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Overview of the Personal Health Information Protection Act, 2004
Personal Health Information
Frequently Asked Questions
QA Program – Multi-Source Feedback System Update
Notice of Election of Members to Council
Regrets
Suspended Members
Overview of the Personal Health Information Protection Act, 2004
On May 20, 2004, the Ontario Health Information Protection Act, 2004 received royal assent. It consists of two parts: the Personal Health Information Protection Act, 2004 (the “PHIPA”) and the Quality of Care Information Protection Act, 2004 (the “QCIPA”). Most of the provisions of the PHIPA and the QCIPA come into force in Ontario on November 1, 2004. It is expected that regulations will be made under the PHIPA and the QCIPA that will also come into force on November 1, 2004. This article is the first of a series of articles on the PHIPA. It will provide an overview of the PHIPA and its impact on the collection, use and disclosure of personal health information in Ontario and address some specific questions that College members may have.
Purposes of the PHIPA
One of the purposes of the PHIPA is to establish rules for the collection, use and disclosure of personal health information about individuals that protect the confidentiality of that information and the privacy of individuals with respect to that information, while facilitating the effective provision of health care.
Application of the PHIPA
There are principally three categories of persons to whom the PHIPA applies:
Health Information Custodians
Under the PHIPA, a health information custodian (“custodian”) is defined as certain listed persons or organizations.
These include:
- the operator of a hospital, nursing home, independent health facility, pharmacy, laboratory or specimen collection centre, ambulance service, or centre, program or service for community or mental health;
- a health care practitioner; and
- the Minister of Health and Long-Term Care.
A “health care practitioner” includes a member of a regulated health profession under the Regulated Health Professions Act (the “RHPA”) who provides health care. The PHIPA also includes certain special rules for custodians that, in essence, are direct providers of health care (“custodian who is a health care provider”) (see paragraphs 1, 2, 3 or 4 of the definition of “health information custodian” in subsection 3(1) of the PHIPA).
Agents
Under the PHIPA, an “agent”, in relation to a custodian, is defined as a person that, with the authorization of the custodian, acts for and on behalf of the custodian in respect of personal health information for the purposes of the custodian, and not the agent's own purposes. This definition means that an employee of a custodian will be an agent for the purposes of the PHIPA. A College member who is an employee of a public hospital or independent health facility will be considered to be an agent of the public hospital or independent health facility for the purposes of the PHIPA.
Recipients
A recipient is a person who is not a custodian and who receives personal health information from a custodian. The College will be a recipient under the PHIPA when it receives personal health information from a custodian.
Duties of Custodians with Respect to Personal Health Information
The PHIPA sets out the duties of custodians with respect to personal health information. These duties include the following:
- information practices generally
• to have information practices that comply with the PHIPA and its regulations.
- accuracy
• to take reasonable steps to ensure that the personal health information is as accurate, complete and up-todate as is necessary, taking into account the use or disclosure of the information.
- contact person and responsibilities of the contact person
• to designate a contact person to ensure that all agents are informed of their duties under the PHIPA, and respond to inquiries, access requests, and complaints from the public.
- written public statement
• to make available to the public a written statement that describes the custodian's information practices, how to obtain access to or request correction of a record of personal health information and how to make a complaint.
- security
• to ensure that personal health information is protected against theft, loss, unauthorized use or disclosure, and that records of personal health information are retained, transferred and disposed of in a secure manner.
- notification
• to notify an individual if the information is stolen, lost or accessed by unauthorized persons.
- limiting collection, use and disclosure
• not to collect, use or disclose personal health information if other information can serve the purpose; and
• to collect, use or disclose only as much personal health information as is reasonably necessary for the purpose.
If a custodian collects personal health information in contravention of the PHIPA, the custodian is prohibited from using it or disclosing it unless required by law to do so.
Duties of Agents of a Custodian
An agent, in relation to a custodian, includes an employee of the custodian. A custodian may permit its agents to collect, use, disclose, retain or dispose of personal health information on the custodian’s behalf only if the custodian is permitted or required by the PHIPA to so handle the information and the collection, use, disclosure, retention or disposition of the information is in the course of the agent’s duties with the custodian and not contrary to the limits imposed by the custodian, the PHIPA or any other law.
An agent may collect, use, disclose, retain or dispose of personal health information as permitted by the custodian or as permitted in the regulations under the PHIPA. If an agent is permitted or required by law to collect, use, disclose, retain or dispose of personal health information, the agent does not require the authorization of the custodian to comply with the law. For example, a member of the College who is an employee of a custodian and who is required under the RHPA to make a report regarding sexual abuse of a patient continues to be required to file the report to the College, whether or not the member’s employer has authorized the member to do so.
