Medical records. You know they exist. But who gets access to them and what’s even contained within them is a bit of a mystery. Are they stored in the cloud? On your doctor’s computer hard drive? In a dusty filing cabinet?
Most of us only need to understand our medical records (and the medical system in general) when we’re sick. But here’s the thing: the time it takes to go from being healthy to requiring numerous medical treatments and appointments is often entirely unpredictable. And if you don’t have access to your critical health information exactly when you need it, your care could suffer as a result. Because at the end of the day, regardless of how great the medical staff are, you are your own best advocate and champion.
Here are six things you need to know about your medical records, before it’s too late.
1. Your health records are not stored in the cloud.
Often when we explain the service Dot Health provides, people assume we pull records from a centralized government database that contains all Canadians’ health information.
We wish it were that simple.
In reality, Dot Health requests your health records directly from your providers, most of whom use some version of an Electronic Health Record (EHR) software. Dozens of EHR vendors in Canada and the U.S. provide iterations of similar products: a software that individual institutions can use to input and store patient medical information. It’s at the discretion of your health care institution which EHR vendor they engage.
2. Your health care provider doesn’t always have access to your medical records.
This may come as a surprise, but did you know that when your health care provider pulls up your record on their computer, they won’t necessarily see everything? This is because EHR systems are chosen by individual providers — and there are dozens of options for them to choose from, most of which do not seamlessly communicate with each other. For this reason, it can sometimes be a headache for your doctor to access medical records from other institutions where you received care, especially if they are in a different city, province, or country. Usually this isn’t a huge deal, as you can communicate the ‘need to know’ stuff, like what prescriptions you’re taking and any major medical issues you’ve dealt with in the past. When this might be an issue is if you’re unable to communicate — like if you show up in the ER feeling unwell or in an extreme case, unconscious.
3. Your health records belong to you — sort of.
While the information your health records contain belongs to you, the medium in which it’s stored is the property of your health care provider or the institution that created it. In other words, you can get a copy of your medical record, but not the original document (i.e. your physician could give you a printed or photocopied version of your records, but it’s not up to you how it’s stored, or whether or not it’s destroyed.)
4. Even though you have the right to a copy of your medical records, access isn’t free.
Did you know that the average Canadian health care provider charges upwards of $30 per 10 pages of medical records, and an additional $0.25 - $1 per page thereafter?
Since the original copy of your records is technically owned by your provider, they get to decide how much they charge to create copies. There are fee guidelines set by regulatory bodies, but these are often vague and inconsistent. The reason they charge is because there is usually administrative labour involved in creating those copies, in addition to the time a doctor will spend reviewing your records. Unfortunately, the cost of this is non-insured and transferred to you, the patient.
5. Your records aren’t stored with your provider forever.
Legislation in Canada requires physicians to store adult patient medical records for 10 years past the last entry in the record. So, if the last time you saw a provider was eight years ago, they’re required by law to continue to store those records for another two years.
This makes sense, especially when it comes to paper medical records — filing cabinets take up a lot of space. However, if you ever decide you want your health information from more than 10 years ago, you may run into trouble. This is why getting copies of your records sooner rather than later is a good idea. When you own copies, you get to control how they are stored and for what time period.
6. Your records might contain errors.
A survey from the Kaiser Family Foundation revealed that 1 in 5 patients will discover an error in their medical records. While usually minor, for some patients these errors could mean the difference between life or death. When physicians are spread thin, and EHR systems are prone to errors (like any other piece of software), it’s beneficial to have as many eyes on your information as possible. When you and/or your family have the ability to review your data, it’s less likely that mistakes in your care will occur.