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When Do You Need a PIA Amendment?

Posted on July 23, 2019 by Jean Eaton in Blog

A Privacy Impact Assessment Is Good For Business

A privacy impact assessment (PIA) is part of a regular business process if you collect, use, or disclose personal health information in your healthcare practice. When you have a previous PIA that has been prepared, submitted to the Office of the Information and Privacy Commissioner (OIPC) and it has been accepted for use–well, that is not the end of your PIA journey.

You need to ensure that you are updating and amending your PIA as your practice matures and as you make administrative and technical changes to the procedures in your practice.

You need a PIA Amendment when you have a previously accepted PIA and any one of these common triggers below.

You Have a PIA That Was Written More Than 2 Years Ago

It is time to review and update this!

Under Section 8(3) of Alberta’s Health Information Regulation, custodians must periodically review the safeguards they have in place to protect health information privacy. This means that custodians need to regularly review the privacy risk mitigation plans set out in PIAs to ensure they continue to protect against reasonably foreseeable risks to the privacy of health information. The submission of your PIA to the Office of the Information and Privacy Commissioner (OIPC) is mandatory and must precede implementation of your new system or practice.

Change in Health Information Act (HIA) Legislation and Regulations

The HIA has undergone significant amendments in 2006, 2010, most recently in August 2018. Make sure that you have updated your privacy breach management program and include mandatory privacy breach notification to the (OIPC) and the Minister of Health (MOH). Again, ensure that your team training has been updated so that they know how to spot, stop, and report a privacy breach. (See Mandatory Privacy Breach Notification)

Changes In Your Electronic Medical Record or Computer Network

You have the same EMR database, but maybe the configuration has changed. For example, a change from a local to an application service provider (ASP) or cloud-based data centre or Software as a Service (SAS) model would trigger a PIA amendment.

Another trigger is a change in your computer network vendor or changes in wireless networking, remote access, or implementing mobile devices.

PIA amendment EMR computer network

Change in Participating Physicians / Privacy Officer

Since your original PIA, you may have new custodians, including physicians, registered nurses, chiropractors, and other health professionals named in the HIA that have joined or left your practice. Your Privacy Officer may have changed, too. Your amendment should include an up-to-date listing of custodians and privacy officers.

New Users / Information Sharing

There have been many recent information sharing initiatives in healthcare. You might now plan to participate in evaluation projects, patient panel management, or other community initiatives. Make sure that you have your PIA amendment and information manager agreements completed, too. (See – The Top 3 Agreements Your Healthcare Practice MUST Have (and Why).

A quick word of caution: if your new information sharing project includes data matching–the creation of new information by combining two or more sets of data—requires custodians to prepare a privacy impact assessment before performing data matching involving health information (HIA sections 70, 71). The custodian that carries out the data matching is responsible for preparing the Privacy Impact Assessment.

PIA amendment new users

Communicating With Patients

If you are adding new technology to keep in touch with patients for appointment reminders, on-line appointment booking, secure email or patient portals, these will trigger a PIA amendment or, perhaps, a project specific PIA. Make sure that your policies and procedures are up to date, too. (See – Can You Use Text Message With Your Patients? )

PIA Amendment Communicating with patients

Alberta Netcare Portal (ANP) / Community Integration Initiative (CII) / CPAR

ANP updated their PIA in 2016 and, therefore, you need to make sure that your corresponding policies and procedures and training have been updated, too. Remember – when you agreed to participate in ANP, you promised that you would review your threat risk analysis (TRA) and update your Provincial Organization Readiness Assessment (p-ORA) when changes occur and at least every two years.

If you want to participate in new initiatives like CII and CPAR, you need to review and update both your PIA and your p-ORA, too.

Maturing Practice

You have learned and grown since your original Privacy Impact Assessment submission. Have you implemented everything that you said that you would? Can you demonstrate that your teams have received privacy and security awareness training? Have you reviewed your Health Information Management Privacy and Security policies and procedures in the last two years?

Keeping up to date without any other significant changes to your practice may not trigger a Privacy Impact Assessment amendment. Make sure that you document your careful review so that you are prepared for your next Privacy Impact Assessment submission.

Important Business Decisions

Creating and reviewing your PIA regularly can help you to spot errors or gaps between the way that you do the work in the clinic and the way that you said that you were going to implement in your clinic.

The questions that we ask during the PIA process are important. The time that you take now to identify the potential risks and prevent those incidents from happening may save you time, money, reputation and even jail time in the future.

