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Is the Medical Record Retention Period Five Years? Legal Basis for Charts and Other Records, and Requirements for Electronic Storage

October 31, 2026

Is the Medical Record Retention Period Five Years? Legal Basis for Charts and Other Records, and Requirements for Electronic Storage
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Key Takeaways

  • Under Article 24(2) of the Medical Practitioners' Act, medical records must be kept for five years, by the hospital or clinic administrator for employed physicians and by the physician otherwise.
  • Insured medical institutions keep charts for five years and other records relating to insured care for three years from the date of completion (Article 9 of the Rules for Insured Medical Institutions).
  • Hospitals must keep 'records relating to medical care', such as nursing records, test findings, X-ray films and prescriptions, for the past two years.
  • Electronic storage requires authenticity, readability and preservability under the e-Document Act and the MHLW ordinance; the current guidelines are Edition 7.0.

"How many years must we keep medical records?" "Do nursing records and test data also need five years?" "Can we throw them away after five years?" These questions come up whenever a clinic opens, closes or moves to an electronic medical record (EMR). This article sets out the retention periods and starting points for medical records (charts) and other records, and the requirements for electronic storage, based on the text of the Medical Practitioners' Act, the Rules for Insured Medical Institutions and Insured Physicians, and the Ordinance for Enforcement of the Medical Care Act.

Disclaimer: This article provides general information based on information published as of October 31, 2026. Laws, notices and guidelines may be amended. For decisions on retaining or disposing of specific records, check the latest original texts and consult the public health center, the Regional Bureau of Health and Welfare, a lawyer or other specialists as needed.

Conclusion: five years for charts, three or two years for other records

RecordRetentionBasisApplies to
Medical record (chart)5 yearsMedical Practitioners' Act, Art. 24(2)All medical care by physicians
Medical record (chart)5 years from completionRules for Insured Medical Institutions, Art. 9 provisoInsured medical institutions
Books, documents and other records relating to insured care3 years from completionRules for Insured Medical Institutions, Art. 9Insured medical institutions
Records relating to medical care (hospital diary, departmental diaries, prescriptions, surgical records, nursing records, test findings, X-ray films, inpatient and outpatient count books, inpatient care plans)Keep the past 2 yearsMedical Care Act Art. 21(1)(ix); Enforcement Ordinance Art. 20(x)Hospitals
Dental records5 yearsDental Practitioners' Act, Art. 23(2)Dentists
Midwifery records5 yearsAct on Public Health Nurses, Midwives and Nurses, Art. 42(2)Midwives
Dispensed prescriptions (pharmacy)3 years from the date dispensing was completedPharmacists' Act, Art. 27Pharmacy operators
Dispensing records (pharmacy)3 years from the last entryPharmacists' Act, Art. 28(3)Pharmacy operators

The key point is that several laws apply, each with different scope and starting points.

Medical Practitioners' Act, Article 24: five years for medical records

  • Paragraph 1: when a physician provides care, the physician must record matters relating to the care in the medical record without delay
  • Paragraph 2: medical records for care provided by physicians working at a hospital or clinic must be kept by the administrator of that hospital or clinic, and other records by the physician, for five years

The duty applies regardless of whether care is insured or self-pay.

Rules for Insured Medical Institutions, Article 9: five years for charts, three years for other records

An insured medical institution shall keep books, documents and other records relating to the provision of insured care for three years from the date of completion. However, patients' medical records shall be kept for five years from the date of completion.

  1. Medical records: five years "from the date of completion"
  2. Other books, documents and records relating to insured care: three years from completion

The article does not list specific record names. We recommend that your document management rules state clearly how nursing records, test records, X-ray images and copies of prescriptions are handled under the three-year rule.

Enforcement Ordinance of the Medical Care Act: two years for hospital "records relating to medical care"

Hospitals must keep "records relating to medical care" under Article 21(1)(ix) of the Medical Care Act. Article 20(x) of the Enforcement Ordinance defines them as the past two years of the hospital diary, departmental diaries, prescriptions, surgical records, nursing records, test findings, X-ray films, books showing inpatient and outpatient numbers, and inpatient care plans.

