PHIPA DECISION 268

Complaint HA23-00049

Trillium Health Partners

November 28, 2024

Summary: An individual asked for a copy of her medical records from a hospital. She specified that she wanted these records provided to her in electronic form “where available”. The hospital invoiced the individual for a paper copy of her records, at a fee of $1,352.00.

In this decision, the adjudicator finds that the hospital is obliged to provide the complainant with an electronic copy of her records. The adjudicator does not uphold the hospital’s fee estimate and instead finds that the hospital is permitted to charge $1,194.00.

Statutes Considered: Personal Health Information Protection Act, 2004,  S.O. 2004, c.3, Sched. A, sections 52 (1.1) , 54(10) , and 54(11) .

Decisions Considered: PHIPA Decisions 111, 185, and 259.

BACKGROUND:

[1] The complainant made a request under the Personal Health Information Protection Act (the Act) to Trillium Health Partners (the hospital), asking for a copy of her medical records. The request stated that the complainant was asking for all test results, handwritten office notes, and consultations and specified that the hospital provide these records electronically “where available.” The complainant included a $30.00 payment with her request.

[2] The hospital located 5,248 pages of records and invoiced the complainant a total fee of $1,352.00 for a paper copy of her records. The breakdown of this fee was: $30.00 for the standard fee; $1,307.00 for photocopying pages 21 through 5248 (at a rate of $0.25 per page); and $15.00 for priority shipping. The invoice acknowledged the $30.00 that the complainant had already paid and requested the balance of $1,322.00. The complainant subsequently paid this amount to the hospital. The hospital provided her with a copy of her records in hard copy form.

[3] Following this, the complainant made a complaint to the Information and Privacy Commissioner of Ontario (the IPC) regarding the invoiced fee and the records being provided in hard copy form.

[4] During mediation of the complaint, the complainant advised the mediator that she had requested an electronic copy of the records, both in the request and in later communication with the hospital. She stated that when she received the invoice that included the photocopying charges, she followed up with the hospital to ask that the records be provided electronically. The complainant stated that at that time, the hospital informed her that the records were “too large” to put in electronic form. The complainant stated that she made the payment for the paper records to avoid delay, but communicated to the hospital that she maintained that she should have been provided with the records in electronic form.

[5] During mediation, the hospital stated that it provided a hard copy of the records because they were largely contained within a legacy system. This legacy system could not produce electronic copies, so the records would have to be printed and then manually scanned in order to be provided electronically. Due to this, the hospital had told the complainant that the cost to receive the records electronically or via paper copy would be the same and that it generally does not send records electronically above a 25- megabyte limit. The hospital also indicated that some records could not be put into a digital format without unreasonable manual effort.

[6] As mediation did not resolve the complaint, it was moved to the adjudication stage, where an adjudicator may conduct a review under the Act. The adjudicator assigned to this complaint decided to conduct a review and sought and received representations from both parties.

[7] The complaint was then transferred to me to complete the review and issue a decision. I reviewed the parties’ representations and determined I did not need to hear from them further before making my decision.

[8] In the discussion that follows, I find that the complainant has a right under section 52(1.1) to access her records in electronic form. As it is not clear whether the complainant continues to seek the records in electronic form, I ask that if the complainant does still seek access to these records in electronic form, she contact the hospital within 30 days to confirm her request. If she does so, I order the hospital to provide the complainant with an electronic copy of the Meditech records within 30 days of receiving the complainant’s confirmation of her access request. I find that the hospital’s fee estimate for providing the complainant with access to the records of her personal health information exceeds the amount of “reasonable cost recovery” under the Act and accordingly, I reduce the fee by $158. I find that, in the event that the complainant confirms her request for electronic versions of her records, the fee for providing those records in electronic format is instead of and not in addition to the fee for paper copies that the complainant has already paid.

PRELIMINARY ISSUES:

[9] There is no dispute between the parties that the hospital is a “health information custodian” as defined in section 3(1) of the Act, or that the records at issue are records of “personal health information” as defined in section 4(1) of the Act.

