“By incorporating the principles of Privacy by Design into the EHR environment, you can accommodate both individual privacy and access to health information for purposes that benefit society as a whole, such as research purposes — a win-win scenario,” said Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario.
The paper, entitled Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win is co-authored by Dr. Ann Cavoukian, and Richard C. Alvarez, President & CEO, Canada Health Infoway. It argues that the current practice of using health information for a range of authorized purposes should continue in the EHR environment, but that this must be done in a way that respects individual rights to privacy while benefitting the health system for all Canadians.
“In addition to their value in direct patient care, information from electronic health records can be used to strengthen public health and other health care decisions,” said Alvarez. “When privacy is considered and built in at the outset, it is possible to imagine having accurate population-based information to help predict and prevent waves of infectious disease, to evaluate the safety of different medicines, or to proactively manage diabetes and other chronic conditions.”
The paper emphasizes that the use of health information for purposes that go beyond the direct care of a person, such as research and health system planning, is not a new undertaking. It has long been used for such purposes with safeguards in place to protect the privacy of Canadians, including privacy legislation and policies, as well as privacy oversight bodies to monitor compliance.
The paper describes how EHRs will make it easier, faster and less expensive to leverage health information for a range of these types of enormously beneficial purposes. While privacy challenges may arise, the paper describes some tools and guidance available to help resolve those challenges, such as the principles of Privacy by Design, the Infoway-sponsored paper Privacy and EHR Information Flows in Canada: Common Understandings of the Pan-Canadian Health Information Privacy Group, and the practice of routine de-identification of information as a key first step in reducing any associated privacy risks.
“The default approach should be that information is strongly de-identified when used for purposes that extend beyond the delivery of healthcare,” said Commissioner Cavoukian.
Research indicates that Canadians have a degree of comfort with using EHR information for such purposes, as long as privacy and security protections are in place. The paper underscores the need for transparency in the way EHR information is managed and safeguarded.
“While key elements are already in place to allow for privacy-protective use of EHR information for public health and other purposes beyond direct patient care,” added Alvarez, “there are still issues that need to be considered as we move forward. Identifying these issues was one of the purposes of producing this paper.”
About the IPC
The Information and Privacy Commissioner is appointed by and reports to the Ontario Legislative Assembly, and is independent of the government of the day. The Commissioner's mandate includes overseeing the access and privacy provisions of the Freedom of Information and Protection of Privacy Act and the Municipal Freedom of Information and Protection of Privacy Act, as well as the Personal Health Information Protection Act, which applies to both public and private sector health information custodians. The Commissioner's mandate includes educating the public about access and privacy issues.
About Canada Health Infoway
Canada Health Infoway is an independent, not-for-profit organization funded by the federal government. Infoway jointly invests with every province and territory to accelerate the development and adoption of information and communications technology projects inCanada. Fully respecting patient confidentiality, these secure systems will provide clinicians and patients with the information they need to better support safe care decisions and manage their own health. Accessing this vital information quickly will help foster a more modern and sustainable health care system for all Canadians.