Health record access fees reduced after complaint filed

Eastern Health has lowered the fees it charges patients requesting records of their own health information, in response to recommendations from Ed Ring, the province's information and privacy commissioner.

Ring released a report today on a fee complaint made in July under the Personal Health Information Act that the health authority charged a patient an unreasonable fee to access to one of his own health records.

The complainant sought access to a one-page copy of a diagnostic test he had undergone at a local hospital. Eastern Health, in accordance with its fee schedule, informed him that a copy of the record would cost $50 plus tax.

Under section 57 of the provincial Personal Health Information Act, a custodian is permitted to charge a “reasonable fee.”

Ring agreed that the $50 fee to provide individuals with their own personal health information was unreasonable and recommended that individuals be charged a maximum fee of $25 for requests of up to 50 pages for various tasks associated with searching for and providing access to requested information.

After the first 50 pages, he recommended a photocopy fee of no more than 25 cents per page.

Ring also strongly recommended that personal health information be provided to individuals free of charge at the point of care, except where the requested information is not easily located or “voluminous in nature.”

Further, Ring recommended that the fee be waived or substantially reduced in all cases where it truly represents a barrier to access.

Eastern Health responded to the complaint by saying the health authority processed 21,841 requests for personal health information in 2010-2011. It said this volume of requests makes it impractical to assess the time and effort expended to respond to each individual request, and thus charge a request-specific fee. Instead, the health authority adopted a flat fee to represent the time and effort it takes to respond to the average request.

Eastern Health also explained the decentralized filing system of health records, with paper records stored in various locations throughout the region and not all records in the same electronic filing system.

 However, prior to this report being issued today, Eastern Health advised this commissioner’s office that it has amended its fee schedule so that patient/executor/next of kin requests for personal health information will now cost $30 for up to 25 pages, $50 for 25 to 100 pages, a copy fee of 50 cents per page for more than 100 pages and additional cost for copying done outside the facility.

Ring said he’s pleased with the progress made by Eastern Health through this reduction in fees towards facilitating better access to personal health information.

“Citizens are becoming more engaged in the management of their own health care, and it is their right under law to be able to access information about their own care and treatment,” said Ring. “The law also allows custodians of personal health information to charge a reasonable fee, however such fees are not meant to be a barrier or deterrent to the right of access.”

The privacy commissioner’s report can be viewed in its entirety online at www.oipc.nl.ca/pdf/ReportPH2012_002_EasternHealth.pdf.