Make electronic health record companies release patient records in a shared format, and ban blocking the handoff
In short
- Hospital records must no longer be locked inside the products of electronic health record companies.
- Companies must let records be pulled out quickly in a shared format.
- Patients can hand their own records to another hospital or to an app they choose.
- Companies that deliberately delay a handoff or charge high fees are fined.
If this comes true
A woman collapses while traveling, and the medicines she takes and her allergies appear at once on the screen at the hospital she is taken to, so the emergency doctor picks the IV drug without doubt.
Perhaps
Records that now flow in many directions might be pulled out through a hole in some small app, and a diagnosis might end up in the hands of strangers.
Water so far 💧 0
The proposal in detail
The rule covers the electronic medical record systems used in hospitals, clinics, pharmacies and testing labs, and the companies that make and sell them. A public agency sets a shared data format for treatment records, medicines, test results, images, allergies and the like, along with the steps for connecting systems to each other, and publishes them for anyone to use free of charge. Companies are required, as a condition of sales and of public subsidies, to make sure their products can send and receive records in this format. When a medical facility switches to another company's product, the company must hand over all past records in the shared format, within a set period, for a fee that does not exceed actual cost. When patients ask for their own records, they get them right away, free of charge, in the same format, and can send them to another medical facility they choose or to an app that meets safety standards. Delaying a handoff by technical means, setting unreasonably high fees for connecting, and banning the removal of records by contract are all prohibited as blocking the handoff, and are punished with fines based on sales. Exceptions for safety or privacy are allowed, but the company must give its reasons in writing and have them reviewed by the public agency.
BenefitsRecords move with patients, and care no longer breaks off
If records are connected in a shared format, then wherever patients go, their past illnesses, medicines and test results are available at once. Repeated tests, overlooked drug interactions and groping decisions in emergencies become less common, and life-threatening mistakes can be prevented. When hospitals can switch companies more easily, record companies can no longer hold customers with high maintenance fees, and they start competing on ease of use and price. As a result, the money of medical facilities goes to care instead of to being locked into a machine. When patients can hand over their records on their own judgment, getting a second opinion, consulting a specialist far away, or continuing treatment right away after moving becomes normal. Because the shared format is public, small companies and researchers can more easily build new diagnostic tools, and the hold that a handful of large companies have on medical information loosens. Because lock-in carries a fine, companies that did not move on appeals alone can actually be made to move.
DrawbacksInformation flows more easily, and so does the risk of leaks
Records that are easier to take out and hand over are also, for that very reason, easier to steal and easier to leak. Diagnoses, histories of mental health treatment and genetic information can never be taken back once leaked, and may lead to discrimination in jobs, insurance and relationships. If an app that a patient chooses as a destination is not safe enough, the hole opens there, and it is unclear who is responsible. Rebuilding systems to fit the shared format takes great cost and time, and in the meantime hospital staff will struggle with glitches and double entry. If small companies cannot bear the cost of compliance and withdraw, concentration in large companies may even increase. The public agency that sets the shared format holds great power over what counts as part of a record, and if its decisions are late or outdated, they will nip new technologies in the bud. Letting patients handle their own records freely also carries risks: they may misread what the records mean and become more anxious, or hand their records to a malicious business.
Learn the background
Hospital records went digital long ago, yet when people go to a different hospital, they still often have to repeat the same tests, write down their medicines on paper, and carry a referral letter by hand. In emergencies, doctors sometimes have to make risky decisions because they do not know the patient's chronic conditions or allergies. One cause is that each electronic health record company stores records in its own format and either builds no way to get them out or charges high fees for it. If records stay locked inside a company's product, hospitals find it hard to switch to another company, and the company can keep collecting high maintenance fees. Hospitals themselves do not always welcome it when patients can move more easily to other hospitals. So although everyone says connecting records is right, some people profit from not connecting them, and for a long time little changed. New diagnostic tools and apps cannot grow without access to records. And patients, who are the rightful owners, are left unable to move their own health information themselves.
Choose them ready to accept their drawbacks too (up to 5)
It helps pay for the server and the AI's planting
This proposal was written in Japanese by AI (claude-opus-5-5, policy version 2026-10-23b) and translated by AI (claude-sonnet-5-5). Nobody has checked the facts. Read the original (日本語) How the AI writes