The development of information technology should naturally allow broader and swifter access to information, especially when it is about data that directly concern the applicants, such as own medical data. In many countries, the patients long ago started to have access to such data in a digital format from home or any place where there is a computer connected to the Internet without disturbing the medical personnel. In Moldova, the people have to yet go to the medical institution. Moreover, they should respect procedures and formalities and sometimes can generate unwanted confrontations with doctors. The authorities assure the patient’s access to own medical data is ensured without limitations, but health policy experts consider some of the provisions are outdated and need to be modified.
Procedures specified by law
In a response to an inquiry made by IPN News Agency, the Ministry of Health, Labor and Social Protection said that in accordance with the law on the rights and responsibilities of patients, the patient has the right to an alternative medical opinion and to be issued with recommendations by other specialists at his request or at the request of his legal representative. In accordance with the law on the profession of doctor, the doctor cannot prevent the patient from choosing another treating doctor.
Under the Order (of 2010) concerning the ensuring of access to own medical data and the list of medical surgeries that require the informed consent, the manager of the medical-sanitary institution is responsible for ensuring access to the patient’s medical records. The information can be provided in the form of a written summary, at the written or verbal request of the applicant (extract from the ambulatory or stationery medical record (F 027 e) and/or copy of any part of the own medical data and files). If the information is already available, the given mention is written in the primary medical documents and the receipt of information is confirmed by the signature of the applicant and the manager of the medical-sanitary institution or subdivision, depending on the case.
If the requested information needs time to be prepared, it will be provided to the applicant based on a written application within 15 days of the registration of the application. The application is addressed to the manager of the medical institution and is submitted to the chancellery/secretariat of the institution. The person in charge of the provision of information from the medical file, who is assigned by order of the manager of the medical-sanitary institution, will ensure the release of the information requested by application.
Contacted by IPN after a case when the registrar recommended the patient to schedule an appointment with the family doctor and get permission to make a copy of the own medical records so as to consult another specialist, vice director of the Centru Local Medical Association Alexandru Barbăroşie said the patient can obtain the copy of any part of the own medical data and medical files in the way decided by the Ministry of Health, Labor and Social Protection. The registrar, as a salary earner without medical studies, wasn’t authorized to solve the problem of the patent’s access to own medial data. That’s why the proposal to go to the family doctor was appropriate. The family doctor is the first contact specialist to whom the person goes and this is obliged to provide primary medical assistance and, if need be, to ensure access to the other types of medical assistance and services specified in the common program. In the absence of urgent medical-surgical circumstances, the applicant was to see the family doctor based on a preliminarily scheduled meeting.
Asked how correct this procedure seems to him when the informing of the family doctor about the decision to consult another specialist can damage the future relations with this, Alexandru Barbăroşie said cases when patients ask for an alternative opinion from other providers of medical services, either public or private, from national or foreign health facilities exist. Such situations do not cause the dissatisfaction of medical personnel or other negative reactions. Moreover, such opinions by qualified specialists can contribute to solving more difficult clinical cases and it is recommended that the patients should discuss their problems and expectations with the doctor.
Anchored in old times
The Order of 2010 concerning the ensuring of access to own medical data and the list of medical surgeries that require the informed consent is outdated, considers health policy expert Ala Nemerenko. She stated that we live in the era of technologies and, if we oscillate around the bureaucratic procedures like the “written request” for obtaining data and confirmation of the receipt of information by the signature of the applicant and the manager of the medical-sanitary institution, the time of doctors and patients is wasted. When a part of the medical file is provided, it is normal to write a relevant mention, but no one extracts parts of files nowadays, in the era of copiers, and only copies are made.
Ala Nemerenko noted it is the right of each patient to have access to any information about his health, the results of analyses, investigations and administered treatment. Information systems by which patients access medical data through portals, without bothering the medical personnel, exist all over the world. We remained anchored in old times when a person is assigned to release information by order of the manager of the medical-sanitary institution, which is bureaucracy and waste of time. “It’s time for the ministry to align its policies to the international ones and create viable information systems,” stated the expert.
Ala Nemerenko believes the issuing of a copy can and should be simplified so that the patient’s signature is no longer needed. Only the identity of the one who asks for information should be checked so as to ensure confidentiality and make sure that the information is not accessed by someone else.
Maria Prokopchuk, IPN
