Despite the recent passage of legislation guaranteeing patient access to personal medical records, most hospitals continue to impose unreasonable obstacles, the Taiwan Health Reform Foundation said yesterday.
The foundation released the results of a survey into accessibility of patient records at over 100 hospitals. Based on telephone interviews with hospital personnel, the foundation found that each hospital required a doctor's authorization before copies of the records could be provided.
The survey included major hospitals such as National Taiwan University Hospital, Taipei Veterans General Hospital, Mackay Memorial Hospital and Cathay General Hospital.
PHOTO: CHANG CHIA-MING, TAIPEI TIMES
"When you have to obtain a doctor's approval to get copies of your medical records, the doctor might suspect the patient's motives for wanting copies of the records. [The doctors] will tell you that you can't understand them or else will choose which records to copy," said Liu Shu-fen (
The foundation also pointed to difficulties in access that arise after doctors retire or when they are absent from work.
Lee Yuan-teh (李源德), National Taiwan University Hospital superintendent, said that patient records are the "intellectual property" of doctors and belong jointly to the doctor and patient. He said it was therefore reasonable that a doctor's authorization be sought before distribution of medical records.
However, foundation chairwoman Chang Ly-yun (張苙雲) said that the primary concern for doctors when they withhold patient records was preventing medical lawsuits.
"What causes a medical dispute in the first place? You need to get to the root of the problem: The quality of medical service is bad because doctors live in their own world where no one else can see a patient's medical records. It's a vicious circle," Chang said.
Chang added that if patient records were more easily accessible, healthcare would improve.
In addition to difficulties in obtaining a doctor's approval to review records, the foundation highlighted other problems that obstructed access to records.
access cost
"The cost [of access] ranges from NT$20 to NT$35 per page. For many patients, this easily adds up to NT$750 or more," Liu said.
The foundation's volunteer researchers found they had to wait an average of 67 minutes, in addition to standing in a queue and paying registration fees, before the process could be completed.
According to the recently amended Article 71 of the Medical Treatment Law (醫療法), hospitals are required to provide copies of patient records upon request. Those which refuse to do so can be fined up to NT$10,000.
"I think that everyone is taking this too seriously. [Hospitals and doctors] are treating a request for a copy of a medical record as if a lawsuit were already under way and that the records already constituted evidence," Bureau of Medical Affairs Deputy Director Hsueh Jui-yuan (
Hsueh promised that the bureau would ensure that patients could gain access to their records within the month.
"Right now, hospitals are not allowed to reject requests for patient records. So it really is a problem of what type of application procedures and requirements constitute a `rejection' of record requests," Hsueh said. "We will insist though that requests be subject to thorough identification checks to protect people's privacy."
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