Deleting patients is different from deleting most other types of information from your database.
A patient record can have one or more 'billing accounts'. For example, a provider may see a patient who is over 65 years old for hypertension. The provider will setup a 'Medicare' billing account for services related to hypertension. If the patient is hurt at work, the provider may setup an 'Industrial/workman's comp' billing account for services related to that injury. Using multiple billing accounts makes it easy to keep the charges, payers, responsible parties, etc separate. The software can handle the billing with less user intervention.
If you delete a patient without first deleting the 'billing accounts' then you will have 'orphan' records. The software cannot handle incomplete information. Before you can delete a patient record, you must first delete any related billing accounts.
If you delete a billing account with an open balance, you will destroy the integrity of the system balances. For example, a billing account has an open balance of $500.00. If you simply delete that billing account then the software will have transactions totaling $500.00 more than the patient balances. Before you can delete a billing account you must first make sure the billing account balance is zero so that after you delete it, the accounts receivable will not change. You must delete all the transactions related to the billing account so that the total patient balances will be equal to the total transaction balances.
It is even more complex. A billing account has insurance records and other types of records that must be deleted. You must make sure that all records that are specific to that billing account are deleted. A patient has one or more telephone/communication records that must be deleted. In all there could be 100 or more records that must be deleted when you delete a patient record.
Here is the process for deleting a patient record.
1. Make sure that all billing accounts related to the patient have a zero balance. This is necessary so that the accounts receivable will not be 'off' after the patient is deleted.
2. Audit/balance any transactions that have been entered.
3. Delete every billing account that is related to the patient.
4. After you do the steps above you should be able to delete the patient record.
Below is an example of a patient billing account screen with the delete button in the lower right:
The Delete button is disabled. You will not be able to delete this patient billing account. Can you see why? There is an outstanding - open balance - of $308.99. You must enter transactions to this billing account so that the balance is zero. You could enter a payment. You could enter a minus adjustment and write-off the balance. Then you must audit/balance those transactions.
Below is an example of the patient record with the delete button in the lower right.
If you press the delete button you will get a message telling you that you cannot delete the patient record.
After you have finished you will not be able to find the patient anymore. However the records that you have 'deleted' are not really gone. They are only 'marked' for deletion. You cannot simply take a record out of a data table. It would leave a hole which is not possible. There is a technical reason for this. Take our word for it.
In order to get rid of records and reclaim the space on your hard drive, you must copy and sort and re index the data. This takes considerable time. If you have a lot of patients, it could take hours. All of your data tables must be locked. No one can use the system while this process it being done. This process is called 'reorganization'. This is part of normal file maintenance and should be done once per week or whatever schedule works best for you. We recommend that you reorganize at least once per week. During reorganization, your files are sorted so they can be accessed faster. All the 'numbers' in the system are checked to be sure that there are no corrupt records and all the patient balances are correct. Like a backup, this is normal maintenance that you should do.
In addition, you should 'de fragment' the hard drive. The de fragment program has nothing to do with the Stratford program. It is a standard maintenance program that you get with the Windows operating system. Defragmentation places the files on your hard drive in contiguous 'sectors' and greatly improves the performance of your computer. This process, like reorganization, can take hours.