Privacy was maintained but the patient died (oops!)

Access & Privacy Conference 2007Edmonton, Alberta

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Agenda

The vision re-visited The privacy journey Delivery of care objectives What’s needed to move forward Putting privacy into perspective Discussion

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EHR vision re-visited

The EHR is a secure & private lifetime record of an individual’s health and care history, available electronically to authorized health providers. It facilitates the sharing of data – across the continuum of care, across health care delivery organizations and across geographies.

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Putting it in delivery terms

“ The ultimate goal is to enable access to health information from wherever you are. If you are from Montreal and break your leg skiing at Whistler, a doctor in Vancouver could access your record to make sure that he or she has information about the medications you are currently prescribed or any underlying medical conditions they need to be aware of.”

Richard AlvarezPresident and CEO, Canada Health InfowayGlobe & Mail, May 30, 2007

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The privacy journey…one province’s story

1996 Current state assessment of Alberta’s health IM/IT

infrastructure 1997

Start of Alberta’s EHR initiative Start of consultations on provincial privacy legislation for

health information 2001

Canada Health Infoway established Alberta’s Health Information Act passed Physician Office System Program established

2003 Agreement on Primary Care Initiative reached

2005 Pan-Canadian Health Information Privacy & Confidentiality

Framework POSP makes PIAs a ‘required’ service

2007 Infoway White Paper on Information Governance of the iEHR

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Where we’re at in Alberta Physicians

Approximately 90% compliance with PIA requirement

Regions/providers Sharing information (lab, drugs and DI text)

via Portal 2006 Any physician can see any patient Access audited

Primary care networks Engaged in discussion re: what data is shared

with whom Inter-jurisdictional

Paper/phone on a patient-by-patient basis Discussions re: increasing access underway

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Delivery of care objectives

Link information at each point of service & make it available to that jurisdiction’s health providers

Capture data about the jurisdiction’s residents who receive care (e.g., lab tests, diagnosis, treatment) in another jurisdiction & make it available in the jurisdiction of residence

Allow clinicians access to non-residents’ health data from their ‘home’ jurisdiction

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What’s possible now

Link information at each point of service & make it available to that jurisdiction’s health providers

Capture data about the jurisdiction’s residents who receive care in another jurisdiction & make it available in the jurisdiction of residence

Allow clinicians access to non-residents’ health data from their ‘home’ jurisdiction

√

X

X

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Inter-jurisdictional sharing Provinces/territories beginning to look at

cross-border scenarios Providing electronic access to information re:

out-of-jurisdiction services One jurisdiction ‘hosting’ part of another’s EHR

infrastructure Multi-jurisdiction initiatives (e.g., public health)

Privacy commissioners not engaged at the build/delivery level

Issues are common but efforts not coordinated at the ‘build’ or project level; jurisdictions at different stages of development

Huge expenditure of resources, significant lapsed time

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What’s needed? Understanding at the political level Deputy Minister support Resources! Privacy Commissioners’ buy-in to the vision Realistic & coordinated timelines National coordination/sharing Coordinated communication strategy with local

customization Clinician leadership at the architecture, design,

development and delivery stages Agreement on WHAT should be shared Feedback mechanism to resolve issues/overcome

barriers associated with real-world projects Common sense

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Impact on EHR agenda

Impact

Pro

bab

ility

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System failure & data loss

Privacy breach

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Thank you!

Mary Gibson Consulting

Ph: (780) 466-2613

Email: mary@marygibsonconsulting.com

Web:

www.marygibsonconsulting.com