Ontario Permits Certain Clinicians to Access Personal Health Information Through the Provincial Electronic Health Records
Date: May 4, 2020
On May 1, 2020, the Ontario government made a new temporary emergency order under the Emergency Management and Civil Protection Act which authorizes certain persons to access provincial electronic health records.
O. Reg. 190/20, Access to Personal Health Information by Means of the Electronic Health Record (Order) authorizes the following persons to access the provincial electronic health record:
- Registered nurses appointed as coroner investigators (RNs), and
- The Chief Medical Officer of Health (CMOH) or a medical officer of health (MOH).
The Order refers to and incorporates the meaning of “personal health information” (PHI) and “health information custodian” (HIC) as those terms are defined in Personal Health Information Protection Act, 2004 (PHIPA). “Electronic health records” (EHR) has the same meaning as section 6.2(4) of O. Reg. 329/04 made under PHIPA.
Under PHIPA, PHI includes, but is not limited to, identifying information about an individual that relates to the physical health of the individual. A HIC includes, but is not limited to, a regulated health professional, hospital or the MOH. Under O. Reg. 329/04, an “electronic health record” means a record of PHI created or maintained in electronic form by Ontario Health to enable HICs to use electronic means to disclose PHI to one another for the purpose of providing or assisting in the provision of health care to the individual whose PHI is contained in the record.
Under the Order, information in the EHR may only be used by the authorized persons above to collect PHI when the following three conditions are met:
- The HIC who provided the PHI to Ontario Health would be authorized or required to disclose the PHI to the CMOH, MOH, Coroner or RN if these persons had directly requested it from the HIC.
- The CMOH or MOH would be authorized to collect the PHI if they had directly requested it (or in the case of the Coroner or RN, directly requested or demanded it) from the HIC.
- The CMOH or MOH requires the PHI for any purpose related to exercising their powers or performing their duties under the Health Protection and Promotion Act (or in the case of the Coroner or RN, exercising their powers or performing their duties under the Coroners Act).
For the Coroner and the RN, an added condition that must be met is that they must have been authorized by the Chief Coroner to use the electronic health record to collect PHI.
The Order also authorizes Ontario Health to make PHI available to the CMOH, MOH, Coroners and RNs by means of the EHR even if Ontario Health does not have custody or control of the PHI.
The Ontario government has stated that the rationale behind the Order is to help reduce demands on clinicians’ time related to death investigations, reduce exposure to COVID-19-related death investigations, and improve the ability to monitor the spread of the virus.
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