Kate Dewhirst talks about the risks associated with snooping (that is, reading health records without a clinical need-to-know or without authorization) in the health sector. See:
Kate Dewhirst is featured in an article by Advocate Daily on the importance of policies in the health sector. See:
Kate Dewhirst is featured in an article by Advocate Daily on the need for social media policies in the health sector.
On May 22nd, DDO Health Law (DDO) hosted its eHealth Risk Management Conference in Toronto. The conference was an opportunity to highlight the opportunities and challenges associated with the increasing role of technology in health care delivery, e.g., managing databases of personal health information and using devices and electronic processes to collect, share and deliver health information. Technology is now being used to communicate with and engage patients and clients (e-mail, apps, social media, discussion boards); to coordinate health care delivery (shared electronic health information systems); and to increase provider efficiency (use of mobile devices at work).
Taking a practical approach to balancing organizational needs and potential risks, speakers from the Healthcare Insurance Reciprocal of Canada (HIROC), eHealth Ontario (eHO) and DDO shared their expertise with a packed audience representing a broad cross-section of the health sector including academic health centres, other hospitals, community mental health agencies, shared services organizations, government agencies, and family health teams.
We asked our attendees – what is keeping your Chief Information Officer awake at night?
The answer – mitigating the risks associated with e-health initiatives. Common themes were the need for oversight (to protect the privacy of health information) and minimizing liability exposure. Whether oversight was framed as a governance, contractual compliance, human resources or system security issue, conference participants consistently expressed a need for additional information and resources to meet their obligations. This was especially true in the context of data-sharing, where many new provincial initiatives were mandating the creation and maintenance of large, pooled repositories of personal health information – creating new province-wide risks and liabilities.
Other, more specific concerns raised included:
- Managing patient/client consent to the creation of databases
- Developing, implementing and enforcing best practices related to employees, client/patient and family use of technology (e.g., mobile devices, e-mail, social media use in the healthcare workplace)
- Ensuring documentation quality where information going into shared databases
- Controlling access to collected information.
The DDO perspective
At the heart of the issues raised at the conference is the age-old problem of how best to safeguard patient/client/staff personal (health) information. In many ways, technology has only increased the scope of oversight required to ensure the security of that information. DDO speakers offered tools (including a Data-Sharing Agreement checklist) as well as best practices and risk management strategies for organizations from a technological and employment standpoint.
If you wish to receive more information about upcoming DDO Health Law conferences and publications, please visit our website at https://ddohealthlaw.com and subscribe to our mailing list.
Commentary on the Supreme Court of Canada’s Decision in Cuthbertson and Rubenfeld v. Rasouli
On Wednesday January 22, 2014, the Ontario Hospital Association (OHA), hosted the Health Links
Conference, bringing together stakeholders from across the healthcare spectrum: the Ministry of
Health and Long-Term Care (MOHLTC), hospitals, the Ontario Medical Association (OMA), local
health integration networks (LHINs), primary care providers, Health Quality Ontario (HQO),
community care access centres (CCACs) and community agencies among others. The conference
was an opportunity to share the implementation challenges and lessons learned from different
Health Links, and to provide attendees with advice, tools and tactics for success going forward.
Launched in December 2012, Health Links are a model of providing better-integrated services to
high-needs patients. A Health Link is a voluntary partnership that may include a hospital as well as
community support agencies, primary care, home care, and long-term care providers – usually with
an identified lead organization. To date, 47 Health Links have been established across the province
with at least one Health Link in every LHIN. The goal is to have 98 Health Links in place by 2015.
Health Links focus on providing customized and coordinated care to the 1%-5% of the health system’s
so-called high-cost/high-needs users. According to Helen Angus, Deputy Minister of Health, these are
patients with complex conditions who rely heavily on the emergency room (instead of services available
in the community); are more frequently readmitted to hospital; and have trouble navigating the system.
From a system costs perspective, this small percentage of patients account for at least 74% of the
MOHLTC/LHIN operating budget.
Health Link implementation challenges
Privacy: One of the key themes at the conference was the issue of privacy and the sharing of patient
information with partners within the Health Links. In many cases, privacy was seen to be a real barrier
to implementing the coordinated care model. Ontario has very clear rules about when and to whom a
patient’s personal health information can be shared – limiting disclosure without consent to those
within the patient’s circle of care. We understand that the MOHLTC has reconvened its provincial-level
privacy forum to address privacy issues and provide guidance on best practices.
Access to Health Links programs in rural communities: The ability for patients, especially isolated seniors
in rural communities, to access services was another major challenge faced by many Health Links. These
Health Links were attempting to develop strategies to ensure that their resources and programs could be
utilized as intended.
Tool Templates: With coordinated care at the heart of the Health Link mandate, many participants were
eager to access tools that would allow them to capture information and provide real-time data to Health
Link partners. With respect to maximizing the value of patient case conferences and creating a repository
for patient information, we understand that a provincial coordinated care plan template is being developed
though there is no word on when it will be released.
The impact of Health Links
Health Links have been around for fewer than 2 years. Anecdotally, and primarily from the patient
experience perspective, the model has been a success. However, there is a recognized need for real
metrics to assess whether the model is working. A long-term evaluative framework and metrics are being
developed that will put numbers to the ultimate value that Health Links have brought to the system.
As a final point, Health Links, with its need for real time data on patients, may be one of the strongest
levers to date for the accelerated creation of the provincial electronic health record.
Click here for more information about Health Links.
The Canada Not-for-profit Corporations Act (NFP Act) is recent, federal legislation that governs federally incorporated non-profits and charities. Proclaimed into force in 2011, the NFP Act prescribed a 3-year transition period for corporations incorporated under Part II of the Canada Corporations Act (CCA) to file for continuance under the new legislation. With the deadline for transition (October 17, 2014) now just six months away, Corporations Canada recently published a list of Frequently Asked Questions (FAQs) that explain the consequences of a corporation’s failure to meet the October deadline. Read More