Transcript health care access and privacy

Privacy was maintained but the
patient died (oops!)
Access & Privacy Conference 2007
Edmonton, Alberta
Agenda
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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 Alvarez
President and CEO, Canada Health Infoway
Globe & Mail, May 30, 2007
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The privacy journey…one
province’s story
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1996
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1997
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Agreement on Primary Care Initiative reached
2005
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Canada Health Infoway established
Alberta’s Health Information Act passed
Physician Office System Program established
2003
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Start of Alberta’s EHR initiative
Start of consultations on provincial privacy legislation for health
information
2001
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Current state assessment of Alberta’s health IM/IT infrastructure
Pan-Canadian Health Information Privacy & Confidentiality Framework
POSP makes PIAs a ‘required’ service
2007
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Infoway White Paper on Information Governance of the iEHR
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Where we’re at in Alberta
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Physicians
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Regions/providers
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Sharing information (lab, drugs and DI text) via
Portal 2006
Any physician can see any patient
Access audited
Primary care networks
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Approximately 90% compliance with PIA
requirement
Engaged in discussion re: what data is shared with
whom
Inter-jurisdictional
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Paper/phone on a patient-by-patient basis
Discussions re: increasing access underway
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Delivery of care objectives
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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
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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
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Provinces/territories beginning to look at crossborder scenarios
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Providing electronic access to information re: out-ofjurisdiction 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
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lapsed time
What’s needed?
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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
Probability
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Privacy
breach
System failure
& data loss
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Impact
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5
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Thank you!
Mary Gibson Consulting
Ph: (780) 466-2613
Email:
[email protected]
Web:
www.marygibsonconsulting.com
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