Who does, and who should, access Your Electronic Health Record
Andre Bredenkamp

Thanks for an interesting post. It made me wonder which elements we’ve already solved for (or have a framework in place for) and which are being driven solely by what new technologies are making possible.

Am I right in thinking that under the Privacy Act anyone has the ability to request and correct health information held about them? So although previously that may taken some time to make a request and have a file copied and delivered to you, anyone with enough perseverance could obtain their clinical record. I know when I worked in a community health setting it was constantly drilled into us that the files could be ‘open’ for client inspection and therefore never assume anything you write will down won’t ever be seen by the client. Of course if you are someone with complex health issues and presenting to multiple clinicians over a long period of time then the effort involved to obtain a full record would be considerable.

Nowadays there are more centralized systems in place for example between GP and hospital admissions. I think the interesting question here is one of ownership. Who owns my record? Is it me and I give permission for those treating me to view and use it, or is it the clinician(s)? If the record is owned by me then I may also give permission to others e.g. a spouse or medical power of attorney.

The technology freight train headed our way is the Internet of Things. All those devices that measure our sleep habits, vital signs, diets, exercise regimes etc. We may be happy for some of this data to be recorded as ‘patient observations’ and see it as a useful addition to our records (e.g. diabetes monitoring). But what about when your employer is collecting this information about you or your car manufacturer? Firstly are you aware it’s being collected, the purpose for which it is being collected, how is it aggregated. Once you’ve got answers to all of that, then finally who should it be shared with?

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