Empower Your Practice

Journal for Practice Managers

Who Owns Patients' Medical Records: Clinics or PMS?

Kate Pope
Written by
Kate Pope
Vlad Kovalskiy
Reviewed by
Vlad Kovalskiy
Last updated:
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Medical records are a crucial part of healthcare, helping doctors provide the best care for their patients. But there's an ongoing debate about who owns patients medical records: clinics or the software companies that manage them.

In this article, we will argue that clinics should be the rightful owners of patients' health records. By giving clinics ownership, we can protect patient privacy and ensure they receive the care they need.

Understanding the Importance of Medical Records

Patient data is more than just papers with information. It contains private and sensitive details about health, treatments, and personal information. These records help doctors to:

  • Understand a patient's medical history.
  • Plan their treatment.
  • And ensure their safety.

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They also allow different health professionals to work together effectively. Since clinics are the ones responsible for providing healthcare services, it makes sense for them to own and manage these records.

Who Actually Owns Patient Medical Records? The Key Stakeholders

The question of who owns patients medical records does not have a single, universal answer. Ownership is shared, contested, and shaped by law, ethics, and technology. To understand the debate clearly, it helps to look at each major stakeholder and what claim they hold.

Patients

Patients are the subjects of the data. Every entry in a medical record describes their body, their history, and their treatment. This creates a strong ethical case for patient ownership. Under frameworks like HIPAA in the United States and GDPR in the United Kingdom, patients hold significant rights over their data, including the right to access, correct, and in some cases delete their records. However, holding rights over data is not the same as owning the physical or digital record itself. Courts and regulators have generally stopped short of granting patients outright ownership of the records that providers create.

Healthcare Providers and Clinics

In most legal systems, the physical or digital record belongs to the clinic or hospital that created it. The provider generates the record, maintains it, stores it, and bears legal responsibility for its accuracy and security. Under UK law, NHS patient records are owned by the relevant trust or health board. Private clinics similarly retain custodial ownership of the records they produce. This custodial role comes with significant obligations, including compliance with data protection law and professional regulatory standards set by bodies like the General Medical Council (GMC).

Practice Management Software Companies

Software vendors store and process health data on behalf of clinics, but this does not make them owners. Under GDPR, they are classified as data processors, not data controllers. They act on the instructions of the clinic and must handle data according to contractual agreements. The data does not belong to them. However, this distinction only holds when contracts are properly written. Clinics that fail to specify ownership explicitly in their agreements with software vendors risk ambiguity that could complicate data access or portability if they switch systems.

The Complexity in Practice

The honest answer to who owns patients medical records is that ownership is layered. Patients own the moral claim to the information. Providers own the record as a document. Regulators set the rules for how it is stored and shared. Software vendors facilitate access without holding ownership. Understanding these layers is essential for clinics, patients, and policymakers alike.

Laws like HIPAA in the United States protect patient privacy and give them control over their medical information. Patients are the ones who the records are about, so they should have ownership rights and patient access.

But it's also important to recognize that clinics, as public health providers, should have ownership as well. Some may argue that practice management software managers should own the records because they host the data and provide the software. It is important, however, to prioritize patient privacy and control over the records of the patient.

What does the law have to say?

In the United Kingdom, patients' medical records are legally owned based on existing laws and regulations.

The Data Protection Act 2018 and the General Data Protection Regulation (GDPR) provide guidelines on personal data ownership and management, including hospital records. Under these regulations, individuals, including patients, have certain rights over their personal data.

Clinics, as healthcare providers, have a legal duty of care to their patients. They are responsible for collecting, storing, and protecting patients' personal data, including medical records, in compliance with data protection laws. Clinics are data controllers under these regulations, as they determine the purposes and means of processing patients' personal data.

Patient records of NHS hospitals are owned by a trust or a health board.

While practice management software managers play a crucial role in managing and digitizing medical records, they are considered data processors rather than data owners. Data processors act on behalf of the data controller (the clinic) and must process data in accordance with the controller's instructions and the requirements of data protection laws.

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Do providers need a contract with PMS as a records manager?

To establish ownership and control over medical records, clinics and practice management software managers typically enter into contractual agreements. These agreements define both parties' rights and responsibilities regarding care records management and access.

It is important for these contracts to explicitly state that the clinics retain ownership of the medical records. In addition, they must grant necessary access rights to the software managers for data processing and management purposes.

It is also worth noting that professional regulatory bodies, such as the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC), have guidelines and ethical standards that emphasize healthcare professionals' responsibility to maintain the confidentiality and security of patient information.

The Role of Practice Management Software

Practice management software has made a big impact on healthcare. It uses computer programs to digitize and organize health information, making it more accessible and easier to manage. This technology has many benefits.

Practice management software plays an important role in keeping medical records secure and accurate. However, it should be seen as a helper rather than an owner of records.

Here are some key roles of practice management software in keeping medical records.

Digitization

It helps you to switch from paper-based records to electronic health records (EHRs). So health and social care providers can convert physical records into digital format, making them easily accessible, and shareable.

uk patient registry

Centralized storage

Practice management software provides a centralized repository for storing medical records. This eliminates the need for physical storage space and minimizes the risk of records loss or damage.

Accessibility and availability

With practice management software, a copy of your records can be accessed from anywhere at any time, as long as there is an internet connection. This accessibility improves efficiency and enables healthcare providers to retrieve patient information promptly, leading to better decision-making and improved patient care.

