Fees for patient notes under scrutiny after privacy commissioner complaint

It is a patient’s information, and practices do have an obligation to give them access to it

Health centre staff are being re­minded they cannot impose fees to provide patients with copies of their medical notes.

Earlier this month, Auck-land’s Orakei Health Services was in the news for trying to charge a patient $100 for a copy of their health records.

Practice manager Kanwal Shah didn’t want to comment on the incident when contacted by New Zealand Doctor.

The patient, who complained to the privacy commissioner, received an apology and re­fund from the practice, which is owned by Ngāti Whātua Ōrākei development company Whai Maia.

Whai Maia chief executive Rangimarie Hunia admitted “an error in our current processes”.

“We will be putting in place the correct technologies to en­able the supply of a printed and digitised version of any individ­ual’s personal medical files, on request and at the clinic’s cost,” Ms Hunia told the New Zealand Herald.

Office of the Privacy Commissioner communications advisor Sam Williams says the office fields similar complaints about once a month.

Under the Health Information Privacy Code 1994, a health cen­tre cannot charge a patient for a copy of their medical notes.

A “reasonable charge” can be imposed only for subsequent re­quests for the same information within 12 months and for cop­ies of an x-ray, video recording or MRI, PET or CAT scan.

Practice Managers and Administrators Association of New Zealand chair Henrietta Taia says it can cause confusion when a patient asks for their notes for their insurance com­pany, given the fees normally imposed for providing insurers with medical reports.

But it is a patient’s informa­tion, and practices do have an obligation to give them access to it, says Ms Taia, the prac­tice manager at Royal Heights Medical Centre in Auckland.

Her understanding is that, in the first instance, patients are not charged for a copy of their notes. But when their health re­cord is extensive, she asks for 24 hours’ notice.

At her former practice, a charge was imposed for a patient who requested their notes for a third time in as many months.

In general, requests for notes are not common, Ms Taia says. At Royal Heights, there’s one request every two to three months, on average, and pa­tients normally have a good reason for asking, for example, because they’re going overseas.

Depending on the practice management system a clinic uses, the process is not always as simple as saving electronic notes on to a USB stick.

Some practices still print notes, and that process can take up to 20 minutes of staff and printing time.

At Royal Heights, notes from more than 10 years ago are still in hard copy, which can add time to the process, as those notes need to be scanned or photo­copied, Ms Taia says