributed and on what timelines, and at whose expense.
No one wants to think about breaking up at the beginning of the relationship, but if you wait until the relationship becomes tense or shows signs of faltering, it may be too late to start developing protocols. Patient medical records is one area that, with the appropriate foresight and advice, partners can get comfortable with a system on the front-end to avoid or mitigate potentially costly disputes at the back-end.