You Know Your Practice Better Than Anyone Else

When you have a coach to guide you through the PIA amendment process, provide you with templates, and give you feedback on your work in regular live training webinars, join me in the on-line step-by-step course, Protect Your Practice, Your Assets, and Your Patients with Privacy Impact Assessments.

Protect Your Practice, Your Assets, and Your Patients with Privacy Impact Assessments

Find out more here: Protect Your Practice, Your Assets, and Your Patients with Privacy Impact Assessments or send me an email.

Practice Management Nuggets Podcast

This topic is included in our Practice Management Nuggets podcast! Be sure to tune in to the podcast episode

When Do You Need a PIA Amendment? | Episode #078

Listen to the Podcast
#PrivacyImpactAssessment, #ProtectYourPractice, Alberta, clinic, health care, Health Information Act, healthcare, HIA, how to do a pia, medical, Netcare, PIA, Privacy Impact Assessment, privacy impact assessment amendment, training

When is a Privacy Breach a Privacy Breach?

Posted on July 13, 2019 by Jean Eaton in Blog

The biggest mistake in managing a privacy breach is not recognizing the privacy breach.

The second biggest mistake is not knowing what to do about it.

The recent publicity about the privacy breach in Alberta when a laptop with health information was stolen and came to the public's attention several months later is not the first news item of its kind.  In fact, this happens frequently in healthcare, retail, government departments and other industries.  This doesn't make it any easier to swallow and certainly doesn't make it right.  But this is an opportunity for you, healthcare provider or practice manager, and vendor to make sure that you have good practices in place to manage your next privacy breach.

Health information is recognized as being particularly sensitive and important to the person that the information is about.  It is so important, in fact, that a new breed of legislation was developed to set out specific rules to ensure that the health information has robust safeguards (administrative, technical, and physical) to keep the health information confidential and secure.  In Alberta, the Health Information Act (HIA) was proclaimed in 2001 to help custodians (people or organizations who collect, use, and disclose health information) ensure that they have identified the risks to breach of health information and how to prevent those risks.  The legislation also ensures that the people who the health information is about have access to their personal health information.

In August 2018, amendments to the HIA were proclaimed that make it mandatory to report a privacy breach that could result in harm to the Office of the Information and Privacy Commissioner (OIPC).

Privacy breaches come in all types and sizes.  One of the most common forms of a privacy breach is when a clinic or healthcare provider intends to send a report to another healthcare provider for continuing care and treatment but it is sent to the wrong physician.  Or, the referral request went to the correct physician but included extra information about another patient that was not part of the referral.

What Is Considered a Privacy Breach?

A privacy breach is an unauthorized access to or unauthorized collection, use, disclosure , loss, or disposal of personal or health information.

To each of us, our own personal health information is important.  As a healthcare industry, we need to ensure that we recognize this and acknowledge that each privacy breach is important to the person the information is about.  We need to make sure that we minimize the risk of the information being used inappropriately or maliciously.  We need to acknowledge to ourselves and to our patients and clients that we are human and that sometimes we do make mistakes and we will strive to do better.

A ‘small' breach of one person one time might have a big impact to the individuals involved.

A ‘big' breach of a lost laptop might have a bigger magnitude affecting many individuals.

When a breach also meets the requirements of mandatory notification, a custodian must report the breach regardless of how many people's information have been included in the breach.

4 Step Response Plan

When you have a privacy breach, follow these four steps to manage the privacy breach incident.

Step 1 – Spot and Stop the Breach

Each breach is important and needs to be recognized. Contain the breach so that it doesn't get any bigger.

Step 2 – Evaluate the Risks

Your privacy officer will investigate the incident and learn about the size, scope, and details about the breach. Consider if there is a reasonable basis to believe that there is a risk of harm to an individual

Step 3 – Notify

Notify the custodian, the affected individuals and (now, with the 2018 amendments), the Alberta OIPC, Minister of Health, Alberta Health (if the breach includes Netcare) and others.

The individual who's information has been breached needs to be made aware of the problem and the risk that might be experienced so that they can be prepare to limit the risks. The custodian needs to know how to manage the privacy breach and report it – internally and perhaps to other stakeholders.

Step 4 – Prevent the Breach From Happening Again

Correct and monitor the incident(s). Actively take steps so that the breach does not happen again.

Not Sure What To Do?

You never know when a privacy breach will happen! Prepare now with a privacy breach management program and coaching from the Practical Privacy Coach!

Learn what to do if you have a privacy breach.

4 Step Response Plan, Alberta, breach, Health Information Act, HIA, OIPC, privacy, privacy breach, training

Can You Predict Successful Privacy Awareness Compliance Training?

