Health Privacy Update: When someone asks for a copy of a “complete health record”, what does that mean?
In Decision 89 of the Information and Privacy Commissioner of Ontario deals with an access request, what lengths a health care organization has to go to look for records and what is a “complete health record”.
In this case, the complainant asked a community care access centre (CCAC) for access to his deceased wife’s complete health record. His wife had received services coordinated by the CCAC and delivered by a few different agencies. He was given a copy of the CCAC’s entire file.
When he reviewed the file, he thought there should be more records – specifically from the agencies that delivered the services. He complained to the IPC.
During the IPC process – the CCAC became part of the local health integration network (LHIN). The LHIN took over management of the privacy complaint.
The new entity, the LHIN, contacted all the service providers that had provided care to the patient as coordinated by the CCAC and got copies of their records (420 pages) and gave those to the complainant.
The complainant thought there should still be MORE records. He then stated he thought there should be copies of the communications he and his wife had with the LHIN (or CCAC), including what would have been a copy of his wife’s will.
The LHIN said “communications”? Huh. Ok. Now you are making a new request. That’s not the same thing as a “complete health record”.
The complainant was miffed. He thought the LHIN was acting in bad faith. He argued that when he asked for the “complete health record” the LHIN should have known that meant communications as well as the health records. He thought they should have from the beginning looked for any record they had about his wife.
The IPC was focused on whether the LHIN had undertaken a “reasonable search” for records and concluded the LHIN had done so.
When the complainant asked for a copy of the “complete health record”, the IPC concluded it was reasonable for the LHIN to assume that meant the traditional health records and not a wider understanding of all communications (or documents not directly related to a patient’s health care). Administrative records do not have to be included in an initial search for a request for a copy of the “complete health record”.
The IPC also said that because the LHIN coordinated the services that were delivered by other organizations, the LHIN was right to ask those agencies for a copy of their records and provide those records to the complainant.
The LHIN did not have a copy of the wife’s will. They said they never received it and it would not have been normal practice to have a copy of a will. The IPC concluded it was not necessary to look further for a copy if one could not be found.
The IPC concluded that the LHIN had acted appropriately and had fulfilled its responsibility to complete a “reasonable search” for health records. The complaint was dismissed.
Bottom Line: This is an important reinforcement of the usual practice for health care organizations when they receive generic access requests. A request for a “complete health record” can be reasonably interpreted to mean the traditional health record. A request for a complete health record does not require a health information custodian to search for administrative records or other peripheral records that could be held anywhere in the organization. That kind of secondary search would be required however on specific request – when a request includes references to records of communications or complaint or administrative content.
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