‘They are my records’: Patients question why they have to pay to access certain medical files

In our Speakers Corner report, a man is asking about medical records and why there is sometimes a fee to access them.

“Who owns these records? Is it me, OHIP, or the clinic?” asked Eric Hudson, who recently tried to get copies of an X-ray he had done.

“I had X-rays done of my knee and I wanted to see the copies of it.”

But in order to do so, he had to pay a fee, which he has paid for other records in the past.

“I thought, why should I be doing this? I don’t understand, they are my records, which the government paid for and they should be shared for free.”

While you can typically get doctor’s notes and test results for free, clinics are within their right to charge a fee for other records, such as copies of X-rays.

“Because copying or transferring medical records is an uninsured service, physicians are entitled to charge patients or third parties a fee for obtaining a copy of their medical records,” according to The College of Physicians and Surgeons of Ontario (CPSO)

But there are limits.

“The fees have to be reasonable on a cost recovery basis. So this is not a money-making operation,” said Information and Privacy of Ontario Commissioner (IPC) Patricia Kosseim.

“Custodians of the records must also first provide the individual with an estimate of the fee,” she said.

Medical staff making notes on a patient’s chart. CITYNEWS

The costs can be high, especially for those switching health-care providers, something Kosseim has experienced herself.

“I had to get my own medical records when my general practitioner retired, only to have to pass the file on to my new GP and it did cost me quite a bit of money, to my surprise. So it is an important issue that affects the lives of Ontarians,” she said.

The IPC did not set the law, which allows fees, but the commission was involved in setting fee guidelines for the health sector as part of Health Order (HO-009).

“Under that order, we interpret and adopt a framework for what a reasonable fee would look like in different scenarios,”

Kosseim said it comes down to administrative costs for clinics to prepare and share records.

“It might involve photocopies. It might involve time in preparing those photocopies. It might be digitising records or making a scan of records,” she said. “Really, how much effort and time had to be put in, depending on the volume of records that are at issue.”

But in a digital age with increased technology, patients, like Hudson, feel the law needs to be revisited.

“Most records are digital, how much time does it take to email them to me?” he asked.

Kosseim said any patient who feels they’re being overcharged can take action.

“I would first take it up with the health-care provider and try to work it out that way. If that doesn’t work, they can contact the IPC. We will then assess and get into the specifics of the case. Oftentimes we’ll look to resolve or to mediate, but if we have to, we will issue a decision, particularly where the fees are high or unreasonable.”

She agrees this is an important discussion, and one citizens have the right to challenge.

“The more people who voice their concerns, I think the more productive it is in bringing about reasonable change that meets the needs of Ontarians, particularly those who are strapped financially, but also are fair to providers who otherwise have to pay for these costs,” she said.

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