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Proposed Personal Health Information Act

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Pan-Canadian Health Information Privacy and Confidentiality Framework ... Pharmacies. Continuing care facilities licensed by DOH. Other prescribed by regulation ... – PowerPoint PPT presentation

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Title: Proposed Personal Health Information Act


1
Proposed Personal Health Information Act
  • Presented to
  • Atlantic Symposium on Privacy
  • in Health Services and Policy Research
  • Presented by
  • Suellen J. Murray, Project Manager
  • Health Information Legislation Project
  • April 20, 2009

2
Canadian Health Privacy legislationBackground
  • Krever Commission of Inquiry into the
    Confidentiality of Health Information (Ontario
    1980)
  • Commission on Future of Health Care in Canada
    (Romanow report 2002) recommended clear and
    consistent privacy rules
  • Federal Personal Information Protection and
    Electronic Documents Act (PIPEDA)
  • effective in 2004 for health care
  • Provinces requested a carve-out from PIPEDA

3
Public Opinion
  • Revisiting the Privacy Landscape a Year Later
  • EKOS Research for Federal Privacy Commissioner
    March 2006
  • 59 said that there are few types of personal
    information that are more important for privacy
    laws to protect than personal health information
  • 77 said that it was of high importance to them
    personally to have strong laws to protect
    Canadians personal information
  • 88 believe that, compared to ten years ago, it
    is more important that Canadian privacy laws are
    updated regularly to ensure that they are keeping
    up with new technologies that may impact personal
    information

4
Provincial Health Information Legislation
Personal Information
Protection of Personal Information in the
Private Sector (1994)
Protection Act
(January 2004)
YK
Personal Health Information Act Passed May 2008
eHealth Act (Introduced April 2008)
NU
NWT
BC
Bill anticipated in 2009
AB
MB
NL
SK
PQ
ON
NB
Legislation in development
Health Information
Personal Health
Health
Protection Act
Personal Health
Information
Information
(September 2003)
Information Act
Protection Act
Act
(April 2001)
(December 1997)
(November 2004)
5
Pan-Canadian Health Information Privacy and
Confidentiality Framework
  • F/P/T initiative to develop consistent rules for
    health privacy
  • Developed by F/P/T team (plus CIHI, CIHR, Infoway
    and Statistics Canada)
  • January 2005 - Signed off by Health Deputy
    Ministers of all provinces (except Saskatchewan
    and Quebec)
  • Recommends a harmonized set of core provisions
    for the collection, use and disclosure of
    personal health information in the public and
    private sector

6
Nova Scotia Current Status
  • Over 40 pieces of legislation govern collection,
    use and disclosure of personal health information
  • Key provincial Acts
  • Freedom of Information and Protection of Privacy
    Act (DOH/DHPP)
  • Hospitals Act (DHAs)
  • Health Protection Act (Public Health)
  • Key federal Acts
  • Privacy Act (Federal government)
  • PIPEDA (all commercial health care providers e.g.
    physicians, dentists, nursing homes)

7
Health Information Legislation Project
Development
  • Project full-time in October 2007
  • Four-person internal working group
  • Discussions held with stakeholders on specific
    issues
  • Dalhousie Health Law Institute contracted to
    propose recommendations for research provisions

8
Health Information Legislation Project
Consultation
  • Started July 31, 2008
  • Discussion Paper link circulated to approx. 200
    stakeholders
  • posted on DOH website
  • Discussion paper, questionnaire online survey
  • Ended November 1, 2008

9
Health Information Legislation Project
Consultation
  • 48 written submissions received
  • 37 presentations on proposal
  • July 2008 April 2009
  • Most key stakeholders have responded
  • Analysis of submissions is underway

10
Health Information Legislation Project Next
steps
  • DOH Working Group will continue to meet with
    stakeholders, and develop full draft legislation
  • It is anticipated that the bill will be
    introduced in 2009
  • Implementation period estimated 9-12 months

11
Proposed PHIA PurposePage 5
  • to govern the collection, use, disclosure,
    retention and destruction of personal health
    information in a manner that recognizes both the
    right of individuals to protect their personal
    health information and the need of health
    information custodians to collect, use and
    disclose personal health information to provide,
    support and manage health care

12
Proposed PHIA Scope
  • Clear scope is key to an effective flow of
    information
  • PHIA only applies to
  • personal health information
  • health care
  • health information custodians

13
Proposed PHIA Scope what is covered? Page 9,
Section 2
  • Identifying information means information that
    identifies an individual or for which it is
    reasonably foreseeable in the circumstances that
    it could be utilized, either alone or with other
    information, to identify an individual. 

