Is it okay for trainees to follow up on patient results after leaving a service?

Question: Residents and students can (and should) be copied on results associated with the orders they enter to the Connect Care clinical information system. Some orders do not get resulted until after the patient has left the hospital or the trainee has left the clinical service. Are we prohibited from accessing health information if not continuing as the patient's treatment physician?

Answer: Trainees may have concerns about a 2016 Alberta administrative law case (with clearer results on appeal); and the more recent Saskatchewan privacy commissioner reaction to ER physician access to charts of emergency patients that they had treated.

Health privacy legislation can differ in detail and interpretation from province to province. Alberta’s understanding of "circle of care" is not narrowly constrained by time or location alone. Need, role, purpose and accountability are important considerations.

For purposes of education (following up on a case), clinical feedback (seeing how one’s clinical decisions affected outcomes), quality control, practice audit and safety reviews, one remains in the circle of care "purpose". It can be important for authorized trainees to access, learn from, and possibly help improve results associated with the interventions they ordered in the care episode they participated in. Indeed, it could be argued that they should be particularly attentive to learning from their actions, as that was a key attribute of their role in the circle of care.

What is not okay is to access the record of a patient one has previously seen for a purpose unrelated to the specific care one participated in. For example, to explore other domains of care or types of information.

The Clinical Information Sharing Approach addresses questions like this.