A Comparative Overview of Medical Record Shredding (PHI) Disposal

Health Insurance Portability and Accountability Act of 1996 or the HIPAA has set the benchmarks concerning the proper disposal of medical records that have become redundant for a medical facility in the United States. These medical records are a source of Protected Health Information (PHI) and hence, contain vital individual information that needs to be safeguarded. A common scenario that requires the deletion of PHI is encountered when the healthcare contract between an individual and a provider is terminated. Under such circumstances, it is absolutely critical that the patient information should be completely deleted from the existing records of the healthcare facility. However, there has been a serious shortcoming in the seriousness with which patient information is being disposed.

This problem is particularly more prevalent among the healthcare practices that still endorse the use of paper for maintaining and updating PHI. Although, document shredding or physically destroying the paper records in any other comprehensive manner is effective, the entire process is rather cumbersome and time-consuming. This is where the advantage of maintaining medical records in the electronic form comes to the fore. PHI stored in the electronic or the scanned format too can lose its relevance since the scanned images may be no longer related to an individual’s health status or due to their inconclusive nature, may no longer provide any reference usage. However, it is much easier to delete electronically-stored PHI, since the maintenance of Electronic Medical Records is a well-planned process, being a part of a computerized content management system. This means the presence of periodic reminders and other self-automated technologies that ensure that unneeded medical records are highlighted to the concerned healthcare-facility professionals for scheduled deletion.

Issues related with disposal of PHI in the paper form
In recent years, there has been an increased emphasis being laid on orienting the healthcare industry towards creating a more eco-conscious workplace environment. As a result, some commonly-recommended ‘green’ practices have found their way to the healthcare facilities, such as Recycling of used paper. As a result, the practice of recycling of on-paper medical records is also gaining ground. However, it should be understood that recycling of medical records does lead to the creation of a very palpable risk to the patient’s privacy. In order to keep the operating costs to the minimal, the budgeted recycling technology in use could severely compromise the level of information safety that is associated with the re-utilization of the paper.

Thus, HIPAA endorses the view that Recycling of medical records does pose a potential violation to the sanctity of a patient’s information and hence, emphasizes that recycling should be allowed only if effective paper shredding methodology can be guaranteed. However, another issue arises in the form of the lack of any kind of standard protocol regarding the shredding techniques being used. As a result, in-house shredding of medical records for the sole purpose of document destruction creates more security concerns rather than resolving them. This is in stark contrast to the maintenance of PHI records in the electronic format which being a paperless medium is inherently a more eco-friendly medium and offers the convenience of immediate and undemanding disposal of patient information.