This was prepared as a follow-up to last month’s Practice Expectation Spotlight, “ Are You Breaking the Law?.”, which provides an overview of the professional expectations that apply to the access, use, and disclosure of personal health information.
For the last six months, Jay Gur, Registered Nurse, has been managing shoulder pain from a softball injury. While the exercises recommended by the physiotherapist improve the pain (when he remembers to do them), his primary care provider (PCP) requested diagnostic images to see if any other treatments could be offered. Jay’s PCP stated that she would review the images and contact Jay with the results and details. Unfortunately, Jay’s PCP is on vacation for the next three weeks, and Jay is frustrated that he and his physiotherapist will not have access to the images.
Jay works at a vaccination clinic and is granted access to eChart to care for his patients. He knows that the result of his imaging is on eChart, and if he could just take a peek at them, or even print them, he could provide them to his physiotherapist. He knows that he is not allowed to use his eChart access to review his own health record, but he is frustrated; he says to his manager, over lunch, “This is my personal health information, after all. Why can’t I look up my imaging?.”
Jay and his manager discuss his situation and consider the following:
- Jay’s care plan may need to be changed once the imaging is reviewed. The practitioner who ordered the images is responsible to review the images, then incorporate their diagnostic reasoning about the images into Jay’s health care plan. Then, Jay’s health care team is expected to include Jay in adjusting the health care plan as soon as possible.
- Jay is correct: According to the Manitoba Ombudsman, the Personal Health Information Act is clear that Jay has a right to request and obtain a copy of his personal health information. (Manitoba Ombudsman). He must contact his PCP as his PCP’s clinic will have processes for patients to access their health records.
- Jay’s manager reminds him that although the information contained in the health record is his, the health record itself belongs to the health region (Canadian Nurse Protective Society ). As custodians of the health record, his employer is responsible for safeguarding the information. In other words, as a patient, Jay has a right to his health information, but must go through the proper channels to access it. As an employee and professional, he is required to follow processes and legislation put in place to protect the health information within the record which includes not accessing health records in a manner that is inconsistent with his professional obligations.
- Jay is aware that the vaccination clinic has a form to complete allowing his patients to request access to their vaccination records. He concludes that his PCP’s clinic will have a similar process.
- PPE and medications are examples of tools that the vaccination clinic provides to Jay to provide care to his patients. Jay understands that it would be inappropriate for him to take medications or PPE home for personal use. When he considers that his eChart access is also a tool to provide patient care, he better appreciates why accessing his own record for personal benefit would be viewed as an abuse of his privilege and why doing so would fail to meet his employer’s expectations, and his professional practice standards.
- Members of the public cannot access diagnostic imaging by accessing eChart. Jay tells his manager that he is hopeful that public access to health records like diagnostic imaging will be more streamlined in the future, and she agrees.
After his conversation with his manager, Jay decides to contact his physiotherapist. He completes a release of information form so his physiotherapist can request his health records. The records are provided to his physiotherapist in time for his next appointment and together they develop a new plan of care.
As Jay’s shoulder begins to feel better, he becomes excited to pitch at a softball tournament in October. He thanks his manager for discussing his problem with him and helping him understand his responsibilities. He asks his manager to keep an eye out for opportunities for him to work on task teams or initiatives aimed at improving and streamlining the public’s access to their health information.
References and Resources
Manitoba Ombudsman, Personal Health Information Act: Know your health information rights. Accessed August 1, 2022. https://www.ombudsman.mb.ca/uploads/document/files/health-info-rights-access-privacy-en.pdf
Canadian Nurse Protective Society, Ask a lawyer: Accessing one’s own personal health information. Accessed August 1, 2022. https://cnps.ca/article/ask-a-lawyer-accessing-ones-own-personal-health-information/
College of Registered Nurses of Manitoba, Practice expectation spotlight: Are you breaking the law?. Accessed August 1, 2022. https://can01.safelinks.protection.outlook.com/GetUrlReputation