ISSUES:

1. Is the hospital required to provide the complainant with the records in electronic format?
2. What is the amount of reasonable cost recovery allowable under section 54(11) of the Act, for the custodian to provide the records in electronic format?

DISCUSSION:

Issue A: Is the hospital required to provide the complainant with the records in electronic format?

[10] Section 52(1.1) stipulates that an individual’s right of access to a record of personal health information includes the right of access to the record in an electronic format. It reads:

The right to access a record of personal health information includes the right to access the record in an electronic format that meets that prescribed requirements, subject to any restrictions, additional requirements or exceptions that may be prescribed.

[11] At the time the request was made, Ontario Regulation 329/04 made under the Act contained the restrictions, additional requirements or exceptions relevant to section 52(1.1).[1] Section 18.0.1(1) of Regulation 329/04 specified that the section 52(1.1) right of access included the right to have the health information custodian provide the record in a PDF file or any other electronic format agreed to by the health information custodian and the individual.

Representations of the Parties

[12] The hospital states that it located 5,248 pages of responsive records. Of those, 4,676 pages – approximately 89% - were found in its legacy Meditech system and its complementary document management system, Chartmaxx. For ease of reference, when I use the term “Meditech,” I refer to the records stored in both of these systems.

[13] Meditech was retired from active use in 2020. The hospital states that the only way to provide the records from this legacy system is by first printing them and then scanning the printed pages into PDF format. The hospital states that it cannot provide electronic versions of those records directly from the Meditech system without going through the printing and scanning process.

[14] The hospital states that it did not initially understand that the request was for all records to be provided in electronic format. The hospital acknowledges that the complainant asked for records to be provided electronically “where available” but notes that the complainant also gave instructions on how to provide paper copies. The hospital states that after it issued the fee estimate invoice, it informed the complainant that the records would have to be photocopied regardless of the format they were ultimately provided in, so that the fee would be the same regardless of whether the records were provided electronically or in hard copy format.

[15] The hospital confirms that it provided all of the records to the complainant in paper format after it received payment of its invoice. In addition to that copy, the hospital states that it later provided the 572 pages of records from non-legacy systems to the complainant in electronic format. However, to now provide the 4,676 pages from the legacy system in electronic format, the hospital states that it would be required to reprint these pages, scan them into a PDF format, and save these scans to an encrypted CD. It appears from this that when the hospital provided the paper records to the complainant, it did not make or keep an electronic copy of them.

[16] The complainant’s position is that her request explicitly stated that she wanted electronic records “where available”. The complainant noted that “[the] request was not to print out the electronic records, create paper records, and then scan the paper records returning them to electronic form.” The complainant states that the hospital has not explained why it could not provide the available electronic information, whether in its native form or another electronic format, given that the hospital has confirmed that the records exist in electronic form.

[17] The complainant asserts that the Meditech system is built on a document imaging foundation, which creates images of documents by scanning them, and then stores these images electronically. The complainant questions why the hospital could not have provided the underlying scanned images, or the raw Meditech data. Finally, the complainant states that if the record could be printed to a printer, it could likewise have printed to a PDF, using Adobe Acrobat or similar software, which would not have incurred the costs of printing.

[18] In its reply representations, the hospital states that at the time that its Meditech system was moved to legacy status in 2020, it did not have the ability to create electronic copies of records or print these records to PDF. The hospital states that though the system holds the records in an electronic form, it cannot export these in electronic form. The hospital reiterates that the only way it can provide records from these systems is by printing out physical copies and then scanning these to PDF.

[19] The hospital states that it approached its vendors to see if it would be possible to obtain electronic records directly from these systems but was informed that these systems lacked that functionality. The hospital states that it is exploring implementing add-ons that may allow for PDFs to be created directly from the legacy systems but that capability is not currently available.

Analysis

[20] Section 52(1.1) is clear that the right to access one’s personal health information includes the right to access this information in an electronic format.

