Mayo Clinic website on Medical Records

Testimony before the National Committee on Vital Health Statistics regarding the Patient Medical ID - July 20, 1998, focused on capability of linking lifelong patient records for research

From The New England Journal of Medicine:

Quoting from "The Threat to Medical-Records Research," a 5-page article written by L. Joseph Melton III, M.D., Department of Health Sciences Research, Mayo Clinic and Mayo Foundation (November 13, 1997). It addresses his concerns over the 1996 Minnesota medical records law which gave patients the right to give or refuse access to medical records by researchers:

"The availability of these records ['5.1 million patients treated since 1907'] also allowed the development 30 years ago of the Rochester Epidemiology Project, one of the few sources of data on the incidence and outcome of disease for a defined geographic population. The Rochester Project links Mayo Clinic medical records for the residents of Rochester and of Olmsted County, Minnesota, with those of the other major providers of health care to community residents, thus ensuring nearly complete coverage of the local population. This was possible because the law in Minnesota, as in 22 other states, provided for 'the release of health records to qualified personnel solely for the purposes of medical or scientific research, if the patient has not objected to a release for research purposes'...This unique data resource is now threatened by growing concern about the privacy of medical data and about control over such personal information, fears that are heightened in an electronic environment...Since the vast majority of patients agree to the broad use of their medical-records data for research, one has to question this expenditure of scarce health care resources [to obtain written consent before access]. Indeed, the overwhelming preponderance of agreement is consistant with the notion of "constructed consent" from the whole patient population...Since we are all patients ourselves, it is easy to understand the desire for privacy. It is also generally understood that there can be a conflict between the personal interests of an individual patient and the public health interests of society at large."

Portion of letter responding to Dr. Melton from Twila Brase, R.N., President, Citizens for Choice in Health Care (published in NEJM on 4/9/98):

Melton states that the Rochester Epidemiology Project, begun 30 years ago, was possible because state law allowed researcher access to medical records. Not so. Melton's quotation of the law supporting his assertion actually comes from a 1992 statute...Melton's article fails to clarify under what statutory authority this sharing of identified patient records in the Rochester Project occurred...[Also] it is not comforting to patients that a physician would advocate...'constructed consent' (majority-conferred obligation)...

1997 law which favored Mayo Clinic's access to medical records without patient consent:

In 1997, a Mayo Clinic lobbyist publicly testified for an alteration to the 1996 law, which had stated that all researchers must obtain consent before accessing medical records generated after January 1, 1997. As a result of the 1997 session amendment, patient consent requirements were limited to external researchers only, not internal researchers, and even that was weakened.