Originally published November 2017
In Canada, patients have the right to control access to their health information contained in medical or health records. They can also place conditions or restrictions on which health providers and others have access to their information, even providers within the circle of care.1
When patients ask for restrictions on who can access their personal health information, physicians should speak with them to determine if there are specific concerns about their care or underlying issues that need to be addressed.
Physicians should then make reasonable efforts to accommodate these requests.
When physicians own or manage their own records, whether in paper or electronic format, they may be able to fulfill the patient’s request by taking a number of actions. In paper records, notes can be made in the record giving directions on who can have access. With electronic records it may be possible to use features such as "masking," "blocking, "lock-boxes," or disclosure directives. In some electronic systems, however, these features may not exist or be limited in what they can do.2 Physicians should consider re-evaluating and updating their software, where necessary, to ensure it meets the needs of their practice and the standards of the profession.
When physicians don’t manage the record, for instance when practising in a clinic or institution, they may still have an obligation to help put the patient’s request into effect, which may start by speaking to the owner or custodian of the record.
When physicians cannot fulfill a patient’s request, they should speak with the patient about what is possible, make a note in the patient’s record, and continue to make reasonable efforts to abide by the requested restrictions and address the patient’s underlying concerns.
Physicians, institutions, or clinics own the medical or health record that they create for patients, whether paper or electronic, but the information remains the property of the patients and they control who can access it.
For more details on restricting access to records, see the CMPA’s Electronic Records Handbook [PDF]. 3
- Canadian Medical Protective Association [Internet]. Managing access to electronic health records. Ottawa (ON): CMPA; Aug. 2015. [cited 2017 July 19]. Available from: https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2013/managing-access-to-electronic-health-records
- Canadian Medical Protective Association [Internet]. 10 tips for using electronic records. Ottawa (ON): CMPA; June 2014. [cited 2017 July 19]. Available from: https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2014/10-tips-for-using-electronic-records
- Canadian Medical Protective Association [Internet]. Electronic Records Handbook. Ottawa (ON): CMPA; 2014. [cited 2017 July 19]. Available from: https://www.cmpa-acpm.ca/static-assets/pdf/advice-and-publications/handbooks/com_electronic_records_handbook-e.pdf