[21] Previous decisions of this office have found that the section 52(1.1) right to access one’s personal health information exists independent of whether the records themselves are held electronically. In PHIPA Decision 185, the records requested were held by a clinic in hard copy format in long-term storage. The requester was provided with paper copies and paid the invoiced fee to do so. He then made a fee complaint to the IPC, stating that he should not be charged photocopying fees for records that he requested in electronic format. The adjudicator in that decision found that the custodian was obliged to provide the requester with the records in electronic format.

[22] In the present case, the complainant’s request expressed a preference to receive records electronically. The hospital held those same records in electronic form. The complainant’s position is therefore that the hospital should be able to provide these to her in some electronic form, whether that is in their native format or as PDFs.

[23] While I understand the complainant’s reasoning, the hospital has been clear in stating that it is not capable of providing electronic records directly from its Meditech system. The hospital has stated that the Meditech system cannot export its electronic records or print these to PDF format. It has approached vendors to confirm that this is the case. I accept the hospital’s statement that it can only provide electronic records from Meditech by printing these out and then scanning the printed versions into a digital format.

[24] The fact that the hospital must take extra steps to provide records in electronic form does not alleviate its section 52(1.1) obligation to do so. The hospital may encounter additional costs to provide the records in this way, but that consideration relates to the question of the fees that may be charged as reasonable cost recovery. It is not relevant to the question of whether it has an obligation to provide those records in the form requested.

[25] The hospital states that it did not understand that the complainant’s request was for all records in electronic format, because it asked for electronic records “where available” and provided instructions on how to provide paper records if need be. The hospital therefore provided all records via hard copy, even those that it could have (and later, did) provided electronically without recourse to printing and scanning.

[26] I do not view this as a reasonable interpretation of the complainant’s request. The complainant’s preference for electronic records should not be negated because she anticipated that some records may not be available electronically and included instructions on how to deal with those records. In my view, the wording of the request does not indicate that the appellant was seeking the entirety of her records in paper form.

[27] Apart from the request itself, the hospital also states that, in a conversation after it sent out the invoice, it informed the complainant that the fee would be the same regardless of the format of the records. Following this, the complainant paid the fee, and the hospital provided the records in paper form.

[28] From the information before me, it is not clear that the complainant understood that she had the option of receiving an electronic version of the records, albeit at the same cost. The letter accompanying the complainant’s payment refers to the hospital’s “refusal to provide the records electronically” and states that the reason provided was that the records were too large. The letter also notes that the complainant is not clear as to why the hospital could not provide the electronic records via CDs, and states that she is making the payment to avoid delay in receiving the records. There is no communication after the fact that indicates that the complainant preferred to receive paper copies of the records.

[29] Even if the fee would be the same, an individual may have reasons other than cost savings for preferring an electronic copy of their records. Other considerations may include available space (the correspondence accompanying the paper records stated that the hospital used two boxes and one envelope to deliver the records) or the ability to more easily search an electronic record.

[30] Finally, the fact that the requester has received a paper copy of her records does not answer the question of whether she is entitled to an electronic copy. This office has previously found, in PHIPA Decision 185, that the fact that a requester received a paper copy of records does not limit that requester’s right to an electronic copy of the records, if they have requested this. I adopt that reasoning and apply it here. I find that the complainant has a right to access her personal health information in electronic format under section 52(1.1) of the Act.

[31] Having made that finding, I note that it is not clear from the complainant’s representations whether she is still seeking an electronic version of the records of personal health information from the Meditech systems (as noted above, the hospital has provided the complainant with electronic versions of the other responsive records). Given this uncertainty, I will not order the hospital to provide her with an electronic version of the Meditech records at this time. Instead, if the complainant still seeks an electronic version of her personal health information records held by the hospital, she should contact the hospital within thirty days of the date of this order to confirm this request. If she does so, I order the hospital to provide the complainant with an electronic copy of the Meditech records within 30 days of receiving the complainant’s confirmation of her access request.

Issue B: What is the amount of reasonable cost recovery allowable under section 54(11) of the Act, for the custodian to provide the records in electronic format?

