In today's article we bring you an overview of the most important legislative changes in Act No. 576/2004 Coll. on health care, services related to the provision of health care, which aim in particular at:
(i) restrict the disclosure and release of data from the patient's medical record,
(ii) to allow the disclosure of information from the medical records of a living patient with full legal capacity to his or her immediate family.
This refers to a situation where the patient is unable to grant a power of attorney to a person designated by him/her due to his/her health condition.
For the sake of clarity, a health record is a set of data about a person's health status, health care and health care-related services. It shall be kept in written form or in electronic form with an electronic signature. Under the current legislation, a patient is entitled to allow another person to consult his/her medical records only on the basis of an officially certified power of attorney (for a limited period of time or until revocation).
The explanatory memorandum shows that, taking into account the inviolability of privacy, protection against unwarranted interference in private life and protection of personal data, the draft amendment respects the free will of patients with full legal capacity, but that necessary exceptions apply in order to protect the life and health of the population.
Restrictions on disclosure and access to medical records
The amendment to the Act introduces, with effect from 1 August 2021, a new legal institute prohibiting the provision and disclosure of data from the data subject's health records. In particular, the introduction of the institute is intended to prevent the disclosure of personal data to family members of whom the data subject does not wish to be informed. By issuing an officially certified prohibition on the disclosure and access to health records for a specific person, the data subject is protected in the future so that in situations where he or she is not able to take independent decisions about his or her health, 'unwanted' persons are not able to take such decisions.
It should be noted, however, that if the application of this prohibition would endanger the health of the person, the prohibition will not be applied and the data from the medical records may be disclosed, despite the prohibition, even to the person to whom it was prohibited.
Access to medical records
The current legislation allows the right of access to data from medical records to be granted only to the extent necessary, as specified in the power of attorney. In practice, complications arise because the scope of the power of attorney, which can be given to access only specific data from the medical records, is impossible to define in the power of attorney. The attorney is not able to objectively predict the development of his/her health condition and therefore it is not possible to precisely define and determine the scope of the power of attorney for access to data from the medical records. In view of the above, the Bill introduces the possibility to authorise a person to access the health records of the data subject in full.
The written power of attorney with a certified signature and the consent should be used as much as possible as they are based on the free decision of the person. However, the previous legislation did not define the possibility of providing the data subject's personal data to family members in cases where the data subject is not able to provide a power of attorney (for written documentation) or consent (for electronic documentation) to consult his/her medical records due to unexpected circumstances (e.g. coma). The approval of the amendment to the law will allow the immediate family (or other close persons) to inspect the medical records to the extent necessary in extreme cases. In the case of a person in custody and a person serving a custodial sentence, certification of the signature on the written power of attorney shall be carried out by the custodial institution or the custodial institution.
Eligible persons
Information may be provided to a spouse, child, parent or their legal guardian. These persons will be required to have a written certificate from the general practitioner of the person concerned, not older than seven days. The general practitioner must, at the request of the person concerned, issue a written confirmation bearing his or her handwritten signature and stamp. In the written confirmation, the general practitioner shall give details of the applicant to the following extent:
- first and last name,
- address of permanent residence,
- the place and date of issue of the certificate,
- information that the discloser is not prohibited from disclosing data about the data subject.
The approval of the amendment to the Act has increased efforts to improve the quality of health care, in particular by providing the possibility for persons closest to the person concerned to inspect the medical records of the person concerned without prior consent. Family members have the possibility of becoming more familiar with the person's state of health, thus providing them with the opportunity to communicate more effectively with the attending physician about the future course of action in establishing the treatment goals of the person concerned.
Source:
https://www.nrsr.sk/web/Default.aspx?sid=zakony/zakon&MasterID=8135