An agent of a custodian is required to notify the custodian at the first reasonable opportunity if personal health information handled by the agent on behalf of the custodian is stolen, lost or accessed by unauthorized persons.
Consent
Consent is the underpinning of legislation concerning the privacy rights of individuals. The PHIPA provides certain circumstances under which a custodian may collect, use or disclose personal health information indirectly or without the consent of the individual to whom the personal health information relates. In all other circumstances, the PHIPA prohibits a custodian from collecting, using or disclosing personal health information about an individual unless it has the individual’s consent. Where consent is required under the PHIPA, the consent must:
- be a consent of the individual,
- be knowledgeable,
- relate to the information, and
- not be obtained through deception or coercion.
Subject to certain exceptions, a consent to the collection, use or disclosure of personal health information about an individual may be express or implied.
Collection, Use or Disclosure of Personal Health Information without Consent
The PHIPA permits the collection, use and disclosure of personal health information about an individual without consent under a number of circumstances. For example, a custodian may disclose personal health information about an individual without consent to a regulated health profession College for the purpose of the administration or enforcement of the legislation governing that College.
Conclusion
This is the first of a series of articles on the PHIPA. It is important that custodians, agents and others affected by the PHIPA become knowledgeable about the PHIPA and its regulations and take the appropriate steps so that, starting November 1, 2004, they will be able to comply with their obligations under the PHIPA and its regulations.
Personal Health Information
Personal health information is information, in oral or written form, that identifies an individual (or for which it is reasonably foreseeable that it could be utilized, alone or with other information, to identify an individual) and that relates to matters such as:
- the individual’s physical or mental health,
- the providing of health care to the individual, including identifying a provider of health care,
- payments or eligibility for health care in respect of the individual, or
- the donation by the individual of a body part or bodily substance. The individual’s health number is also personal health information.
Frequently Asked Questions
What is the Difference Between Privacy and Confidentiality?
Laws governing health professionals and health facilities have always been concerned about the confidentiality of patients’ health information. The objective of laws related to confidentiality is to ensure that information collected about patients is not inappropriately disclosed to third parties. The objective of laws related to privacy is to permit the individual to control the collection, use or disclosure of his or her personal information. Laws related to privacy will entitle the individual to know and consent to the purposes for which the personal information is collected, used and disclosed and provide the individual with a right of access to and correction of the personal information held by an organization about the individual.
I am an MRT who is employed by a public hospital. How does the PHIPA affect me?
A person who operates a public hospital is a custodian under the PHIPA. An MRT who is an employee of a hospital acts as the hospital’s agent with respect to the handling of personal health information of the patients of the hospital. Under the PHIPA, a person who is a health care practitioner (e.g. an MRT who provides health care) and an agent of a custodian is not considered to be a custodian for the purposes of the PHIPA. Therefore, the hospital will have primary responsibility for implementing policies and practices that comply with the PHIPA. However, it will be important for the MRT to understand and comply with the policies and practices that his or her hospital implements to comply with the PHIPA and its regulations. In addition, the PHIPA has provisions that relate to the obligations of agents of a custodian. (See “Duties of Agents of a Custodian” above.)
I am an MRT who is employed by an independent health facility. How does the PHIPA affect me?
A person who operates an independent health facility (“IHF”) is a custodian under the PHIPA. An MRT who is an employee of an IHF acts as the IHF’s agent with respect to the handling of personal health information of the patients of the IHF. The answer to this question is the same as the answer to the question above related to an MRT who is an employee of a public hospital.
How does the PHIPA impact the regulatory activities of the College?
The PHIPA provides that nothing in the PHIPA shall be construed to interfere with the regulatory activities of a College under the RHPA. For example, the PHIPA provides that a custodian is not relieved from a legal requirement to disclose personal health information. The PHIPA also permits a custodian to disclose personal health information about an individual without consent to a health regulatory College for the purpose of the administration or enforcement of the RHPA. The PHIPA is not intended to impact health regulatory Colleges' ability to carry out their role in governing their members.
Where can I go for more information?
Members may wish to refer to the resources made available by the Ministry of Health and Long-Term Care or by the Ontario Information and Privacy Commissioner.
This information is of a general nature only and should not be constructed or relied on as legal advice.
