The requirements for confidentiality between patient and physician are a problem.
a)    The provision identifies a medical record as one generated by the doc in the process of rendering health care services.  There are a lot of records generated outside the patient-physician relationship.  Example is an IME.
(1)    But traditionally, they are treated the same as a medical record, legally–same discovery tests apply, etc.
(2)    EX:  If asked by insurance company to examine patient, and you see the patient and you tell patient it is an examination by insurance request and not for the purpose of treatment; there is no report and no physician-patient relationship.  Is there a requirement for confidentiality?