We share our suggestions for ordering neurological records from Kaiser Permanente Northern California.
GENERAL GUIDELINES
As noted in our generic instructions for ordering neurological records from any institution, the brain bank:
- now requires that records be at the brain bank prior to the passing of the intended brain donor
- neurological records ONLY are needed. No primary care physician records or hospice records. In the cases of Parkinson’s Disease, only the most recent 6-8 years of records are needed.
- it is always easiest to download neurological records via the online patient portal. If you don’t have access to the online patient portal, records must be ordered from the medical records office or clinic. Records can be sent from medical records offices or clinics directly to the brain bank. One advantage of this approach is that there may be no fee to the family. One disadvantage of this approach is that the family has no real way to confirm that records have been sent.
- ideally, records should be sent to the brain bank by email or posted to the cloud for download by the brain bank. Second choice is by fax. Third choice is by mail with tracking. Last choice is by mail with no tracking.
- ordering records and following up with the medical records offices or clinics is the family’s responsibility
KAISER PERMANENTE NORTHERN CALIFORNIA INFORMATION
These suggestions are derived from speaking with staff from the medical records office and viewing helpful webpages, including:
Release of Medical Information | My Doctor Online
If you are the intended donor, or the intended donor’s legal representative and have access to MyDoctorOnline patient portal, Kaiser recommends that you use options #1, #2, or #3.
1. Download records through MyDoctorOnline (online patient portal).
Downloaded records may be submitted to Mayo Clinic by:
- Secure email to Dennis Dickson, MD, ℅ the Brain Bank Coordinator, Rachel LaPaille-Harwood, at [email protected]
- Post to the cloud (Google Drive, Dropbox, Box, or other online file sharing service). Then email link to file(s) to the Brain Bank Coordinator, Rachel LaPaille-Harwood, at [email protected]
- Fax to 904-953-7117 (Attn: Dennis Dickson, MD)
- US Mail to Dennis Dickson, MD, Mayo Clinic Jacksonville, Birdsall 310, 4500 San Pablo Road, Jacksonville, FL 32224-1865 (phone 904-953-2439)
2. Complete the online “Request Your Medical Records” form.
You can order records by completing an online request form via the MyDoctorOnline patient portal. Your request will be processed within 5 business days. You can download records once complete.
If you need assistance, or have questions; you may use the following link to obtain the contact information for your regional Kaiser Permanente Release of Medical Information (ROMI) Department.
ROMI department phone numbers | My Doctor Online
Forward the records via email to the brain bank or post the records to the cloud for the brain bank to download.
3. Call the regional Release of Medical Information (ROMI) department during normal business hours (Monday through Friday, 8:30 a.m. to 5 p.m.).
The ROMI department may take your request over the phone. Once your request has been completed, the medical records will be sent to the email address on-file (associated with the patient’s account). Your request will be processed within 5 business days.
Then you can forward the records via email to the brain bank or post the records to the cloud for the brain bank to download.
4. Request medical records be sent directly to the Mayo Clinic. Kaiser has its own Authorization For Use Or Disclosure Of Patient Health Information form that may be emailed to your regional ROMI department. Provide as much information as possible on the form, such as:
-> Section 2. Recipient Name:
Please enter Mayo’s information as follows:
Dennis Dickson, MD, Mayo Clinic Jacksonville
4500 San Pablo Road, Birdsall 310
Jacksonville, FL 32224-1865
Phone: 904-953-2439
Fax: 904-953-7117
Email: ℅ Rachel LaPaille-Harwood: [email protected]
-> Section 3. This disclosure can be used for the following purpose(s):
Check the box for “Other” and add any of the following examples as the purpose for release: “medical research,” “clinical-pathological correlation” or “brain bank research.”
-> Section 4. I authorize the following to be disclosed for the selected time frame:
Check the box for “Medical Records”. Then check the appropriate box for time frame. (Note: If records may go beyond five years, select “All electronic records”.)
-> Section 5. Check the boxes below if you want this release to include the protected treating department or HIV initial test result information. If not checked, this treating department information will be excluded.
If applicable, check the box for: “Mental Health Treatment records.”
Be sure to sign and date the form. Unsigned forms will not be accepted.
If the intended donor is not able to sign the form, the medical power-of-attorney should sign his/her name. When you email the completed authorization form, include the medical power-of-attorney document. (When emailing, we highly encourage a follow up call to your regional ROMI department to ensure the request has been processed, ask and record the date the request was completed and by what method it was sent to Mayo Clinic. This information will come in handy if Mayo has issues receiving the medical records.)
Email the completed form to your regional Release of Medical Information (ROMI) department. (Kaiser’s ROMI offices no longer encourage faxed requests.) Your request is processed within 15 days. Depending upon the size of the file, records are delivered to the brain bank via email or by USPS on CD.