[32] Having found that the hospital is obliged to provide the records in electronic form, the next question is what fee the hospital is permitted to charge as the amount of reasonable cost recovery for providing access to those records.

[33] Sections 54(10) and (11) of the Act provide custodians with the discretion to charge a fee for providing an individual with access to their own personal health information. These sections state:

54 (10) A health information custodian that makes a record of personal health information or a part of it available to an individual under this Part or provides a copy of it to an individual under clause (1) (a) may charge the individual a fee for that purpose if the custodian first gives the individual an estimate of the fee.

(11) The amount of the fee shall not exceed the prescribed amount or the amount of reasonable cost recovery, if no amount is prescribed.

[34] Section 54(11) of the Act prohibits a health information custodian from charging a fee that exceeds “the prescribed amount” or the “amount of reasonable cost recovery.” As of the date of this decision, there is no regulation that prescribes fees for access under the Act. The IPC has the authority, pursuant to Part VI of the Act, to conduct a review to determine whether the fee charged exceeds “the amount of reasonable cost recovery” within the meaning of the Act.

[35] The expression “amount of reasonable cost recovery” is not defined in the Act. However, the IPC has previously considered the meaning of this phrase for the purposes of the fee provisions in the Act.[2] Applying the purposive approach to statutory interpretation, the IPC has concluded that the phrase “reasonable cost recovery” in the Act does not mean “actual cost recovery,” or full recovery of all the costs borne by a health information custodian in fulfilling a request for access to an individual’s own personal health information. The IPC has also concluded that the use of the word “reasonably,” to describe cost recovery, suggest that costs should not be excessive, and that as a whole, section 54(11) must be interpreted in a manner that avoids creating a financial barrier to the important purpose of the Act to grant a right of access to one’s own personal health information.[3]

[36] These past orders concluded that a fee scheme set out in a proposed regulation to PHIPA, published by the Minister of Health and Long-Term Care in 2006 (the “2006 framework”), though never adopted, provides the best framework for determining the amount of “reasonable cost recovery” under the Act. I agree with this reasoning and will apply the 2006 framework in this decision.

[37] The 2006 framework reads, in part, as follows:

Fees for access to records

25.1(1) For the purposes of subsection 54(11) of [PHIPA], the amount of the fee that may be charged to an individual shall not exceed $30 for any or all of the following:

1. Receipt and clarification, if necessary, of a request for a record.

2. Providing an estimate of the fee that will be payable under subsection 54(1) of [PHIPA] in connection with the request.

3. Locating and retrieving the record.

4. Review of the contents of the record for not more than 15 minutes by the health information custodian or an agent of the custodian to determine if the record contains personal health information to which access may be refused.

5. Preparation of a response letter to the individual.

6. Preparation of the record for photocopying, printing or electronic transfer.

7. Photocopying the record to a maximum of the first 20 pages or printing the record, if it is stored in electronic form, to a maximum of the first 20 pages, excluding the printing of photographs from photographs stored in electronic form.

8. Packaging of the photocopied or printed copy of the record for shipping or faxing.

9. If the record is stored in electronic form, electronically transmitting a copy of the electronic record instead of printing a copy of the record and shipping of faxing the printed copy.

10. The cost of faxing a copy of the record to a fax number in Ontario or mailing a copy of the record by ordinary mail to an address in Canada.

11. Supervising the individual’s examination of the original record for not more than 15 minutes.

(2) In addition to the fee charged under subsection (1), fees for the services set out in Column 1 of Table 1 shall not, for the purposes of subsection 54(11) of [PHIPA], exceed the amounts set out opposite the service in Column 2 of the Table.

[38] Section 25.1(2) of the 2006 framework allows for fees above the $30 to be charged for services specified in an attached table[4]. This table sets out fees that may be charged for specified tasks that may be required to prepare or view records. Of relevance to this complaint are Items 1, 3, and 12 of that table. Item 1 states that the fee “[for] making and providing photocopies or computer printouts of a record” is 25 cents for each page after the first 20 pages. Item 3 permits a fee of $10 for “making and providing … a compact disk containing a copy of a record stored in electronic form.” Lastly, Item 12 allows a fee of $45 for every 15 minutes after the first 15 minutes “[for] the review by a health information custodian or an agent of the custodian of the contents of a record to determine if the record contains personal health information to which access or disclosure may or shall be refused.”

