With meaningful use taking up all the top slots on the national EHR to-do list, record retention and preservation don't even make the first page.

Data storage is so cheap, so the popular thinking seems to be, we'll just keep everything and worry about it later. But Milton Corn, M.D., deputy director for research and education at the National Library of Medicine, thinks we should worry about it now. He's been worrying about it since shortly after the American Recovery and Reinvestment Act allocated billions of dollars for EHRs and he first began to consider the torrents of electronic medical data that will result.

What should be kept? For how long? What storage methods should be used, and will they be vulnerable to technological obsolescence? How can we ensure that the trove of information locked in the records can be analyzed by researchers without compromising patient privacy? "I think it's a rich issue and the discussion has just gotten started," Corn says. "I would like it if every hospital and physician's office started giving some thought to what they're going to do."

To that end, he organized a workshop in April, held at the NLM and co-sponsored by the National Institute for Standards and Technology, the Department of Veterans Affairs, and the National Archives and Records Administration. It attracted more than 90 attendees and identified some basic issues that all providers will have to deal with eventually.

"Our data will change formats and media many times," says Mark Frisse, M.D., professor of biomedical informatics at Vanderbilt University, who spoke at the workshop. "The question is, what's the cost of ownership and what is its real value? Do we need data on every American, or is it better to have really intensive data on 500 people or 1,000? Archivists must make these decisions in the here and now."

A feature story in the June issue of Health Data Management explores the myriad of issues surrounding the preservation of electronic health records.


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