Dr. Laura Durcan:

I worked in the US in two different large healthcare systems. There was an integrated healthcare system and we could access somebody's records from the different institutions where they had sought care in the state of Washington. The psychiatry records were generally closed so I could not access those. Similarly, there were different levels of access. For example, a healthcare assistant would get to vital signs or medication, which would not be considered sensitive. There was a different level according to the person's log-in on the computer. Everyone was paranoid and a person had to swipe their card every time they accessed the system. A big notice came up asking was the user providing care for this person before accessing that record. That worked well.