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Management

Client records – access and ownership

02/07/2018
By Karen Crouch
The importance of sound administration policies related to the safe storage and access of client records cannot be overstated. KAREN CROUCH examines best practice for both management and employees.

Client and general administration records are the lifeblood of a practice, without even mentioning legal requirements or criticality of ready access. Consequently, they are vital to ensure efficient client and practice management. While administration records are undisputed assets of the practice, access to and ownership of these private records in particular, may differ.

The introduction of e-health records has increased accessibility to client information as it is now under the personal control of each client. This source of valuable information is also hyperlinked to various other websites and computer applications.

Of course, before developing a library of client records as part of a new practice start up, owners must carefully consider the technological aspects of record retention, assured availability and secure storage. An experienced IT provider will be able to provide all relevant advice and materials on information management options (e.g. cloud, hosted or native applications) to select from.


"The primary benefit of client records, apart from ensuring accurate historical and healthcare information, is to develop and grow business"
Karen Crouch

Back up of records is naturally a critical factor in such considerations as ready access to patient information, recent and/ or historical, is an essential element of quality healthcare.

Additionally, apart from ready, reliable access to records, the security of computer applications – whether remotely located or housed in-practice – is a vital requirement, particularly in light of the frequent incidence of ‘hacking’.

Having ensured safe storage, accessibility and back up, owners need to heed legal requirements. In determining the reasonable and legally defensible entitlements of owners and clinicians, various ‘engagement’ scenarios are worthy of deeper consideration:

  • Employee: a clinician engaged under typical employer-employee conditions, which will, for instance, include payment of superannuation by the practice owner. These staff members do not have any rights to remove or copy records (or even view out of curiosity or other reasons) for any purpose other than the normal course of performing their daily duties.

  • Contractor: a clinician engaged as an individual or through his/her personal entity to provide healthcare services to all clients of the practice, utilising all business facilities and resources, regardless of whether clients were introduced by the owner or contractor. It is worth noting that, in the optometry industry, verbal agreements with ‘contractor clinicians’ are not uncommon. Contractors may have an entitlement to remove or copy client records during or after their employment.

  • Licensee: a clinician engaged to provide services to his/her own clients (introduced by the licensee, not the practice), utilising practice facilities and resources. This category is invariably covered by a formal Facilities Agreement or similar contract as terms and conditions differ markedly from those of contractors or employees – in this circumstance, all client records remain the property of the licensee and may be removed if the licensed clinician leaves the practice.

The primary benefit of client records, apart from ensuring accurate historical and healthcare information, is to develop and grow business, whether for practices or for individual clinicians who may operate on a part time basis at more than one practice.


So, naturally, when a clinician ceases work in a particular practice, they may seek to take copies of certain client records in the hope of enticing those persons to their new place of employment. In instances where high quality service has been consistently provided to the client, the clinician will invariably seek to build on that goodwill and retain their regular clients who may prefer to be serviced by a proven supplier.

Conversely, the owner may wish to retain such records to secure the ongoing custom of those clients who promote success of the business. When a written contract has not clearly defined rights/responsibilities, these conflicting interests may result in a dispute, particularly between owners and contractors.

A few other facts are worthy of note:

  • Practices must facilitate access to client records in its possession to allow clinicians to provide reliable, fully informed healthcare services;

  • Without inferring any wrongdoing, if a [departing] clinician decides to extract copies of selected or several client records for their personal future benefit, it would be relatively easy to do so without raising suspicion; and

  • There is no specific, optometry industry related legislation dealing with these matters, particularly in the absence of formal contract documentation.

So, what is the best approach to avoiding possible disputes?

The most practical and prudent solution is to execute written contracts that clearly and unambiguously define both parties’ rights upfront. Such contracts usually contain certain restrictive covenants to protect practice owners’ businesses, e.g. the employee/contractor clinician agrees not to be involved, directly or indirectly, in another practice that competes with the owner’s business and is within a reasonable time/radius.

Image courtesy: Pixabay | Myrfa



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