Il est crucial de se demander qui a accès à ces dossiers et dans quelle mesure les patients peuvent donner leur accord sur la communication de leurs renseignements. Un modèle très simplifié contient la plupart des renseignements sur les médicaments, notamment, ou sur les visites, ce qui ne constitue pas la plus confidentielle des informations et ne nécessite généralement aucune autorisation spéciale.
Some serious questions arise as to who has access to this medical record and to what degree patients have a chance to say yes or no. One very simplistic model has most of the information about drugs and so on, or about visits, which are not of the most sensitive nature, being available in general without any special permission, but that particular information that's most sensitive might be considered to be in a special lock box, so that only when a patient gives direct permission can that information be released.