Intended for healthcare professionals


US policy requires immediate release of records to patients

BMJ 2021; 372 doi: (Published 18 February 2021) Cite this as: BMJ 2021;372:n426

Linked Opinion

New German digital project paves the way for online access to personal electronic health records

  1. Liz Salmi, senior strategist of research dissemination for OpenNotes1,
  2. Charlotte Blease, Keane OpenNotes scholar12,
  3. Maria Hägglund, associate professor in health informatics3,
  4. Jan Walker, co-founder of OpenNotes12,
  5. Catherine M DesRoches, executive director of OpenNotes12
  1. 1Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
  2. 2Harvard Medical School, Boston, MA, USA
  3. 3Department of Women’s and Children's Health, Uppsala University, Uppsala, Sweden
  1. Correspondence to: L Salmi lsalmi{at}

Patients and clinicians should embrace the opportunities

On 5 April a new federal rule will require US healthcare providers to give patients access to all the health information in their electronic medical records without charge.1 This new information sharing rule from the 21st Century Cures Act of 20162 mandates rapid, full access to test results, medication lists, referral information, and clinical notes in electronic formats, on request.

The US is not alone in providing patients with full online access to their electronic health records. In Sweden, patients gained access to their records between 2012 and 2018.3 Estonian citizens have had full access since 2005.4 The sharing of personal health information isn’t without precedent in the US: around 55 million people already have access to their online clinical notes,5 and many more have access to laboratory results and other parts of their records. But for some US clinicians, the new rule may feel like a shock.6

To patient groups, however, it is the culmination of 25 years of advocacy and relationship building with clinicians, researchers, and policy …

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