Legal Conditions of Patients’ Access to Medical Records in Poland

Abstract The flow of information contained in medical records can be controlled by implementing appropriate legal and technical procedures and the hospital is protected against costs associated with the loss or release of medical records to unauthorised persons. The aim of the article is to analyse the legislative and organisational regulations defining the scope of obligations of healthcare system entities to keep medical records, as well as the effectiveness of tools ensuring the protection of patients’ rights with regard to medical records produced as a result of health care services provided to them. An analysis of the legal state of affairs was carried out (October 2021) regarding the patient’s rights to medical records and access to them, an analysis of the personal and material scope of the right to medical records, including the right to patient privacy and confidentiality in terms of medical records. The analysis of the legal situation regarding medical records and the patient’s right to them concerned the applicable rules regarding access to records during the patient’s life and after death, also in the context of persons authorised by the patient. The results of the analysis dealt with the forms in which the records were made available to persons and entities authorised by the legislation, as well as the consequences of violating patient’s rights to medical records. The results of the analyses made it possible to formulate the following conclusions: the issue of the implementation of the right to documentation is very important and constitutes a fundamental right of the patient. The policy of ensuring access to medical records to authorised entities is an important element of the functioning of a healthcare entity. All participants in the system are obliged to exercise due diligence in respecting the rights and obligations imposed, to ensure security during the processing of medical records kept on various information carriers – paper, electronic, portable carriers. Budgetary resources should be provided to continue investing in the development of central IT systems that allow for the secure collection of relevant information from medical events and ensure access to it at an appropriate level of security.