Every doctor who asks me about going digital asks a version of the same question: what happens to my old records?
The short answer is that nothing has to happen to them before you start. You don’t have to encode them, scan them, or move them anywhere first. The folders stay in the cabinet, and most of them stay there for good.
It’s also what most of the clinics I’ve talked to that went digital in the last ten years actually did, whether they planned to or not. The full-migration plans I’ve seen mostly stalled, and it was never the doctor; a running clinic has no spare month. The ones who started with the paper still in the cabinet mostly never needed the month.
“Migrate my records” means three different things
When a doctor says they need to migrate their records, they usually mean one of three things, and they have three different answers.
Just the patient list
Names, numbers, birthdays. This is the one worth moving early, and it’s small. A few hundred names is about a day of typing for a secretary, or an import if the list already lives in a spreadsheet.
The last few visits of your regulars
The patients you see every month, usually a few dozen, and their last handful of visits. This is the part that makes the new chart useful early, and it’s small enough to do one patient at a time.
Every chart since the clinic opened
Every visit, every lab result, every patient. This is what the word migration brings to mind, and it’s the part almost nobody finishes. It’s also the part you almost never need.
The cabinet is mostly patients who aren’t coming back
This is the thing I’d ask you to notice, because it changes the size of the job.
A clinic that’s been running since 2012 has a folder for everyone who ever walked in. The patient who came once for a fever in 2014. The family whose HMO changed in 2019. The referral who went back to their own doctor. They’re all in the cabinet, and they take up the same space as your regulars.
Pull out the folders of patients you’ve actually seen this year and the cabinet gets a lot smaller. Pull out the ones you’ll see in the next thirty days and, for most solo practices, it fits on a desk; for a busy one, a shelf. Either way, that pile is the whole migration, and the rest is storage.
Sort the cabinet by who is coming back
The useful way to think about the old folders is by patient, not by method. Three groups, three answers.
This month’s patients
Their folders come out of the cabinet and sit next to the computer. When each one arrives, the doctor reads the old folder the way they always have and writes today’s visit into the new chart. Nobody types history. The folder is a reference, and the new chart starts from today.
This year’s regulars
The patients you see every month or two. Their folders stay put until each one next walks in, and at that visit the secretary keys in the last visit or two while the doctor is with the patient. Ten minutes per patient, done at the visit rather than in advance, which means it happens in the order patients actually return and never turns into a backlog.
Everyone else
Nothing. They’re storage. If one of them comes back in 2028, the folder comes out, the doctor reads it, and today’s visit goes in the new chart like anyone else’s.
If you want the cabinet gone
Some doctors do, for space or for peace of mind. That’s a hired scanning job, priced per folder, and the one rule is to do it after the clinic is already running on the new system, never as the condition for starting. Ask whether the scans can be attached to each patient in your system before you pay for the job, because a folder of PDFs on a hard drive is a second cabinet.
Whatever retention rule applies to your practice applies to the paper exactly as it did before. Nothing here asks you to throw a folder away, and if you’re not sure what that rule is, your specialty society is the place to ask, not a software vendor.
All of this assumes the old records are on paper. If yours are locked inside software from a vendor that shut down, that’s a different job with a different order, and I wrote that one up separately in what to do when your EMR vendor shuts down.
The one question to ask before you pick a tool
Can it start with an empty patient list and fill in as people book, or does it need the old records loaded first?
That one answer tells you whether the system was built to be started or built to be migrated into. I wrote up the other questions worth asking, including how to check that the company behind it is real, in how to choose an EMR in the Philippines.
Where I’m coming from
We build one of these, so I’m not neutral. Ten years of seeing this from the vendor’s side is the only reason I know the cabinet mostly stays shut.
Count the patients you’ll see in the next thirty days. Those folders come out and go next to the computer. The rest stay where they are, and you’ve started.