Representations

[39] The complainant states that Order HO-009 provides a purposeful approach to the interpretation of “reasonable cost recovery.” The complainant relies on this order for the principle that any interpretation of “reasonable cost recovery” that imposes a financial barrier or deters an individual from exercising their right of access to their records of personal health information must be avoided.

[40] The complainant states that the fee charged in this instance is not reasonable, as the hospital “copied records which were already in electronic form and provided both a paper copy and then later an electronic copy.” The complainant states that she is prepared to pay the reasonable cost of recovery, which she states is $40.00 based on the reasoning and fee schedule set out in HO-009.

[41] The hospital states that the complainant’s calculation of the fee does not take into account the fees for services permitted under the 2006 framework as “reasonable cost recovery.” The hospital takes the position that the fee of $1,352.00 is permitted if one follows that framework. The hospital states that it charged the standard $30 fee specified within the 2006 framework, $15 in shipping costs, and $1,307 for photocopying of pages 21 to 5248, at the rate of $0.25 per page. This is the per-page rate set out in the 2006 framework for photocopying or computer printouts.

[42] The hospital states that in IPC Decisions 111 and 185, custodians were permitted to charge a fee for scanning records to provide these on CD if the records are not already available in electronic form and do not require severing. The hospital relies on those decisions as authority for its per-page charges. The hospital’s rationale is that it is necessary for it to print and then scan the complainant’s records in order to make those records available to the complainant on a CD.

[43] The hospital acknowledges that it could have provided electronic versions of the 572 pages from non-Meditech sources without first scanning them. The hospital charged a fee for those records at $0.25 per page when it provided the paper copies to the complainant, representing $143 of the total fee charged. However, the hospital opposes lowering the overall fee charged by that amount.

[44] The hospital states that the IPC should uphold the full fee amount, because the hospital could have charged for review time of the records as a whole but chose not to do so. The hospital states that in this case the records required a straightforward review, and that based on the rate of five seconds per page for straightforward review set out in PHIPA Decision 111, it could have charged an additional $1,260 for this review,[5] a much greater amount that the $143 it charged for the records that were already available in electronic form. The hospital takes the position that based on reasonable cost recovery, the fee should not be reduced by the $143, given the additional review time that it did not charge to the complainant.

Analysis and Decision

[45] The 2006 framework does not specifically address the scenario of whether a health information custodian may charge a fee to scan records in order to provide these in electronic form. However, the hospital cites PHIPA Decisions 111 and 185 as authority for its ability to charge a fee for this that is equivalent to the fee for photocopying records.

[46] In PHIPA Decision 111, the health information custodian held records in hard copy format. They stated that in order to sever these and provide them on a CD, the records would first need to be scanned. The custodian charged for scanning of these records at the same rate as photocopying. The adjudicator considered the reasoning of similar situations under the Freedom of Information and Protection of Privacy Act and the Municipal Freedom of Information and Protection of Privacy Act, and ultimately determined that it was in keeping with that reasoning to charge fees for scanning hard copy records in order to put them onto a CD. She found that “it is reasonable for a custodian to charge fees in this way, where records exist in hard copy and need to be scanned in order for them to be put onto CD.”

[47] Similarly, in PHIPA Decision 185, there was a request for records in electronic form and a custodian who kept only paper copies of the relevant records. In that case, the adjudicator adopted the reasoning in PHIPA Decision 111, addressing the situation as follows:

While scanning paper records to make them available to a requester in electronic format and photocopying paper records are different activities, neither the Act nor the 2006 framework list fees for activities that could be considered to be analogous to scanning or present another logical means of calculating fees for scanning records. No regulations setting legislated amounts that health information custodians can charge under the Act have been enacted. There being no persuasive evidence to support an alternative method of calculating fees for the scanning of paper records to make them available to the complainant in electronic format, I agree with the reasoning applied in PHIPA Decision 111 and find that a charge of $0.25 per page for scanning after the first 20 pages is in keeping with the principle of reasonable cost recovery at section 54(11) of the Act.

