■ Duties and responsibilities:

Expectations of physicians in practice

Did you know? Patients can restrict access to their health information

A shelf full of medical records

Originally published November 2017 / Reviewed September 2021
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In Canada, patients have the right to control access to their health information contained in medical or health records, whether paper or electronic. While physicians, institutions, or clinics own the medical or health records that they create for patients, the information remains the property of the patients, who can place conditions or restrictions on which health providers and others have access to their information, including 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 will also want to explain to patients that restricting access to some or all personal health information could result in another healthcare professional not being able to provide appropriate care. Physicians should document these discussions in patients’ records, and 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. 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 are not the custodian of a patient’s 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 custodian of the record.

When physicians cannot restrict access in the manner requested by the patient, 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.

For more details on restricting access to records, see the CMPA’s Electronic Records Handbook [PDF]. 2


References

  1. 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
  2. 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

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.