Regional medical care support hospitals (Art. 21-5) and advanced treatment hospitals (Art. 22-3) must also keep referral letters and discharge summaries, among others.

Article 21(1) of the Medical Care Act applies to hospitals; the requirements for clinics (including Article 21(2) for clinics with long-term care beds) do not list records relating to medical care. For insured clinics, the question is whether nursing and test records fall under "other records" in Article 9 of the Rules for Insured Medical Institutions (three years).

Dental, midwifery and pharmacy records

  • Dental: five years under Article 23(2) of the Dental Practitioners' Act, with the same allocation of duty as for physicians
  • Midwifery records: five years under Article 42(2) of the Act on Public Health Nurses, Midwives and Nurses
  • Pharmacies: dispensed prescriptions for three years from the date dispensing was completed (Art. 27) and dispensing records for three years from the last entry (Art. 28(3)) of the Pharmacists' Act

When does the period start?

LawStarting point
Medical Practitioners' Act, Art. 24Not stated ("keep for five years")
Rules for Insured Medical Institutions, Art. 9"From the date of completion"
Pharmacists' Act, Art. 27"From the date dispensing was completed"
Pharmacists' Act, Art. 28"From the date of the last entry"

For insured institutions, it is practical to manage records as five years from the date care was completed. For patients who are still attending, the count has not started, however long ago the first visit was. Because the texts do not define how to determine the "date of completion", set an internal rule, such as using the last visit date.

Can records be disposed of after five years?

The law sets a minimum retention period. It does not require disposal after the period ends. Consider the following.

Limitation periods for damage claims

Basis of claimLimitation periodArticle
Tort (harm to life or body)5 years from knowing the damage and the wrongdoer; 20 years from the tortCivil Code Arts. 724 and 724-2
Non-performance (harm to life or body)5 years from knowing the right can be exercised; 20 years from when it can be exercisedCivil Code Arts. 166(1) and 167

Claims may still be made after the five-year retention period. Some institutions keep records longer, but how long is a decision for each institution based on the nature of care, storage costs and risk.

Balance with personal information protection

Article 22 of the Act on the Protection of Personal Information requires businesses to endeavor to delete personal data without delay when it is no longer needed. Rather than keeping everything forever, set retention periods in your rules and dispose of records systematically when they expire.

Disposal methods

Medical records contain sensitive personal information. Use reliable methods, such as dissolving or shredding paper and irrecoverable deletion of electronic data, and keep a disposal log. When storage is outsourced, the guidelines (Planning and Management volume) require the retention period and destruction or return procedures at the end of the contract to be written into the contract.

Requirements for storing records electronically

The e-Document Act and the MHLW ordinance

Medical records may be kept as electronic records under the e-Document Act and the MHLW Ordinance No. 44 of 2005. The ordinance's appended table lists medical records under Article 24 of the Medical Practitioners' Act and Article 23 of the Dental Practitioners' Act, records under Article 9 of the Rules for Insured Medical Institutions, records relating to medical care under Article 21 of the Medical Care Act, and others.

The three principles of electronic storage

Article 4(4) of the ordinance and the enforcement notice of March 31, 2005 require:

PrincipleMeaning
AuthenticityWhether and how data was altered or deleted during the retention period can be confirmed, and responsibility for creation is clear; false entry, rewriting, deletion and mix-ups are prevented
ReadabilityData can be displayed immediately in a clear and orderly form and printed when needed
PreservabilityData is kept in a restorable state throughout the retention period

The Guidelines for the Safe Management of Medical Information Systems

Specific measures are set out in the MHLW guidelines. Edition 6.0 (May 2023) split them by reader, and the current edition is 7.0, issued in June 2026, with five volumes. See The MHLW Guidelines for the Safe Management of Medical Information Systems.

