Helping other's help themselves...

[Rena705]

I realize that this is a medical website but I believe it is also what would be considered a self-help site.  In the months that I have been a member here I have come across many instances of members having doors shut in their faces and lies told to them about their medical records etc.  We have always been of the mind that medical records are the property of the patient and that they should be readily available to the patient.  The following was taken from the Alberta College of Physician's and Surgeon's website:

Release and Transfer of Medical Records
Patients are entitled, pursuant to a June 12, 1992 Supreme Court of Canada decision, and more recently the Health Information Act (HIA) of Alberta (Section 7(1)) to review their medical records and these must be made available to the patient or to the patient's legal representative on provision of proper authorization. Patients may also inspect their own records. The patient owns the information on the records, but does not own or have a right to possess the physical records. The patient is entitled to a copy of the medical record. (which of course usually costs $1.00 per page!)
Requests should disclose the purpose to which the information will be put. If it is not clear, the physician should determine the reason for the demand for release of information. If the record might be used in a possible legal action in which the physician may be named, legal advice should be sought. In any event, however, the record must be released as directed by the patient or his/her legal agent.

The question as to how long medical records should be kept by a physician is another question often asked by our members as past history is very important in a search for a possible diagnosis of MS.  The following was also taken from the Alberta College of Physicians and Surgeons website:

Disposition of Medical Records
The ethical physician must make every reasonable effort to preserve medical records for a reasonable length of time in all circumstances, and to make the information available to appropriate persons on proper authority whenever required.
In December 1994, Council passed an additional motion regarding the retention of certain bulky recordings:
A physician shall retain for a minimum period of ten years, or in the case of minor patients, until two years after the age of majority or for ten years, whichever is longer, by electronic means or storage of hard copy, the entire interpretive report and a segment of continuous physiologic recordings, whether abnormal or not, sufficient to support the interpretation made.
In November 2002, Council of the College of Physicians and Surgeons of Alberta passed a motion that:
1.  Records of diagnostic imaging services provided to a patient including test results, archived digital images and interpretation reports shall, subject to subsection (b), be securely stored for a period of at least ten years.
2.  Where the patient was a minor at the time the diagnostic imaging services was provided, the record shall be securely stored for a minimum period ending:
Physician’s Office Medical Records : CPSA Policy Page 7 of 10
a)  ten year
or
b)  two years after the patient’s eighteenth birthday, whichever date is longer.
3.  Diagnostic images stored on film shall be securely stored for a minimum of five years or in the case of minors, two years after the patient’s eighteenth birthday, whichever is later.
4.  Mammography films should be securely stored for a minimum of five years and should be securely stored for a minimum of ten years when there is no intervening study.
Council recommends that other clinical patient records be retained for a minimum of ten (10) years following the date of last service; in the case of minor patients, they should be kept at least until two (2) years past the age of majority or for ten (10) years, whichever is longer.
Following this period of availability, records may be disposed of by secure and confidential shredding, burning, or erasing. Commercial shredding services are available.
Very practical problems exist with respect to storage and access. The public and physicians, from time to time, find that it is important to review previous medical records. They expect them to be available and to be transferred on request to:
a)  Another physician
b)  Third parties - lawyer, Court, insuring agent, government agency
Possible solutions for retention include storage by:
a) Partners
b) Colleagues
c)Medical clinics
d)Hospitals
e)Family
f)Bonded commercial storage
The College of Physicians and Surgeons of Alberta may be consulted in individual cases.
All physicians when ceasing practice for any reason must notify the College of Physicians and Surgeons of Alberta of the whereabouts of patient records for future access. When a chart is given over to a colleague for custody, that duty is relieved simply by a release from that patient if the custodial physician has not attended the patient.
Special consideration should be given to the disposition of medical records when closing a medical practice for a variety of reasons including the following:
a)  Suspension under discipline
b)  Erasure under discipline
c)  Voluntary erasure
d)  Retirement
e)  Unexpected acute illness, chronic illness, or death

This is just an example of the laws here in Alberta and are only applicable to Alberta.  I would imagine that every province in Canada and every State in the U.S.A. has their own set of laws and I am sure that they are accessible on the internet should one take the time to look.  I feel that this is important information as physicians have a responsibility to follow the laws as do the patients and they are in place for the benefit of both parties.

Hope this is of some help to someone out there!

Rena705

[Sunnytoday]

Just a note, as a Health Information Technician, a standard request is great, but will often be turned down for release, they usually want their own form filled out... I know, a bother, but it's often for the good and it's usually facility policy, not necessarily HIPAA. You can try it though! :)

I always applaud looking at your own files, but with many places going electronic that is getting more difficult to do without paying for the copies, which can get costly at $1.00 a page. Do, go ahead and try to as much as possible though.

This is a good thread, and as noted, each state has their own rules here in the US, and when the states rules and regulations go up against the federal regulations, the facility must apply whichever one is the most strict, or tightest and will proctect you information the best.
~Sunnytoday~

[Lulu54]

FYI I started a new post called Personal Health Records that has a link to a website that will walk you through the process of gathering all of your records and storing them in one place - it even has standard request for files forms and releases.  - Laura

[Cre8_it]

This is really good to know.  I also know that the medical records are stored in commercial buildings in Ontario.  For how long, I'm not sure.  I did data entry at one of those companies, we had to input medical file numbers, names, addressess etc.  So that if anyone requested thier file, this company would be notified, and release it.  

I also think that it is a good idea for everyone to get thier file and check things out.  A friend of mine had many problems, and had many tests done, including laperoscopy.  Her dr told her that they could'nt figure out what was wrong with her.  She was put on all kinds of different pills for four years.  She then moved to Ontario and had her file transferred to the new dr.  The new dr told her that in her file it stated that they had found endometreosis. Her new dr did a laperoscopy and by this time it had grown so much that her bowels were just covered.  Needless to say,  this could have been prevented if her old dr was actually acting like a dr!