[48] I note in that in the present case the hospital holds electronic versions of the records at issue, not hard copies as in PHIPA Decisions 111 and 185. Normally, electronic records would be expected to be provided without recourse to printing and scanning. Indeed, a recent decision of this office, PHIPA Decision 259, directly addresses that scenario. In that case, a hospital provided printed records and charged the associated printing fee, though its record holdings were electronic. The hospital stated that it could produce the records at issue electronically, by saving them to PDF, but stated that the per-page fee should be permitted due to the work required to prepare the records in this way. The adjudicator found no evidence before her that the hospital needed to print out the records in order to save them on a digital storage device and disallowed the photocopying fee.

[49] However, in the case at hand, there is evidence that printing the records was a necessary step to providing them electronically. I have already found that I am satisfied that the hospital is not capable of providing the records at issue to the complainant electronically, without recourse to first printing and then scanning.

[50] I understand the complainant’s frustration at being charged the equivalent of a photocopying fee when she is requesting records in an electronic format that are already held electronically. However, custodians are permitted to charge fees that are consistent with reasonable cost recovery. This office has found that in cases where hard copy records must be scanned in order to provide electronic versions, the cost of scanning equivalent to the cost of photocopying is consistent with the principle of reasonable cost recovery. I adopt and apply that reasoning to the case at hand. Given the hospital’s inability to export electronic records from its Meditech records holdings, it is permitted to charge fees that represent its reasonable cost recovery of printing and scanning those records. I find that the hospital is permitted to charge $0.25 per page for printing pages to be scanned after the first 20 pages up to page 4,676.

[51] The reasoning above does not apply to the 572 pages of records which the hospital was capable of providing electronically without first printing and for which it charged $143. The hospital acknowledges that it charged for scanning of these pages but was later able to provide these in electronic form, without the need for scanning. However, its position is that it could have charged for review time of the records, and that even for a straightforward review of the records, this would have cost far more than the scanning costs associated with these records. The hospital states that based on this, its overall fee was in line with the principle of reasonable cost recovery and should not be reduced.

[52] The hospital is correct that previous decisions of this office have allowed fees to be charged for review of records, and that for straightforward reviews, the review time allotted per page has been 5 seconds.[6] However, the hospital made the decision not to charge for that review time when determining its fee estimate. The hospital only raised review time during the IPC complaint, in the context of reasons why the fee allotted on a per-page basis should not be reduced to reflect the hospital’s overcharge for the 572 pages of records it could have provided electronically without recourse to printing. I am not persuaded that the hospital may now charge an amount of review time to directly offset the amount that it overcharged for scanning of records. I find that the hospital’s claim of fees for review time at this point in the process does not align with the principle of reasonable cost recovery.

[53] Finally, the fee charged by the hospital included $15 for shipping the paper records. However, section 25.1(1)9 of the 2006 framework states that the $30 standard fee includes “electronically transmitting a copy of the electronic record instead of printing a copy of the record and shipping of faxing the printed copy” if the record is stored in electronic form. As the complainant had a right to an electronic copy of the records, the $15 shipping fee is not permitted under reasonable cost recovery, and I disallow this fee.

[54] I note that Item 3 of the Table permits a fee of $10 to be charged “[for] making and providing a floppy disk or a compact disk containing a copy of a record stored in electronic form.” This office has found that this same charge can apply to a similar device used to store electronic records, such as a USB.[7]

[55] I have already determined that in order for the complainant to obtain an electronic copy of the Meditech records, she must confirm this request to the hospital. When she does so, the appellant should also indicate if she would like these records provided on a storage device or if she would like these transmitted electronically, as these methods have different costs associated with them. The complainant is entitled to choose if she would like the records provided via electronic transmission or digital storage device.