QA Program – Multi-Source Feedback System Update
Over the last six months, the College has made tremendous headway in the development of a multi-source feedback system that is expected to eventually become an essential part of the QA program administered by the College. The system – being developed by Dr. Claudio Violato under the direction of the College’s QA Committee – will provide a means to assess how members of the profession actually perform in practice. The College is required by legislation to conduct a practice assessment of members of the College.
During the summer, a group of College members and members of the QA Committee worked with Dr. Violato to draft four different feedback questionnaires based on the six essential competencies of the College’s Standards of Practice. These questionnaires are preliminary tools and are being considered as a means of gathering feedback on professional performance. They were initially assessed by 38 MRTs over July and August, and they are now ready to be tested by a broader group of volunteers.
The College is asking 400 MRTs to volunteer to test these questionnaires in a pilot study. As a volunteer in the pilot study, you would be asked to complete a self-questionnaire, identify six peers to complete a peer questionnaire, identify six co-workers (non-MRTs) to complete the co-worker questionnaire, and have 25 patients complete a patient questionnaire. It is anticipated that the self, peer and co-worker questionnaires will take not more than 25 minutes for each person to complete and that the patient questionnaire will take about 15 minutes to complete.
Once all the information has been submitted by study participants, each participant will receive a summary sheet which will provide him or her with confidential feedback regarding his or her performance in practice and will compare his or her performance in practice to that of other MRTs in the pilot study. The QA Committee will also receive a copy of the summary sheet (with your name and other identifying information removed) for the purpose of evaluating these questionnaires as tools for the multi-source feedback system.
The pilot will take place in January 2005 over a six week period. The QA Committee and Dr. Violato will analyze the results, and may make adjustments to the program before it is submitted to Council for its approval, likely in the summer of 2005.
MRTs who do not have direct patient contact are not eligible to participate in the pilot. Prior to the program being submitted to Council for its approval, consideration will be given to how best accommodate MRTs who do not have patient contact.
The College will continue to recruit members to participate in the study up to December 2004.
This is a voluntary study, and you are asked to identify to the College whether you would like to volunteer for it. While the College would like to encourage your participation, only 400 volunteers are needed. There is no stigma attached to non-participation. However, those who participate in the pilot on a voluntary basis and complete the questionnaires will be treated as having completed one practice assessment if they are randomly selected prior to January 1, 2012 once the formal practice assessment is implemented.
Please note, however, participation in the study does not exclude you from being randomly selected to submit your Self-Assessment Profile, Continuous Learning Portfolio and related Quality Assurance records.
If you would like to volunteer to participate in the pilot study you may contact the College by:
facsimile: (416) 975-4355
e-mail: info@cmrto.org or
telephone: 1 (800) 563-5847 or (416) 975-4353.
Notice of Election of Members to Council
Electoral Districts 3 and 6
District # 3 (Central District) is composed of the geographic area within the territorial boundaries of the Regional Municipalities of Durham, Peel and York, the Counties of Haliburton, Northumberland, Peterborough and Simcoe, the City of Kawartha Lakes and the City of Toronto.
District # 6 (Nuclear Medicine) includes all of the Province of Ontario.
| Date: |
Friday, May 6, 2005 |
| Place: |
College of Medical Radiation Technologists of Ontario
170 Bloor Street West,
Suite #1001
Toronto, Ontario M5S 1T9 |
| Time: |
Ballots must be received at the College no later than 5:30 p.m. on May 6, 2005 |
Regrets
Colleagues of John Olczak informed the College of his passing on seeing his name on the Suspended Members list in the summer Insights. Any distress this may have caused is regrettable and the College extends its condolences to John’s family and friends. To avoid this situation in the future, colleagues may wish to provide appropriate information to the College so that College records can be adjusted accordingly.
Suspended Members
The following are the people whose certificates of registration have been suspended effective September 17, 2004 for failure to pay their fees in accordance with section 24 of the Health Professions Procedural Code. A person whose certificate of registration has been suspended is not a member of the College unless and until the suspension is removed.
| 07855 |
Cook, Joyce |
| 08293 |
Mahomed, Amina B. |
| 06671 |
Tate, Gordon B. |
| 06809 |
Moroz, Ward A. |
| 02961 |
Skam, Judy L. |
| 02717 |
Henderson, Everdina |
| 11633 |
Kemp, Anne |
| 11719 |
Ni Laighin, Ciara |
| 11671 |
Gauthier, Sebastien |
| 12008 |
Masella, Cindy A. |
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