Posted on June 13, 2019 by Jean Eaton in Blog

Protect your organization and your patients.

Investing in privacy awareness compliance training that is engaging, practical, and easy to access will prevent a privacy breach in your healthcare practice.

But, how do you find the right training?

Look for a strong completion rate.

A high completion rate is the single best predictor of successful privacy awareness compliance training. Most on-line courses have a 6-15% completion rate.

The Privacy Awareness in Healthcare: Essentials program from Corridor Interactive has a completion rate of 95%.

And the investment is only $35 per person.

Give your patients the gift of privacy. Improve your healthcare practice with privacy awareness education.

HURRY! A privacy breach can happen at any time!

 

health care, healthcare, HIA, PHIPA, privacy, privacy awareness compliance training

What is a PIA?

Posted on March 11, 2019 by Jean Eaton in Blog

Have you ever been in a situation where you had a great idea that you wanted to implement and then someone asked you if have a PIA for that?

     
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Maybe you wanted to add a new digital health app to make it easier for patients to book appointments with you, or get access to Alberta Netcare Portal, use the internet to get on-line consultations for your patients, or start using a new EMR.

Or maybe you have a new healthcare practice and you are excited about choosing the right location, the right equipment, the right vendors that fit your budget and your goals.

A PIA is a practical business tool in your healthcare practice.

A PIA is an important tool that you can use to help you with that project management.

It will help you anticipate risks to the project before it starts and avoid serious problems, wasted time and money.

The PIA process requires you to have written policies and procedures so that you can implement the project effectively and train your staff consistently. Sometimes a PIA is a requirement of legislation. But it is always a best practice whenever you implement a project that includes personal health information.

Watch the video now to take a look at what is a PIA, what will a PIA do for you, and when you need a PIA. Just click on the image above to play the video.

Would you like more information about Privacy Impact Assessments for your healthcare practice?

By entering your email address above, you are requesting about upcoming training and related resources. You can opt out at any time, and we'll never rent or sell your email address.

health care, Health Information Act, healthcare, HIA, Netcare, PIA, privacy, Privacy Impact Assessment, What is a PIA?, what is a privacy impact assessment

The Top 3 Agreements Your Healthcare Practice MUST Have (and Why)

Posted on November 29, 2018 by Jean Eaton in Blog

In order to provide services, healthcare practices must collect pertinent information from patients. This data gathering often includes many sources of information, across different types of technology, among multiple vendors. Good business practices and health records management is supported by three agreements your healthcare must have: information manager agreement (IMA), information sharing agreement (ISA), and successor custodian agreement.

For instance, when a patient attends a clinic, their details are nearly always entered into a computer software program to maintain demographic information, manage patient appointments, and to process payments. Often, health service providers (including physicians, pharmacists, chiropractors, dentists, psychiatrists and more) record their patients’ notes into an electronic medical record (EMR).

Patient information is shared between providers where required. For example, when the patient visits a diagnostic lab for testing, results are often transmitted electronically to the ordering physician’s fax machine or to the EMR.

Custodians including physicians, pharmacists, chiropractors, dentists, and psychiatrists, as defined by the Alberta’s Health Information Act (HIA), must follow HIA legislation when they collect, use, and disclose health information.

Often, custodians are also the owners of independent healthcare practices. However, an owner of a healthcare practice is not the custodian if they are not also an active member of a regulated health profession named as custodians in the HIA.  

1. Information Manager Agreement

The HIA allows custodians to contract with other health service providers and vendors for the purposes of providing information management or information technology services, so patients can receive health services, and make payments. This often requires the custodian to share patient information with a vendor (or give them access to) so the vendor can process, store, or provide information as needed.

The custodian selects one or more business to provide the services, equipment, or software to assist in the management of health information. For example: EMR provider, contracted transcriptionist, billing agent, remote backup service, etc. These businesses are known in the HIA as information managers.

Before sharing health information with someone else, the custodian must ensure that the partners and vendors have reasonable safeguards in place to protect sensitive health information. The custodians must ensure that there is a written agreement between the custodian and the information manager. These agreements are known as “Information Manager Agreements.” This requirement is stated in the HIA section 66(2).

The Information Manager Agreement (IMA) is one of three crucial agreements a healthcare practice must have in place.

