Staff at Tahoe Women's Care in Carson City, Nev., are digging through thousands of medical records left in disarray after the group's South Shore office shut its doors last year.
The Tahoe Women's Care office in South Lake Tahoe closed after contract negotiations between Barton Health and two OB-GYN physician groups fell through last fall. Barton opened its new facility, Barton Women's Health, on Jan. 2, but some new patients are still waiting for their previous medical charts.
According to Barton spokeswoman Rebecca Wass, Tahoe Women's Care staff boxed and alphabetized the records before they were delivered to the Nevada office at the end of December. The problem is those boxes became disorganized when they were moved into storage, gynecologist Dr. Gary Willen said.
"It's totally screwed up. To find one chart you have to look through 5,000," Willen said. "The contract says, 'deliver the records.' [Barton] met the letter of the law, if not the spirit."
According to Barton spokeswoman Monica Sciuto, Barton paid to have the files delivered to Tahoe Women's Care and that those records were left in good order.
"It is in Barton's best interest that the patient charts arrive arranged and orderly as it is likely that many patients would want to have access to their medical records in the long run," Sciuto wrote in an email.
Yet Willen said that if a new Lake Tahoe patient visits him or Dr. Carol Habaradas --another physician who formerly contracted with Barton and now practices in Carson City - the medical staff will have to physically search the storage unit for the chart. That means sifting through almost three dozen 40-pound boxes that he estimates contain anywhere from 6,000 to 10,000 records total.
If the team doesn't find the chart, they can reconstruct the patient's medical history by directly contacting labs for information like a women's blood test or pap smear results. It's a process that costs time and money, Willen said.
Dr. Kelly Shanahan with Emerald Bay Center for Women's Health said she hasn't had to conduct any new tests for patients since she's been able to get the necessary records from labs, but piecing together those histories often relies on a patient's memory. And some labs only keep the medical information for six months.
"Sometimes my staff has to be detectives to track those records down ... It's not a good way to treat the people in your community," Shanahan said.
Willen said he's still trying to get permission from Barton to transfer the records electronically, access that he thinks he should have by the end of March.
"We'll get through it. But I'm not going to let any patient that comes to me suffer for it. It won't affect the level of care," Willen said.
Sciuto stated in an email that, like Willen, the Barton Women's Health physicians don't need prior medical records to see a patient and that there are no delays regarding Tahoe Women's Care access to their electronic records.
"While it is helpful to have these records, it is not necessary to get an appointment and start care right away ... Barton Women's Health would be happy to work with patients to get the required forms filled out and sent to Tahoe Women's Care or any other prior provider for the acquisition of their files," Sciuto wrote.
As a California nonprofit and under the Corporate Practice of Medicine Act, Barton cannot legally employ physicians. Instead, it contracts with a number of physician groups to treat patients at the hospital, physician offices, the community clinic and the surgery center.
Barton entered into contract renewal negotiations with Tahoe Women's Care and Emerald Bay Center for Women's Health in January 2012, but was not able to come to an agreement with the physician groups. According to obstetrician and gynecologist Dr. Kris Kobalter, Barton told Tahoe Women's Care that the practice was losing too much money and they would need to downsize the number of doctors and decrease costs.
Barton was offering competitive, fair market value salaries, Barton Health's Chief Medical Officer Dr. Clint Purvance told the Tribune in October, but the groups couldn't come to an agreement.