When is a patient’s access to medical records subject to payment?
One of a patient’s basic rights is access to his medical records. This right is also enjoyed by the patient’s legal representative or a person authorized by the patient, and, after the patient’s death, by his relatives (with certain limitations).
Patients have the right to inspect their records, including health care databases, free of charge. This access is usually carried out at the place where health services are provided, or at the premises of the health care provider. This right also includes the ability to take notes or photos yourself.
The patient has the right Also to receive documentation, in various forms: excerpt, copy, copy or printout, by electronic communication, on a computer data carrier, or even by issuing the original against acknowledgment of receipt and subject to return after use (at the request of courts and public authorities, or when the speed of obtaining the documentation is important for the life or health of the patient).
However, the form in which the documentation is made available depends not only on the patient’s wishes, but also, among other things, on what medium it is on (e.g., films of X-rays are issued in originals subject to return), or on the organizational regulations of the entity keeping the documentation (for example, paper documentation can be made available electronically in the form of a scan or on a computerized data carrier, if the regulations of the entity provide for such a possibility).
Providing access to medical records is, of course, an additional task for the entity holding them and may entail additional costs, so the Law of November 6, 2008. The Law on Patients’ Rights and Patients’ Rights Ombudsman grants these entities the right to demand fees for providing access to records in the form of an extract, copy, copy or printout, or on a computer data carrier, as well as in the form of a scan of paper records sent electronically.
At the other extreme is the guarantee of being able to ensure that each patient obtains his or her records (which are often voluminous).
Thus, the legislator decided that it is free of charge to provide the first access to the documentation (whether in parts or in full) in the form of an extract, copy, copy or printout, on a computer data carrier, including paper documentation sent electronically in a scan or on a data carrier. It is also free to obtain documentation via electronic communication means, as long as the documentation is originally kept in electronic form. The provision of Art. 28 para. 2a and b of the law introduces several more exemptions from the fee in specific situations.
For subsequent access already health care providers may demand fees. They can determine the amount themselves, while not exceeding the statutory limits:
- one page of an extract or copy of medical records – may not exceed 0.002 of the average salary in the previous quarter (until 29.02.2024 is therefore 14.39 PLN),
- one page of copy or printout of medical records – may not exceed 0.00007 of the average salary in the previous quarter (until 29.02.2024 is therefore 0.50 PLN),
- access to medical records on a computerized data carrier – may not exceed 0.0004 of the average salary in the previous quarter (until 29.02.2024 is therefore PLN 2.88).
Medical records, in addition to their obvious function as a record of health status and history of services provided, are one of the primary means of evidence in disciplinary and judicial proceedings. It is therefore a document of momentous power. The patient must have access to it, but the exercise of this right must not unduly burden the provider.
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According to the law of November 6, 2008. On Patient’s Rights and Patient Ombudsman (i.e., OJ 2023, item 1545) (hereafter: the A.P.A.) – every patient, has the right to access medical records concerning his or her condition and health services provided.