Set Up Smart Data Entry - Organizing medical health records

Records organization

Records can be sorted based on patient demographics, test results, medical conditions, treatments, and other relevant parameters. This organization facilitates easy navigation and retrieval of specific records when required.

Security and privacy

Practice management software employs robust security measures to protect patient records' confidentiality and privacy. It includes features like user authentication, encryption, audit trails, and access requests and controls.

Interoperability

Modern practice management software enables seamless exchange of health records among different providers and systems. Interoperable software facilitates continuity of care, as patient information can be securely shared between clinics, hospitals, laboratories, and other healthcare entities.

What Rights do Patients Have?

In the United Kingdom, patients have certain legal rights over their medical records. These rights are protected by laws and regulations aimed at safeguarding personal data and ensuring patient privacy.

Right of access, meaning they can request a copy of their records and any information held about them by healthcare providers, including clinics and hospitals.

Right to rectification. If patients believe that their medical records contain inaccurate or incomplete information, they have the right to request correction or updating.

Right to erasure, meaning they have the right to request the erasure of their medical records in certain circumstances. One of the exceptions is when the retention of the records is necessary for compliance with a legal obligation or for legal claims.

Right to restrict processing, meaning that the healthcare provider can continue to store the records but must limit the processing activities they undertake with the data.

Right to data portability. Patients have the right to receive a copy of their medical records in a structured, machine-readable, and commonly used format.

Right to complaint, meaning they have the right to lodge a complaint with the Information Commissioner's Office (ICO) in the UK. The ICO is the independent authority responsible for enforcing data protection laws.

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What Happens to Medical Records When a Clinic Closes or Switches Software?

One of the most practical and underappreciated aspects of the ownership debate is what happens to records when a clinic ceases to operate or moves to a new practice management system. This scenario exposes the real-world consequences of unclear ownership.

When a Clinic Closes

When a private clinic closes, the medical records do not simply disappear. The clinic has a legal obligation to notify patients and arrange for records to be transferred to another provider or retained in secure storage for the required period. In the UK, GP records are typically retained for a minimum of ten years after the patient's last contact. Specialist records may be kept for longer, depending on the nature of treatment.

Patients should be informed of where their records will be held and how they can access them. If a clinic closes without making proper arrangements, the responsibility may fall to the relevant healthcare regulator or, in the case of NHS services, the relevant integrated care board.

When a Clinic Switches Software Systems

Switching practice management software is increasingly common as clinics seek better tools. The key risk during a migration is data loss or inaccessibility. Clinics should ensure before signing any software contract that they have clear rights to export their complete patient data in a standard, interoperable format. A contract that locks data inside a proprietary system effectively transfers control, if not legal ownership, to the vendor.

This is why data portability clauses matter. Clinics should insist on the ability to retrieve all patient records in a format compatible with other systems, without penalty or delay, if they choose to move to a different provider.

Frequently Asked Questions About Medical Record Ownership

Do patients legally own their medical records?

In most countries, patients do not hold legal ownership of the physical or digital record itself. The clinic or hospital that creates the record is typically the legal custodian. However, patients retain strong rights over the information contained within those records, including the right to access, correct, and in some circumstances erase that information under laws like GDPR and HIPAA.

Can a clinic refuse to give a patient their records?

In the UK, clinics cannot generally refuse a patient access to their own records. Under the Data Protection Act 2018, patients have a right of access and record holders cannot charge for this unless the request is manifestly unfounded or excessive. There are limited exceptions, such as where releasing the record could cause serious harm to the patient or another person.

What happens to my medical records if I change GP?

Your GP records move with you when you register with a new practice. The NHS Summary Care Record, which includes key information such as medications and allergies, is accessible to authorised clinicians across different settings. Detailed historical records are transferred from your previous GP practice to your new one, though this process can take some time to complete.

Can software companies use patient data for research or commercial purposes?

No, not without explicit legal basis and appropriate patient consent or anonymization. Under GDPR, software vendors are classified as data processors and can only use patient data as instructed by the clinic. They cannot use identifiable patient data for their own research or commercial purposes. Any secondary use of health data for research requires either patient consent or a formal legal gateway, such as approval from an NHS Research Ethics Committee.

Who is responsible if medical records are lost or breached?

The data controller, which is the clinic, holds primary legal responsibility for protecting patient records. If a breach occurs due to a failure by the practice management software vendor, the clinic may still face regulatory scrutiny and must report the breach to the relevant authority within 72 hours under GDPR. Liability between the clinic and vendor will typically depend on the terms of their data processing agreement.

Empowering Clinics as the Rightful Owners

Giving clinics ownership of medical records has several advantages. It ensures that patients have more say in their healthcare decisions. When clinics own the records, they can better coordinate care among different providers. Clinics also can protect patient privacy and confidentiality. It is possible for them to ensure that only authorized people have access to patient information.

To strengthen clinics' ownership rights, clear agreements should be made between clinics and software managers. These agreements should clearly state that clinics own records and control them.

Policymakers should also recognize and support clinics' ownership of medical records. They can do this by creating laws that protect clinics' ownership rights. Additionally, developing systems that allow easy data sharing between clinics and software managers will help manage records effectively.

Conclusion

Clinics should be recognized as the rightful owners of patients' medical records. These records are essential for providing quality healthcare. By giving clinics ownership, we protect patient privacy, ensure coordination among healthcare providers, and empower patients to make decisions about their own health.

It's a necessity for clinics, software managers, and policymakers to work together to find the right balance between ownership and managing medical records. As a result, patients will receive the best care while their information remains secure.

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