Accessing External Health Records for Results from Another Practice
It is generally not ethical to access external health records solely to provide investigation results that were ordered by a different practice, as this violates the principle that patients should follow up with the ordering provider who has clinical context and responsibility for those results.
Core Ethical Framework
The fundamental issue here centers on appropriate access boundaries and clinical responsibility. When a provider orders investigations, they assume responsibility for reviewing results, interpreting them in clinical context, and communicating findings to the patient 1. Accessing records from another practice to provide results you didn't order creates several problems:
Why This Practice Is Problematic
Breach of appropriate access principles: Healthcare data should only be accessed when there is a legitimate clinical need within an established patient-provider relationship 1. Simply retrieving results ordered by another provider doesn't meet this threshold unless you are actively providing care that requires this information 1.
Violation of "minimum necessary" standards: Data sharing and access should follow the principle of accessing only the minimum information necessary for the specific clinical purpose 1. Accessing records to satisfy patient convenience rather than clinical necessity exceeds this standard.
Undermines continuity of care: The ordering provider has clinical context about why tests were ordered, what they're looking for, and how results fit into the patient's overall management 1. Providing results without this context can lead to:
- Misinterpretation by patients
- Missed follow-up on abnormal findings
- Fragmented care
- Loss of accountability for result management
Patient Privacy Concerns
Patients have significant concerns about unauthorized access to their health information 1. Research shows patients are particularly worried about:
- Who accesses their records and for what purpose 1
- Access to sensitive information (mental health, sexual health, substance abuse) 1
- Unauthorized sharing between providers 1
Even though the patient is requesting access, your act of retrieving records from an external system may constitute unauthorized access from the perspective of the ordering practice and the health information system 1.
The Appropriate Pathway
Patients must be directed to follow up with the ordering provider or practice for several reasons:
- Clinical responsibility: The ordering provider needs to review and act on results they requested 1
- Documentation: Results should be documented in the ordering practice's records with appropriate follow-up plans
- Medicolegal protection: The ordering provider assumes liability for result management
- System integrity: Maintains proper boundaries in shared health record systems 1
When Access Might Be Justified
Access to external records is appropriate only when:
- You have an active clinical relationship with the patient requiring this information for their current care 1
- The information is necessary for immediate clinical decision-making (not just patient convenience)
- You are assuming clinical responsibility for acting on the results 1
Common Pitfalls to Avoid
Don't confuse technical access with ethical access: Just because you can access shared health records doesn't mean you should 1. Technical capability must be paired with appropriate clinical justification.
Don't let patient pressure override professional boundaries: Patients may not understand why they need to contact the ordering provider, but this doesn't justify circumventing proper channels 2.
Don't assume previous provider behavior sets the standard: The fact that another provider accessed records inappropriately doesn't make it acceptable practice 1.
Practical Approach
When patients request results from another practice:
Explain the principle: "The doctor who ordered these tests needs to review them with you because they have the full picture of why they were ordered and what they mean for your care" 1
Provide clear direction: Give specific contact information for the ordering practice
Offer appropriate assistance: If the patient has difficulty reaching the other practice, you can help facilitate communication between practices through proper channels
Document the interaction: Note the patient's request and your explanation in your own records
The integrity of the healthcare system depends on maintaining appropriate access boundaries and ensuring clinical accountability follows the ordering provider 1.