Relationship Declarations in the EHR - It is your responsibility

Posted on: September 29, 2022

What you need to know:

When opening an electronic health record (EHR) you are accessing confidential patient information. It is mandatory that you establish the relationship (reason for accessing) you have to the patient record you are opening for accountability purposes. 

There are two types of relationships to the patient record: 

  • The direct care or support-of-care role you have (e.g., Consulting Physician, Community RN, Dietician, MOA)


  • The function you are undertaking when accessing the record for a non-direct-care or non-support-of-care reason (e.g., Data Remediation, Quality Review, Approved Research Study)

It is essential to select the correct relationship, as what you declare forms part of the permanent legal record, is audited and available to the patient.  

Incorrect relationship declaration may lead to confusion for the patient, and could result in professional repercussions for you, such as investigations into potential unauthorized activity in the EHR and/or patient complaints to Island Health and regulatory bodies.

What you need to do:

  • Always declare the correct relationship
  • Ensure your reason for accessing a chart aligns with your Permitted Work Purpose;
  • When reviewing a chart for a non-direct-care or non-support-of-care reason, use the comments box to provide additional detail about your reason for accessing (e.g., a quality chart review or a reference number as appropriate); and 
  • Remember comments become part of the health record and are available to the patient.

For resources click - here.


​Clinical Informatics Educators -


Information Stewardship, Access and Privacy Office -​