TORONTO, Sept. 2 /CNW/ - Ontario's Information and Privacy Commissioner,
Dr. Ann Cavoukian, today released a new publication that includes specific
practical examples to help clarify any confusion over when health information
custodians can assume a patient's implied consent to collect, use or disclose
personal health information.
The brochure, Circle of Care: Sharing Personal Health Information for
Health-Care Purposes, was developed with the collaboration of seven health
organizations. "This brochure cuts through the confusion surrounding the term
circle of care," said the Commissioner. "We are using seven relevant examples
from across the broader continuum of the health sector to provide such
"There had been some confusion in the health sector as to the meaning and
scope of the circle of care concept," explained Commissioner Cavoukian. "In
part, this may have been because the term does not appear in the Personal
Health Information Protection Act, 2004. It is, however, commonly used in the
health-care community to describe the provisions in the Act that permit
health-care providers to assume a patient's implied consent to collect and use
personal health information - and to share that information with other
health-care providers - in order to provide health care to that patient,
unless the patient expressly indicates otherwise."
The Act is based on the premise that privacy can be protected, without
needless delays in the health system.
"Overall, the Act is working very well, but clarity needed to be brought
to bear on the circle of care concept," said Commissioner Cavoukian.
The seven examples in the brochure address this. As a fictional
61-year-old patient is followed through much of the health-care system, the
examples provide specific guidance relating to when a health provider can
assume implied consent.
The seven health organizations that worked with the IPC include (in
alphabetical order): the College of Physicians and Surgeons, the Ontario
Association of Community Care Access Centres, the Ontario Association of
Non-Profit Homes and Services for Seniors, the Ontario Hospital Association,
the Ontario Long Term Care Association, the Ontario Medical Association and
the Ontario Ministry of Health and Long-Term Care.
Here is a condensed version of one of the examples used in the brochure:
A patient is sent by his family doctor to a laboratory for blood and
urine testing. A geriatrician, a specialist whom the patient has been
referred to by his family doctor, would like to obtain the results of
those tests. He would also like to obtain a list of the patient's current
prescriptions from the pharmacy where he fills all his prescriptions.
Can the laboratory and pharmacy disclose this personal health information
and can the geriatrician collect information based on assumed implied
Yes. The laboratory, pharmacy and geriatrician may assume implied
consent. The personal health information was received by the laboratory
and pharmacy - and will be received by the geriatrician - for the purpose
of providing health care to this patient.
"Personal health information may be shared within the circle of care -
among health-care providers who are providing health care to a specific
patient - but not outside that circle," stressed Commissioner Cavoukian. "Any
sharing of personal health information with other health-care providers for
purposes other than the provision of health care - or the sharing of personal
health information with persons or organizations that are not health-care
providers, such as insurers and employers - requires the express consent of
To see a copy of the brochure, visit www.ipc.on.ca.
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, in addition to educating the
public about access and privacy issues.
For further information:
For further information: Media Contact: Bob Spence, Communications
Co-ordinator, Direct line: (416) 326-3939, Cell phone: (416) 873-9746, Toll
free: 1-800-387-0073, firstname.lastname@example.org