I would love to know what is in mine!

[wishforchange]

Well in the UK medical records are NOT the property of the patient, they belong to the state.  All records are kept lifelong until a minimum of 25 years after the person's death.  

There is also a current move to put everyone's records on a nationally available database.  The security measures on this is hopeless.  It means effectively that any medical information, every consultation, our whole lives, are available online.  Almost anyone can access them.  From a schoolkid on work experience in a hospital or civil seivice department, domestics, health assistants, shop assistants in pharmacies.

This is being done throught the back door.  Patients can opt out, but have to go to the trouble to find out about it and inform their GP.  Since we are not told about it, most of course do not.

I am in the process of trying to get harmful information taken off my records.  I believe the information will outlive me by several decades.  It is the core of my problems with the health service.  Reminds me, I have to re-iterate to my doctor I want to opt out of the national database.  Told him but he did nothing about it.  This time will tell the practice manager.  

As children, helpless in the information held on us by our doctors and shared about us by our parents, our private details are held on file, again shortly for all to see.  

This country stinks.

Am getting so angry about to have another coronary so may stop now and swallow a bottle of herbal tranquilizers or something.

wish        for some dam sense in the UK healthcare system.  

Explosion iminent.........

[Rena705]

The data collected from the site that LGK54 provided states the following:

What are Consumers’ Rights to See and Obtain a Copy of Their Medical Records Under  the HIPAA (Health Insurance Portability and Accountability Act) Privacy Regulation?

In general, a consumer must be allowed to inspect or obtain a
copy of her PHI (personal health information) from a covered entity within 30 days from the date the request is received. If the covered entity provides a
written statement of the reasons for delay, the deadline can be
extended up to 30 days.8 The covered entity can charge
“reasonable” cost-based fees for providing the information.9
State law that is not preempted by HIPAA (see discussion below)
may establish a fee standard. If the covered entity does not
maintain the individual’s PHI, the covered entity must let the
consumer know where to direct her request. If the consumer
agrees to the arrangement and to the fees, the covered entity can
provide the consumer with an explanation or a summary of the
requested information, rather than a copy of the PHI.10
Under conditions described below, a covered entity can deny
access to certain information and only need provide an
opportunity for the consumer to review the denial. Any time a
covered entity denies a consumer access to all or part of his or
her PHI, it must give the consumer a written denial within 30
days.11 The denial notification must contain a basis for the denial
and, if applicable, information about the consumer’s review rights
and procedures for filing a complaint with the covered entity or
the Secretary of HHS.12
A covered entity does not have to give a consumer access to the
following and does not have to give the consumer an opportunity
for review:13
* psychotherapy notes (the HIPAA privacy regulation’s
definition of psychotherapy notes is narrow:
“Psychotherapy notes means notes recorded (in any
medium) by a health care provider who is a mental health
professional documenting or analyzing the contents of
conversation during a private counseling session or a
group, joint, or family counseling session and that are
separated from the rest of the individual’s medical
record” (emphasis added);14
* information compiled in reasonable anticipation of or for
use in a civil, criminal, or administrative action or
proceeding;
* PHI maintained by a covered entity controlled under the
Clinical Laboratory Improvements Amendments of 1988;
* under certain circumstances, information requested by an
inmate;
*information created or obtained by a covered health care
provider in the course of research that includes treatment,
which may be temporarily suspended while the research is
in progress, if the consumer has agreed to the denial of
access when consenting to participate in the research . . .
www.healthassistancepartnership.org " 7
and the covered health care provider has informed the
individual that the right of access will be reinstated when
the research is complete;
* information contained in records subject to the Privacy
Act;15 and
* information obtained by the covered entity from someone
other than a health care provider under a promise of
confidentiality and access to which would be “reasonably
likely to reveal the source of that information.”
A covered entity may deny a consumer access to her PHI, but it
must provide the consumer an opportunity for review of the
denial if a licensed health care professional, in the exercise of
professional judgment, determines that16
* it is reasonably likely that access to the requested
information would endanger the life or physical safety of
the consumer or another person;
* because the information makes reference to another
person, it is reasonably likely to cause substantial harm to
the other person; or
* because the consumer’s personal representative
requested the information, it is reasonably likely to cause
substantial harm to the consumer or another person.

http://www.****.***

I do not know yet if these laws cover all states or not...but I will work on finding out and any further information provided by fellow members on this subject would be gratefully accepted...sending it to me in the form of a personal message would probably work the best and then I can work through it and hopefully come up with a possible document for the Health Pages provided it is approved by Quix.

Rena

[Lulu54]

Each state may have individual laws - here's the example I found from Massachussetts....


http://www.massmedboard.org/consumer/pdf/medical_records_brochure.pdf

[Lulu54]

A good copy of the Rights To Access Medical Records Under HIPPA Rules can be found here-

http://www.healthprivacy.org/usr_doc/RighttoAcces.pdf

[mokibear]

Wow really great info. Thanks for posting that. If I can find some time, I'll try to check out Ontario's Physicians and Surgeons website. Never even had thought of it.

Hugs
Moki

[Rena705]

I wish I knew how to access similar information that would cover all the states and provinces and that way it would be useful in the Health Pages...I am going to have a look but don't know if I have the wherewithall to do that much...if I had more time I would but then again...I guess there isn't that much of a rush...I guess we will see what Quix thinks and go from there eh?

Hugs,

Rena

[Wobbly]

this is great information...it should be somewhere on the Health Pages??  

I know usually ask for a copy...and sometimes they hesitate...and sometimes, they say wait to get a copy from your GP...ummm
so now I know I can get it then...thanks alot.

take care
andi
LL