[56] I have considered the fee that the custodian may charge for providing the records in electronic format in light of the 2006 framework and the principle of reasonable cost recovery in section 54(11) of the Act. I find that if the custodian provides the records in electronic format on a storage device such as a CD or USB, a total fee of $1204.00 is in accordance with the principle of reasonable cost recovery. However, if the custodian transmits the records in electronic format to the complainant electronically (for example, by secure email or as a password protected PDF via regular email), the custodian is not permitted to charge $10 for a storage device as contemplated in Item 3 of Table 1. Where records in electronic format are transmitted electronically, I find that the amount of reasonable cost recovery and the amount that the custodian is permitted to charge, is $1194.00.

[57] For clarity, the breakdown of each of these fees are as follows:

	Fee if electronic records are provided on a storage device	Fees if electronic records are transmitted electronically
Flat rate fee for the tasks set out in section 25.1(1) of the 2006 framework including:	$30.00	$30.00
15 minutes of review Photocopying (or scanning the first 20 pages) packing and mailing the records postage administrative tasks
Fee for scanning the remaining pages of paper records to make them available in electronic format ($0.25 per page for 4656 pages of records).	$1164.00	$1164.00
Fee for making and providing the records in electronic format available on CD or USB (only to be charged it the records are to be provided in one of these manners)	$10.00	N/A
Total Cost	= $1204.00	= $1194.00

[58] The total costs listed above represent overpayments by the complainant of either $148 or $158, dependant on whether the complainant requests an electronic version of the Meditech records, and if she does so, whether she asks for those records to be provided via electronic transfer or via electronic storage device. In either case, the fees for providing the records in electronic format are instead of and not in addition to the fee already paid for paper copies of the records.

[59] In the result, I do not uphold the fee charged by the hospital.

ORDER:

1. I order the hospital to provide the complainant with a refund of in the amount of:
1. $148 if the complainant contacts the hospital within 30 days of the date of this order to request her Meditech records be provided to her via an electronic storage device; or
2. $158 if the complainant either does not contact the hospital within 30 days of the date of this order to request an electronic copy of her Meditech records or contacts the hospital within 30 days of the date of this order to request her Meditech records be provided to her via electronic transmission.

Original Signed by:		November 28, 2024
Jennifer Olijnyk
Adjudicator

 

APPENDIX TABLE 1

ITEM	COLUMN 1	COLUMN 2
1.	For making and providing photocopies or computer printouts of a record	25 cents for each page after the first 20 pages
2.	For making and providing a paper copy of a record from microfilm or microfiche	50 cents per page
3.	For making and providing a floppy disk or a compact disk containing a copy of a record stored in electronic form	$10
4.	For making and providing a microfiche copy of a record stored on microfiche	50 cents per sheet
5.	For making an providing a copy of a microfilm of a record stored on microfilm that is,
	i. 16mm	$25 per reel
	ii. 35mm	$32 per reel
6.	For printing a photograph from a negative or from a photograph stored in electronic form, per print,
	i. measuring 4” ´ 5”	$10
	ii. measuring 5” ´ 7”	$13
	iii. measuring 8” ´ 10”	$19
	iv. measuring 11” ´ 20”	$26
7.	For making and providing a copy of a 35mm slide	$2
8.	For making and providing a copy of an audio cassette	$5
9.	For making ad providing a copy of a ¼”, ½”, or 8mm video cassette,
	i. that is one hour or less in length	$20
	ii. that is more than one hour but not more than two hours in length	$25
10.	For making and providing a copy of a ¾” video cassette,
	i. that is not more than 30 minutes in length	$18
	ii. that is more than 30 minutes in length	$23
11.	For producing a record stored on medical film, including x-ray, CT and MRI films	$5 per film
12.	For the review by a health information custodian or an agent of the custodian of the contents of a record to determine if the record contains personal health information to which access or disclosure may or shall be refused	$45 for every 15 minutes after the first 15 minutes
13.	For supervising examination of original records	$6.75 for every 15 minutes