Kath­leen Fin­lay was inter­viewed by CTV News on a sto­ry con­cern­ing the high costs of patients access­ing their med­ical records.  In this case, a fam­i­ly was ini­tial­ly charged more than $1000 to see their late father’s hos­pi­tal record. It is the kind of bar­ri­er that reduces trans­paren­cy and patient and fam­i­ly engage­ment, and a con­trib­u­tor to a less safe health­care cul­ture because of it.

More below.

Patient Access to Med­ical Records is a Must for Safer Health­care 

Finan­cial bar­ri­ers, like high fees for patient infor­ma­tion, reduce patient empow­er­ment, thwart account­abil­i­ty and risk adverse out­comes

The Cen­ter for Patient Pro­tec­tion has received dozens of inquiries and com­ments from patients and fam­i­ly mem­bers about con­tin­u­ing dif­fi­cul­ties with the afford­abil­i­ty of obtain­ing records of their hos­pi­tal treat­ment. Pub­lic inter­est in the sub­ject was recent­ly ignit­ed after it was report­ed that Iris Kul­bats­ki, Ph.D., was charged more than $1,000 by Uni­ver­si­ty Health Net­workto access her late father’s records. Kath­leen Fin­lay, founder and CEO of The Cen­ter for Patient Pro­tec­tion was inter­viewed by CTV News and oth­er media out­lets on the sto­ry.

It has long been the posi­tion of The Cen­ter that med­ical records, and espe­cial­ly those involv­ing a cur­rent or recent­ly hos­pi­tal­ized patient, should be made avail­able free of charge to patients or to des­ig­nat­ed sur­viv­ing loved ones.

Yet it is not uncom­mon for patients and fam­i­lies to be charged up to sev­er­al thou­sand dol­lars for those records, accord­ing to reports made to The Cen­ter.  Charges of $1000 are fre­quent. This rep­re­sents a finan­cial hur­dle that most patients and fam­i­lies are unable to clear, and should nev­er be required to when they are typ­i­cal­ly already under severe phys­i­cal, emo­tion­al, and often finan­cial, stress.

Trou­bling, too, is the prac­tice of cer­tain health­care providers to with­hold parts of the med­ical record in an effort to hide errors.  In a case involv­ing a car­diac arrest, one of Canada’s largest teach­ing hos­pi­tals with­held the car­diac mon­i­tor print­out for sev­er­al years before ulti­mate­ly dis­clos­ing it.  It showed unex­plained delays between the time of the alarm and the response of the ICU team. In anoth­er case, it took mul­ti­ple  efforts to obtain the patien­t’s full chart, despite the fam­i­ly being assured each time that the hos­pi­tal had pro­vid­ed the full and com­plete record. When the miss­ing records were final­ly pro­vid­ed, they showed numer­ous and repeat­ed med­ical errors and break­downs in care that were not dis­closed in the respons­es to the pre­vi­ous three requests.

An informed patient is a safer patient.  Patient feed­back is an indis­pen­si­ble learn­ing tool for health­care providers. But in too many cas­es, bar­ri­ers to obtain­ing records make it impos­si­ble for fam­i­lies to know whether their care was, in fact, safe, or whether it fell below accept­able stan­dards. Many have been shocked to learn, after they were final­ly able pay the high fees to obtain the records, that they reveal seri­ous break­downs in care, includ­ing med­ical errors that were nev­er dis­closed to the patient or fam­i­ly.  In oth­er cas­es, con­cerns voiced by patients and fam­i­lies about the dete­ri­o­ra­tion of the patien­t’s con­di­tion, which pre­ced­ed the arrival of adverse, or even sen­tinel, events, were omit­ted from the records alto­geth­er.

When a cloud of uncer­tain­ty and lack of trans­paren­cy are allowed to come between the patien­t’s inter­ests and health­care providers, it under­mines the sense of trust and con­fi­dence that is nec­es­sary in that rela­tion­ship.  Some juris­dic­tions have aban­doned all charges for health­care records.  Ontario is not among them.

As part of our Pol­i­cy Pre­scrip­tions for Safer Health­care, The Cen­ter for Patient Pro­tec­tion, once again, calls on the Ontario gov­ern­mentto adopt a no-fee pol­i­cy in respect of health­care records, and urges health­care providers to adopt a sim­i­lar pol­i­cy.  After all, Ontario and oth­er Cana­di­an provinces have no prob­lem devot­ing hun­dreds of mil­lions of tax­pay­er dol­lars to pay for the lia­bil­i­ty insur­ance pre­mi­ums of doc­tors. Sure­ly it is not too much to expect that a sim­i­lar pub­lic com­mit­ment should apply to mak­ing the health­care records of patients, who own the infor­ma­tion about them that is being col­lect­ed by hos­pi­tals, avail­able with­out encum­brances to those patients.

If you or a loved one have had a prob­lem obtain­ing med­ical records, please let us know.  Togeth­er, we can make sure that our med­ical infor­ma­tion can be seen and used by us when we need it most.

In hon­our of the mem­o­ry of Hen­ry Kul­bats­ki, Iris and her fam­i­ly have launched a peti­tion to low­er the bar­ri­ers to access­ing patient med­ical charts.  You can vis­it the site now.  Please con­sid­er sign­ing the peti­tion.   

 

RELATED

CTV News inter­view on the fore­go­ing sto­ry.

Turn­ing Trans­paren­cy into Patient Safe­ty

Our Pol­i­cy Pre­scrip­tions for Safer Health­care