Health Information Management:
Health Records, Coding & Central Registration
Health Information Management
Health Information Management which includes Health Records, Patient Registration, and Coding and Abstracting, provides superior customer service to both internal and external stakeholders and ensures accuracy and quality whilst safeguarding the integrity of the Health Record.
Health Records oversees the collection, processing, storage, and retention of patients' health records after a visit to RVH. We respect and maintain the confidentiality of every patient's personal health information and its custody according to government legislation and health centre policies.
RVH may only maintain some of your records. Please be sure to bring your Health Card and/or valid personal identification and debit/credit card for applicable payments
Accessing a Health Record
Collection, use, access and/or disclosure of personal health information is governed by Ontario law (Personal Health Information Protection Act 2004). You have a right, by law, to access your own hospital health record either by viewing or requesting a copy. There is no charge to send copies of a health record to another physician or health care provider under the circle of care.
Obtaining a Copy of your Health Record or the Health Record of Another Individual
Consent for the collection, use and/or disclosure of personal health information is obtained from the patient, regardless of age, if the patient is capable of understanding the information presented to them and the impact of consenting or declining. If the patient is not capable, consent is obtained from the Substitute Decision Maker who may be:
• The individual's (patient's) guardian of the person or guardian of property
• The individual's attorney for personal care or attorney for property
• The individual's representative appointed by the Consent and Capacity Board
• The individual's spouse or partner
• A child or parent of the individual
• A parent of the individual with only a right of access
• A brother or sister; or
• Any other relative.
In the case of a conflict, the capable patient's decision prevails with respect to consent for the collection, use and/or disclosure of their personal health information.
You can obtain a copy of your own hospital health record by submitting an authorization form to the Health Records department (see downloads above).
Obtaining a Copy of the Health Record of a Deceased Individual
If you are requesting a copy of the hospital record of a patient that is deceased, you must submit proof of your legal signing authority as well as an authorization form to the Health Records department.
You must provide either:
• A copy of the deceased person's Will naming you as the Executor or,
• In the absence of a Will, a letter notarized by a lawyer to confirm your legal signing authority
Obtaining a Copy of your Health Record for a Third Party
For your protection, a copy of a health record will not be released to third parties without your written authorization.
You can request that a copy of your hospital health record be released to a lawyer, insurance company, or any other third party specified by you, by having the third party submit a written request with your authorization to the Health Records department.
Obtaining a Copy of the Health Record for other Health Care Providers
When requested, copies of your health record may be released to health care providers outside the hospital to ensure the best continuing care for you. Your attending physician at the hospital may also share reports or summaries of your treatment at the hospital with other physicians and health care providers involved in your care to ensure they are aware of treatments or medications that may affect your ongoing care.
Viewing your Health Record
A person can review their own health record at RVH by submitting an authorization form to the Health Records department.
To avoid delay, please make sure that all information is completed on the authorization form, ensuring that it is dated and signed by you.
This authorization is valid for 90 days and pertains to the release of information that is specific to treatment received on or before the date signed.
There is an administrative fee associated with a request to view and/or obtain a photocopy of your health record. The fee for copying varies with the size of the record. Pre-payment of this fee is required prior to accessing your health record (see above for the Service Fees download).
Request Turnaround Times
• All third party requests are completed within 30 days
• Requests from physicians are completed within 48hrs
• Requests from other hospitals are completed within 24hrs
• Urgent Requests within the Circle of Care are completed when received