Disclosure of personal health info limited
For the London Free Press – September 28, 2009
PRIVACY: The Personal Health Information Protection Act spells out three basic ways that such information can be released
The term “Circle of Care” is often used to describe the ability of health-care professionals to share patient information among those treating that patient.
But the term doesn’t actually appear in the Personal Health Information Protection Act (PHIPA),
A recent publication by Privacy Commissioner Ann Cavoukian and seven health organizations tries to reduce confusion over the term. This article is a summary; the full text is at www.ipc.on.ca/ images/Resources/circle-care.pdf.
Consent to disclose personal health information under the PHIPA is addressed in three basic ways:
First, information may be collected, used or disclosed without consent where permitted or required by PHIPA. For example, disclosure will be permitted for the purposes of the Health Protection and Promotion Act.
Second, information may be collected, used or disclosed with the express consent of the individual or his/her substitute decision-maker. Such consent must be informed, relate to the information collected, used or disclosed, and not obtained by deception or coercion.
Third, information may be collected, used or disclosed with the implied consent of the individual. This is crucial for efficient care.
A health information custodian can assume implied consent to collect, use or disclose personal health information only when all of these conditions are met:
- The information must fall within a category about which custodians are entitled to rely on assumed implied consent.
- The information must have been received from the individual, his or her substitute decision-maker or another custodian.
- The custodian must have received the information to provide or help provide health care to the individual.
- The information must be collected, used or disclosed by the custodian to provide or help provide health care to the individual.
- The information may only be disclosed to another health information custodian.
- The custodian receiving it must not be aware that the individual has expressly withheld or withdrawn consent for its collection, use or disclosure.
For example, implied consent would exist where a patient visits her family doctor and is referred to a specialist. Consent is implied for the doctor to disclose patient information to the specialist.
But assumed implied consent would not exist if the specialist tried to disclose the patient’s personal health information for use in research on the disease affecting the patient. That’s because the information would not be used to provide care to the patient.
Re the ‘circle of care’ – in 100% of the communications I have recently had with health care personnel, the PATIENT is somehow not part of this circle. I pointed this out to a ‘new professional group’ in the northern Southwestern Ontario area, that is working with people who have diabetes. The response to my comments re including the patient in the group discussion was that the ‘discussion’ as about / for the patient but did not include the patient. As well, recently I have attempted to access a hard copy of ‘blood results’. When I pointed out that the initial report was incomplete, I was advised only the ‘circle of care’ could easily download the report I wanted. I wrote the software company behind the e-health report and was advised I had to travel to the hospital where the ‘blood work’ was done to access this information – and yet the local MD [outlying institution]could access the complete report with no difficulty . I have been aware of PHIPA for decades, and gained more specific knowledge recently. It is quite disturbing that the only person who can’t have access to medical information, be it imaging or reports / letters of any sort, is the person all these are ‘circled around’. Why am I paying [taxpayer] for something I can’t access?
Long time health care provider
Comment by Susan — October 3, 2009 @ 3:21 pm