Patients’ access to medical records around the world
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1481 (Published 11 July 2024) Cite this as: BMJ 2024;386:q1481
This article in BMJ of July 11th describes the variations in infrastructure and law that affect the ability for patients to see their own health records in different countries. Patients seeing their own records is now often upheld as a basic right.
Australia
Privacy law gives patients a general right to request access to the health information stored about them. The My Health Records system, launched in 2012, is run by the Australian Digital Health Agency. It gives patients access, through the central myGov website, to information on medical conditions, treatments, prescriptions, allergies, and test or scan results.
Brazil
Medical records are centralised by Brazil’s universal, public Unified Health System (SUS), with the health ministry’s official Meu SUS Digital app offering patients access to their records of medical interactions, vaccination records, medication history, and transplant queue status (for those awaiting transplants).
Canada
In Canada’s decentralised and publicly funded health system, patients can request data through their healthcare providers, with patient portals and other mechanisms for electronic access existing at the province or territory level. These offer access to medication history, laboratory and other results, and appointment booking information. Currently there is no comprehensive right for patients to share their health information to third parties.
Chile
Citizens have no right under law to access their medical records. Access, where provided, is usually of digital copies of sometimes handwritten notes from appointments or exam results accessed online by a one-time download code. Efforts to create a digital healthcare infrastructure, eliminating paper records, aim to improve patients’ access to their records.
China
A 2014 statute gave Chinese citizens a right to access their medical records. Launched in 2017, the Chinese eHealth card is a step towards regularisation of medical data and contains patients’ medical history, although it has been implemented patchily. Some healthcare providers (in this mixed public-private system) have developed their own standalone apps, some send data by post or recorded on compact discs, and some hospitals have self-service kiosks where patients can print their records.
Estonia
The Estonian e-health record system, the EHIS, began operation at the end of 2008. Through a centralised online patient portal citizens with an ID can view their medical documents, see records of past doctor visits and prescriptions, and grant permission for others to view their records.
France
A 2002 law gave patients the right to consult their medical records and allowed doctors to share medical notes among themselves to coordinate care. Health records are centrally held and accessed by patients through a digital platform, Mon Espace Santé (My Health Space), which was launched in 2022 and is managed by the Ministry of Health. Patients can also block access to specified documents on the website and app.
Germany
German citizens gained the right to access their digital health records in 2021. The centralised electronic patient health record (elektronische Patientenakte or ePA) is managed by patients, who can access it through the ePA app or website or can view it in doctors’ and health insurers’ offices. Since 2023 patients have been able to share their data with outside parties for research purposes.
India
Patients’ records are paper based and confined to one healthcare provider (but accessible to the patient). The national government’s Ayushman Bharat Digital Mission, launched in 2021, aims to create a database of health records that will connect patients to a digital ecosystem, including providers and payers, and that can be accessed through an app. It is being rolled out at state level.
Japan
Japanese citizens have had the right to access their medical records since the 1990s. Most citizens do not have digital access to their health records, but paper copies are usually provided on request, apps are available that display lists of patients’ prescriptions, and digital portal sites are being developed.
Kenya
Under article 35 of the Kenyan Constitution patients can make a request in writing to the relevant health information bank to examine and receive a copy of their health data. Enacted in 2023, the Digital Health Act will create a centralised data system that includes patient accessible healthcare records.
Nigeria
Citizens have a right to access their medical records through the National Health Act 2014. Local healthcare institutions store these records, typically using paper based systems. Attempts are being made to introduce digital records, but these face major barriers, including internet connectivity and lack of functioning hospital websites.
Singapore
Singapore’s national HealthHub, launched in 2015, provides access to personal hospital records, test results, medical appointments, and referral letters from public healthcare institutions. It can be accessed by a website or app, and patients can grant friends and family access to their records through a caregiver access module.
South Africa
Each province in South Africa has its own autonomous health department, with records being the property of healthcare institutions, but copies available on request, by law, to patients (for which a reasonable fee may be charged). Some provinces, such as Western Cape Province, have created electronic health records through which patients can access their clinical records.
South Korea
South Korea’s My HealthWay app, launched in February 2021 by the Ministry of Health and Welfare, is designed to “establish the sovereignty of personal medical data” and provides access to 113 items of health information, including medical check-up data, prescription data, and vaccination history.
Sweden
Swedish citizens can access their health records through the electronic health record PAEHR, which launched in 2016. Individual Swedish counties decide what information patients can access on PAEHR, and patients have the right to block information in their medical records from view.
United Kingdom
The General Data Protection Regulation (GDPR), in conjunction with the Data Protection Act 2018, gives everyone in the UK the right to access their medical records. Records held by patients’ general practices can be viewed on the NHS app or by request to the surgeries, with a response due within 28 days.
United States
There is no centralised record keeping across the US system of private healthcare providers and the government insurance providers Medicare and Medicaid, though the 21st Century Cures Act 2016, which came into force in April 2021, requires patients to be given immediate, easy, and free access to health information. Privately run patient portals enable access through smartphone apps or computers, with some private apps being able to access data from Medicare and Medicaid.
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT gmail.com