SHB 1394
In CommitteeHouse
Hospital medical records
Concerning the retention of hospital medical records.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill increases the minimum time hospitals must keep medical records from 10 years (or longer for minors) to 26 years from the date the record is created, regardless of patient discharge date. It also clarifies how records must be stored and what happens if a hospital shuts down.
- All hospital medical records must be kept for 26 years from the date the record was created, regardless of when the patient was discharged.
- Records may be stored on paper, microfilm, electronic formats, or other approved media.
- Applies to records created before and after the law takes effect, but does not require hospitals to re-create or re-acquire records they already destroyed legally under the old rule.
- If a hospital closes, it must immediately arrange for secure preservation of its records, with approval from the Department of Health.
- The Department of Health must create rules specifying what types of records must be kept and what information they must contain, and may allow photographic (e.g., scanned) copies.
Who is affected
- Hospitals — Hospitals must now keep all medical records for at least 26 years from the date the record was created, regardless of when the patient was discharged. This applies to both paper and electronic records and may require changes to current record-keeping systems or storage practices.
- Patients — Patients may have access to older medical records for longer periods, especially for follow-up care, legal or insurance claims, or continuity of care across providers. Minors’ records are no longer treated differently under this rule.
- Washington State Department of Health — The state agency responsible for licensing and overseeing hospitals must issue new rules defining what constitutes a medical record and how it must be stored, and must approve record transfer plans if a hospital closes.
- Patients’ families and legal representatives — Patients’ families or legal representatives may need to locate and request older records for estate, legal, or healthcare decision-making purposes, especially if records were previously destroyed under the old 10-year rule.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (4)
Patients gain long-term access to their full medical history for up to 26 years after creation, improving continuity of care across providers, supporting accurate diagnosis of chronic or latent conditions, and enabling better-informed decisions for life-altering health events (e.g., surgery, pregnancy, mental health crises).
HealthcarePeopleRef: Sec. 1, subsection (1)Extended retention supports patients’ legal rights — such as in medical malpractice claims, disability applications, or insurance disputes — where older records are critical evidence, reducing the risk of denial due to missing documentation.
Rights & LibertiesPeopleRef: Sec. 1, subsection (1)Mandating immediate, DOH-approved record preservation during hospital closures protects public health data integrity, ensuring continuity of care for patients who rely on those facilities — especially vulnerable populations in rural or underserved communities.
Public SafetyPeopleRef: Sec. 1, subsection (2)Families and caregivers of children with complex medical histories gain access to records well into adulthood, supporting transition to adult care, accommodations in higher education, and informed life planning — particularly valuable for those with developmental or chronic conditions.
EducationPeopleRef: Sec. 1, subsection (1)
Potential Concerns (3)
Hospitals and healthcare systems will face increased operational costs to store and manage medical records for 26 years instead of 10, potentially requiring investments in digital archiving infrastructure, physical storage space, or third-party vendors — costs that may be passed to patients or absorbed by already strained hospital budgets.
Business & EmploymentLean industryRef: Sec. 1, subsection (1)The bill explicitly exempts hospitals from re-creating or re-acquiring records they legally destroyed under the prior 10-year rule, but this creates a fragmented, inconsistent record landscape — hospitals that kept records longer (e.g., due to litigation risk or internal policy) retain them, while others do not, increasing administrative complexity for inter-institutional record requests.
Business & EmploymentIndustryRef: Sec. 1, subsection (1)(b)The Department of Health must develop and enforce new regulatory standards for record retention and format, requiring additional staff time and technical expertise — though the fiscal impact is unspecified, this represents a new regulatory burden on state oversight capacity.
Local GovernmentLean industryRef: Sec. 1, subsection (3)
Who Is Most Affected
Hospitals face increased compliance costs for storage, digitization, and potential vendor contracts. While the exemption for previously destroyed records reduces retroactive burden, the 26-year rule exceeds industry best practices (typically 7–10 years), straining budgets — especially for small/rural hospitals.
Patients benefit significantly from longer access to records, especially those with chronic conditions, elderly patients, and those involved in legal or insurance claims. However, low-income and rural patients may still face barriers accessing archived records if hospitals digitize or outsource storage.
The Department of Health gains new rulemaking and oversight responsibilities, requiring technical and legal resources. This is a modest increase in workload but not a major budgetary shock — the agency already manages similar regulatory frameworks.
Legal representatives (e.g., malpractice attorneys, estate planners) and families may benefit from greater record availability, but also face challenges if records are inconsistently retained across hospitals — increasing research time and costs.
Insurance companies may benefit from more complete records for claims adjudication, but could face higher liability exposure if older records support previously unverifiable claims — though this is speculative and not directly incentivized by the bill.