"Stroud v. Abington Memorial Hospital: Is This Why Chart Alteration Might Be Appealing?",and
"On Penalties for Alteration of Electronic Health Records"
"UPMC and the Sweet death that wasn't very sweet: How EMRs can detract from a clear narrative, and facilitate spoliation and obfuscation of evidence."
A commenter to the latter post led me to another blog where it was pointed out that in Michigan, intentional chart alteration by a healthcare provider is a felony (a criminal act, not just a civil matter), and looks like it has been since the early 1930's.
This would apply not just to paper records, but electronic as well, since the advent of HIT did not alter the essentials of medical record keeping:
Section 750.492a
THE MICHIGAN PENAL CODE (EXCERPT)
Act 328 of 1931
750.492a Placing misleading or inaccurate information in medical records or charts; alteration or destruction of medical records or charts; penalties; applicability of subsections (1) and (2); basis for civil action for damages not created.Sec. 492a.
(1) Except as otherwise provided in subsection (3), a health care provider or other person, knowing that the information is misleading or inaccurate, shall not intentionally, willfully, or recklessly place or direct another to place in a patient's medical record or chart misleading or inaccurate information regarding the diagnosis, treatment, or cause of a patient's condition. A violation of this subsection is punishable as follows:
(a) A health care provider who intentionally or willfully violates this subsection is guilty of a felony.
(b) A health care provider who recklessly violates this subsection is guilty of a misdemeanor, punishable by imprisonment for not more than 1 year, or a fine of not more than $1,000.00, or both.
(c) A person other than a health care provider who intentionally or willfully violates this subsection is guilty of a misdemeanor, punishable by imprisonment for not more than 1 year, or a fine of not more than $1,000.00, or both.
(d) A person other than a health care provider who recklessly violates this subsection is guilty of a misdemeanor.
(2) Except as otherwise provided in subsection (3), a health care provider or other person shall not intentionally or willfully alter or destroy or direct another to alter or destroy a patient's medical records or charts for the purpose of concealing his or her responsibility for the patient's injury, sickness, or death. A health care provider who violates this subsection is guilty of a felony. A person other than a health care provider who violates this subsection is guilty of a misdemeanor punishable by imprisonment for not more than 1 year, or a fine of not more than $1,000.00, or both.
(3) Subsections (1) and (2) do not apply to either of the following:
(a) Destruction of a patient's original medical record or chart if all of the information contained in or on the medical record or chart is otherwise retained by means of mechanical or electronic recording, chemical reproduction, or other equivalent techniques that accurately reproduce all of the information contained in or on the original or by reproduction pursuant to the records media act that accurately reproduces all of the information contained in or on the original.
(b) Supplementation of information or correction of an error in a patient's medical record or chart in a manner that reasonably discloses that the supplementation or correction was performed and that does not conceal or alter prior entries.
(4) This section does not create or provide a basis for a civil cause of action for damages.
History: Add. 1986, Act 184, Eff. Mar. 31, 1987 ;-- Am. 1992, Act 210, Imd. Eff. Oct. 5, 1992
© 2009 Legislative Council, State of Michigan
I will be giving some attention to try to make this well-deserved penalty the Law of the Land for electronic medical records.
-- SS