14
Proposed PHIA Scope who is covered?Page 6
  • Applies to health information custodians
  • Exhaustive list of custodians proposed for
    legislation
  • Department of Health
  • Regulated health professionals who provide
    health care
  • District Health Authorities IWK Health Centre
  • Pharmacies
  • Continuing care facilities licensed by DOH
  • Other prescribed by regulation

15
Health Information Legislation Key Issues
  • The Personal Health Information Act will provide
    consistent rules for providers within circle of
    care

16
Health Information Legislation Key Issues
  • Requirements for practices and policies to
    protect personal health information
  • general privacy policy
  • privacy contact person
  • communications materials
  • specific policies procedures (e.g.
    secure destruction)

17
Health Information Legislation Key Issues
  • Custodian shall only allow access to the
    information that the employee, agent, vendor etc.
    requires to carry out their duties and
    responsibilities

18
Health Information Legislation Key Issues
  • Ability of individual to limit or withdraw
    consent for use and disclosure of their
    information

19
Ability to withdraw or withhold consentPage 12,
section 7
  • Known as the lockbox
  • Already a requirement for providers under PIPEDA
    most provinces have it in their PHIAs
  • Allows an individual to decide if s/he wants to
    prevent information from flowing within the
    circle of care
  • Can apply to a specific provider (e.g. Dr. Jane
    Smith) or specific piece of information (e.g. lab
    results)

20
Health Information Legislation Key Issues
  • Ability to audit for reporting access to
    individual health records

21
Health Information Legislation Key Issues
  • Requirement to report to individual any breach of
    their personal health information

22
Mandatory reporting of breachPage 35
  • Breach proposed provision defines breach as
    taking place when information is stolen, lost or
    subject to unauthorized access, use, disclosure
    copying or modification
  • Other jurisdictions, policies qualify
    reporting requirement
  • adverse impact (Newfoundland Labrador)
  • harm or embarrassment, public disclosure or
    malicious use (NS DOH)

23
Health Information Legislation Key Issues
  • To be effective, the legislation requires
    independent privacy oversight

24
Independent privacy oversight Pages 47-48
  • Independent privacy oversight is critical to an
    effective privacy framework
  • Nova Scotia is the only jurisdiction in Canada
    without independent privacy oversight
  • Privacy Review Officer Act passed in November
    2008

25
Health Information Legislation Key Issues
  • Researchers must support privacy protection by
    limiting use of identifiable information in
    research and seeking consent for use of personal
    health information (with some exceptions)

26
Public Opinion
  • Electronic Health Information and Privacy
    Survey What Canadians Think
  • Infoway/Federal Privacy Commissioner August 2007
  • 87 support the use of electronic health records
    in research provided that personal details are
    removed
  • 54 support the use of electronic health records
    in research if identifying details are not
    removed
  • 66 support linking health information to other
    information (e.g. education, income) but only
    with consent

27
Research Pages 28-32
  • Proposed research provisions seek to balance use
    and protection
  • Proposed provisions require that the minimum
    amount of information necessary for research
    purpose may be used or disclosed
  • Consistent with TCPS Ethical Conduct for
    Research Involving Humans

28
Research Pages 28-32
  • Issues include capacity of Nova Scotia REBs,
    distinction between research and planning and
    management of health system
  • Legislation will also take into consideration
    proposed Health Policy Research Centre
  • www.nshrf.ca for more information

29
For more information
  • Discussion paper is available at
    www.gov.ns.ca/health/phia
  • Comments/questions can be e-mailed to
    phia_at_gov.ns.ca
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