Saturday, December 22, 2007

Storage and Backup of Clinical Records

Clinicians should all be aware of the necessity of keeping secure and private clinical records. A major problem is where to store them. I have been engaged in a seemingly endless quest to find places to put my "stuff" following the sale of a large house in a rural-suburban area and the subsequent move into a much smaller apartment. This compacting process has included such trivial efforts as discarding standard sized Jewel Cases and using either the slim-line type or paper or vinyl sleeves to store CDs and DVDs. I have purchased a very large capacity but small sized Maxtor outboard hard drive. Along with efforts in the computer area, I have given away, donated, discarded, or sold items such as a breadmaker, fine, unused cooking equipment, antique furniture, and half my "wardrobe." The latter was comprised primarily of jeans with holes in the knees and flannel shirts with gaping rents at the elbow, so not much loss there. I have shredded many records and plan to store client records in .PDF file form soon. I had tried the free CutePDF Writer and free Converter and found them to be the best for my needs among the various types of .PDF programs. I liked them so much, really, that I purchased the CutePDF Pro version which included the CutePDF Form Filler for $49.95. Among the many other features provided in the Pro version are the ability to scan to PDF (scan your session notes directly into a PDF document,) the ability to FTP upload the document (for file sharing or for online storage,) and most important to compliance with HIPAA requirements, the ability to encrypt the document at a 40-bit or 128-bit level. With the Form Fill portion, one could easily produce a standard intake or interview form, save to PDF, encrypt it, and be compliant in storing it online, burned to disk, or saved on a hard drive. I'm sure by this point I must seem like I am doing a paid advertisement. I am not. Certainly there are other similar programs available, but I have used this one and am thoroughly satisfied with it.

Another aspect to consider when using any computer to produce important documents is the absolute certainty that it will crash or die, taking all your records with it, at the most inconvenient possible time. The answer to this is backup, backup, backup! I have had enough computers quit without giving the required two weeks notice that I have learned this lesson several times over. Again, I have tried and accepted a method to insure against this disaster. I use a Maxtor OneTouch 4 Plus 750 GB external drive which can be used with either a USB.2 or a FireWire 400 connection to the computer. A review of this drive by PC Magazine staff rated it very good and states that the bottom line is; "The Maxtor OneTouch 4 Plus exists as extra storage, but it's really there to save your butt. The next time your system crashes, this drive will get you on your feet again." The drive comes in 250, 500, and 750 GB models, with a very recent release of a 1000 GB (1TB) model, made by pairing two 500 GB drives in one case. One can store the usual documents, pictures, music, and the like on any of them. This series of drives also backs up everything on your computer, including the Operating System, to restore to a new drive in case of a catastrophe. Again, I know that there are similar drives and programs that allow the same types of backup, but after obsessively studying the specifications and abilities of everything I could find with these capabilities, this was my choice and it has worked well.

Backing up only files of whatever type can be accomplished by burning them, in encrypted form, to CD or DVD. There are many programs that will do this efficiently and effectively. I use Roxio's Easy Media Creator 8 (it has advanced to Easy Media Creator Suite 10 recently) and find it more than adequate to do what I want it to do.

Finally, there is online storage for files. I trust it enough for blogs, songs, pictures, and relatively unimportant documents. However, having had my EIN and SS numbers with all other personal and business information "lost" by a government agency, I am less than enthusiastic about the security of information stored anywhere not directly under my control. If you have a Google account and use the Firefox browser, there is an add-on available called G-Drive that allows one to store up to about 5 GB of information online free. A number of other companies offer free and paid storage with varying sizes, charges, and layers of security. I will simply mention MediaMax which offers 25 GB of free storage and increasingly larger amounts for increasing fees.

Until I write next, I'll be trying to force myself to part with my dissertation data (collected over 30 years ago) and deciding what to do with the toy airplanes with 16 foot wingspans. Even the cats seem a bit anxious.

Peace, Doc

Copyright © 2007, Thomas A. Blood, Ph.D.

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