For preservability, data must remain readable through system updates and migrations; the System Operations volume calls for adopting standards. See also Backup Design for Medical Institutions and Log Management and Audit Trails.

Storing records outside the institution, including the cloud

Storing records outside the institution requires meeting the standards of the notice "On Places for Storing Medical Records" (March 29, 2002, last amended March 25, 2013). The institution remains responsible for retention even when it outsources storage.

Scanning paper records

Article 4(1)(ii) of the ordinance permits storage of electronic records created by scanning documents. Edition 7.0 (System Operations volume) states:

  • Use scanners that meet certain standards for optical resolution and sensors so that enough information is captured to satisfy the retention duty
  • Before scanning, check that no information lies outside the scannable area, for example documents stuck on top of each other
  • Scanning never fully reproduces the original, and some useful information may be lost, so digitize carefully. Keeping the original paper after digitization is highly effective for authenticity and preservability
  • If the paper is kept, the scanned data is reference information and the retention requirements do not apply to it, though privacy protection is still required

The required approach differs depending on whether the electronic data or the paper is the official record. See What Is OCR? and Moving from Paper to an EMR.

When closing a clinic

Within the scope of our research, we could not confirm any statutory provision that specifically sets where and how records must be kept after a clinic closes. The duty under Article 24(2) of the Medical Practitioners' Act lies with the clinic administrator (or the physician). If you plan to close or transfer the clinic, decide early:

  • Who keeps the records, where, and until when (and what is handed over to a successor)
  • How to respond to disclosure requests from patients and inquiries from other providers
  • For EMRs, whether data can be exported in a readable format after the contract ends

Check the procedures with your public health center or prefecture. See also EMR Data Migration Guide.

Checklist for retention and disposal

  • Your document rules state the retention period and starting point for each type of record
  • You have decided how to determine the "date of completion" (for example the last visit)
  • Hospitals keep at least two years of records relating to medical care
  • You have decided what happens after five years (extended retention or disposal timing)
  • Disposal uses reliable methods and is logged
  • You have confirmed with your vendor that electronic storage meets the three principles
  • Outsourcing and cloud contracts state the retention period and end-of-contract procedures
  • You have decided whether to keep paper after scanning

Summary

  • Medical records must be kept for five years under Article 24 of the Medical Practitioners' Act, and insured institutions keep them five years from completion
  • Other records relating to insured care are kept three years from completion
  • Hospitals keep two years of records relating to medical care, such as nursing records, test findings, X-ray films and prescriptions
  • Legal periods are minimums. Set retention and disposal rules considering limitation periods and privacy
  • Electronic storage requires authenticity, readability and preservability; check the guidelines (currently Edition 7.0)

See also The MHLW Guidelines, Backup Design, Log Management and Audit Trails and What Is OCR?.

Pottech provides AI electronic medical records for clinics. If you have questions about electronic storage requirements or record management, please feel free to contact us.

Frequently Asked Questions

Q. How long must medical records be kept?
A. Five years under Article 24(2) of the Medical Practitioners' Act. Insured medical institutions also keep charts for five years from completion under Article 9 of the Rules for Insured Medical Institutions.
Q. How long must nursing records be kept?
A. Hospitals must keep records relating to medical care, including nursing records, for the past two years. Insured institutions keep records relating to insured care for three years from completion. Define the handling in your internal rules.
Q. When does the retention period start?
A. The Rules for Insured Medical Institutions say 'from the date of completion'. The Medical Practitioners' Act has no explicit starting point; insured institutions can practically count from the date care was completed.
Q. Can we dispose of records after five years?
A. The legal retention duty is five years, but civil-law limitation periods for damage claims run five years from knowledge of the damage and the wrongdoer and 20 years from the tort. Each institution should decide disposal timing with this in mind.
Q. What are the requirements for electronic storage?
A. Authenticity, readability and preservability. Specific measures are set out in the MHLW Guidelines for the Safe Management of Medical Information Systems.

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