D.A. Rossiev - Dr.Sc.(Med.), Professor, Head of Department of Medical informatics and innovation technology, Krasnoyarsk State Medical University n.a. Professor V.F. Voino-Yasenetsky
S.D. Gusev - Ph.D.(Med.), Associate Professor, Department of Medical informatics and innovation technology, Krasnoyarsk State Medical University n.a. Professor V.F. Voino-Yasenetsky
A.A. Pavlushkin - Post-graduate Student, Department of Medical informatics and innovation technology, Krasnoyarsk State Medical University n.a. Professor V.F. Voino-Yasenetsky
E.V. Plita - Post-graduate Student, Department of Medical informatics and innovation technology, Krasnoyarsk State Medical University n.a. Professor V.F. Voino-Yasenetsky
V.S. Kuznetsov - Post-graduate Student, Department of Medical informatics and innovation technology, Krasnoyarsk State Medical University n.a. Professor V.F. Voino-Yasenetsky

Background: In the sphere of direct medical aid one of the most essential problems is inquiry-information support of medical decision adoption. It is realized by means of operative access to full and authentic information about a patient - health. Electronic (EHR) and personal health records (PHR) are classes of the system which are to solve the above mentioned problem. In the world and in Russia the number of projects on introduction and exploitation of electronic health records increases. The problems of medical data confidence provision remain quite urgent. The tasks of confidence and access of medical data provision are often in contradiction. In the paper the variant of this problem solution is suggested. Results: An access to medical data must be selective. First, a patient might divide the medical data into categories according to their access level. Second, it is important to consider the level of a patient-s confidence to a certain doctor. Third, the level of access to the data must be connected with the fact of the patient-s medical aid obtained from the specialist at the given moment of time. The authors distinguish three types of medical documents on the level of their access: public, operative and special confidential. Three kinds of medical employees are distinguished: confidential experts, common specialists and a black list. The matrix of access to a medical document is worked out with consideration of these factors. Stages of presentation of temporary situational access to medical data within the frames of reception and hospitalization are described: formation of enquire for data access, confirmation of permission, data usage, close to data access. A new way of access right presentation during reception or hospital cure is suggested: use of SMS with a code or USSD-queries. Advantages of the given approach in comparison with electronic keys usage are: a wide spread of cell phones in the population, provision of doctors - working places with special devices (readers) is not required. Conclusion: The suggested way of access rights differentiation to a medical document depending on the category of electronic medical data, the category of medical employees by the level of confidence, usage context and also the way of access presentation to medical data can be used in various systems running electronic and personal health records.