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When Melissa Snider found a new family doctor closer to her home in Denfield, Ont., she was happy at the thought of no longer travelling to London for medical visits.
The relief turned to shock however when her former family doctor quoted Snider $100 per person to transfer her records, along with those of her husband and their three children, to a new physician.
“It was quite surprising to me that transferring medical records for a family of five would cost me $500,” said Snider, whose kids are all under the age of nine.
“My kids are all healthy so it would just be vaccine records for them, and my husband and I are pretty healthy too, so our records themselves would not be very extensive. Half a grand in this economy is just not doable for something so silly.”
Snider said she had previously paid around $35 for the service. She asked a Facebook group for moms if others have been in this situation. She said she received a variety of responses, with some saying their doctor did it for free, and others saying they had to pay varying fees.
Access to personal health information and related fees is governed by the Personal Health Information Protection Act and not covered by the Ontario Health Insurance Plan (OHIP), according to the College of Physicians and Surgeons of Ontario (CPSO).
The work involved in fulfilling a request for medical records may include locating and retrieving records, reviewing them, preparing the materials for disclosure, and securely transferring them to the patient or the receiving health-care provider, says the College of Physicians and Surgeons of Ontario. (Copyright (c) 2017 Stokkete/Shutterstock.)
The work involved in fulfilling a request for medical records may include locating and retrieving records, reviewing them, preparing the materials for disclosure, and securely transferring them to the patient or the receiving health-care provider, said CPSO spokesperson Laura Zilke.
The Information Privacy Commissioner recommends a $30 fee for electronic transfers, according to the Ontario Medical Association, which sets out recommended fees in its Physicians’ Guide to Uninsured Services.
In some cases, doctors may charge $30 for the first 20 pages and then $0.25 per extra pages, but all other methods of reproducing records should be charged for at cost, the guidance states. This can include clerical labour costs, toner and paper costs, equipment, and storage space.
“Among other requirements, physicians must provide a fee estimate in advance and charge only reasonable fees that reflect cost recovery,” said Zilke, adding that physicians must consider these recommendations and the patient’s ability to pay.
“CPSO’s policy requires that fees be reasonable, reflect cost recovery, and be commensurate with the nature of the service provided, including factors such as the materials used, the time required to prepare the records, and the direct cost of sending them.”
‘Patients shouldn’t have to pay’: family physician
Snider wonders why there isn’t a centralized system where every clinic charges the same fee, or bases fees on a patient’s medical history.
The current system is “disconnected” because clinics have their own system of storing health information, with some using paper charts and others electronic records, said Dr. Jobin Varughese, president of the Ontario College of Family Physicians.
When patients move between clinics, doctors and their teams must spend hours preparing and sending those records manually, he said, adding that it contributes to paperwork and other administrative tasks that take away time doctors can spend with patients.
“It’s pretty clear that we need to get to a point that patients shouldn’t have to pay for their records and family doctors should be able to spend their time caring for patients rather than moving records through a disconnected system,” he said.
“Patients should be focused on their health, not on how their medical records move from one doctor to another.”
Dr. Jobin Varughese is president of the Ontario College of Family Physicians. He agrees that patients shouldn’t have to pay to have their medical records transferred to a different clinic. (Submitted by the Ontario College of Family Physicians)
Varughese believes this issue should be eliminated once Ontario rolls out the provincewide Primary Care Electronic Medical Record, where patient records are integrated onto one accessible system.
The electronic record aims to provide clinicians with a more complete view of a patient’s health history, improving coordination across the health system and reducing delays caused by missing records. It also seeks to save patients money in transfer fees, unnecessary medical tests and lab work.
“Right now it’s on the patients to have to remember dates and times and so being able to reduce that burden will be helpful. It will also reduce the need for patients to repeat the same information to different providers just because their records aren’t available,” said Varughese.
The province is currently in a procurement phase but Varughese said officials have consulted with family physicians and he’s hopeful this will simplify the process for doctors and patients.
As for Snider, she plans to provide her new doctor with a verbal medical history and not pay the hefty transfer cost.