If You Don’t Have an IMA

If you are a custodian who uses vendors as part of your business and you do not have an IMA with that vendor…

  • You are in breach of the HIA.
  • You may incur fines under the HIA.
  • You may face sanctions and disciplinary actions from your professional regulatory college.
  • Almost certainly, you will encounter conflicts, poor communication, between yourself and the vendor(s) and the other participating custodians in your practice.
  • You may lose control of the health information as reported in the Investigation Report H2013-IR-01from the Alberta Office of the Information and Privacy Commissioner (OIPC).

In a press release from the Alberta OIPC in 2013, Information and Privacy Commissioner Jill Clayton noted that:

“The HIA allows custodians to disclose health information to IT service providers, such as EMR vendors, under an appropriate Information Manager Agreement. When custodians do not sign these agreements, they may find themselves in the unfortunate position of losing control over the health information they need to provide health services.”

Investigation Report H2013-IR-01 (https://www.oipc.ab.ca/news-and-events/news-releases/2013/investigation-report-h2013-ir-01.aspx)

Who Must Create the Information Manager Agreement?

The custodian is responsible to ensure that there is an appropriate IMA created and signed.

The information manager can assist the custodian by preparing templates of the IMA including specific details of the services that they will provide and the safeguards that the vendor will implement to protect personal health information.

Key Points About IMAs

A few important notes about IMAs.

  • IMA must be signed by the custodian.
  • Agreements signed by individuals who are not custodians are not valid under the HIA.
  • Custodians are required under the HIA to have an IMA with the vendor before disclosing health information. If there is no agreement in place, the custodian is in breach of the HIA.
  • Custodians are responsible for the health information that they collect, use, and disclose. Therefore, the custodian is responsible for the IMA and to ensure that the health information will be handled confidently and securely.

Key Points IMA

The custodian can select the best vendor and information manager for the job. The vendor who understands the requirements of the HIA and who can demonstrate that they have implemented the appropriate reasonable safeguards and can assist the custodian to develop an appropriate IMA is, in my opinion, demonstrating a significant competitive advantage.

All healthcare providers in a community practice should spend time when creating their business to establish good business practices, including developing written contracts and agreements to improve the efficiency of the business and to make things happen in the way that they are planned.

Here is a common example

Dr. Alice and Dr. Mark created a welcoming family medical practice in a new sub-division of their city. They each worked hard to attract new patients, hire and train staff, and develop a profitable business.

In the last few years, Alice and Mark had differences of opinion on how to grow their business. In the end, Alice decided that this type of practice wasn’t for her. She decided to leave and join a larger practice in a neighbouring subdivision. Alice wanted to take her patient’s records with her to her new practice and continue to see her patients at the new location.

Mark, who had signed the IMA with the EMR vendor, did not agree to Alice’s request to transfer her patient records to her new group practice.

Alice and Mark argued and eventually involved a professional mediator to help them resolve their business conflict. Hurt feelings between the providers and staff, costly delays in their business and expenses could have been avoided if Alice and Mark had established clear expectations in the event of the termination of their business partnership when they started their group practice. An IMA between custodians in a group practice is a recommended best practice.

When You Have Multiple Custodians in Your Healthcare Practice

When the practice has multiple providers, the owner and custodian frequently assumes responsibility for maintaining the contracts and IMAs with the vendors. Each of the participating healthcare providers may delegate the responsibility of maintaining the vendor arrangements to the custodian owner. This can be achieved with an IMA between the owner / custodian and each participating custodian.

Custodian Owner IMA

Each healthcare provider custodian is considered the custodian of the health information that they collect. The custodians can jointly agree to all use the same EMR. This provides continuity of care for the patients and economy of scale for the participants of the practice.

When the owner/custodian signs the agreement with the EMR, they become the signatory custodian. The EMR vendor takes their instructions from the signatory custodian.

The owner / custodian is now an information manager for all the participating custodians.  but does not become a custodian of the health information provided to them in their roles as an information manager.

For example,

Dr. Bill opened his medical practice, ABC Clinic. Later, additional physicians were recruited to work at ABC Clinic. The physicians are each custodians as defined by the HIA.

Dr. Bill assumes the responsibility for the operations of the clinic including the computer network and the contract with the EMR vendor. Dr. Bill is the information manager for the patient records at the clinic.

Each physician signs an IMA with Dr. Bill and agree that he will continue to manage the patient records on their behalf. Dr. Bill is operating as an information manager.

In his role of the information manager, Dr. Bill must follow the instructions from each physician, the custodian, as it relates to the management of their patients’ records.

2. Information Sharing Agreement (ISA)

When you have more than one physician in your practice, you need an agreement about how you will decide to manage the personal health information in your practice.

An Information Sharing Agreement (ISA) focuses on the internal decision making about all things related to personal health information whereas, an IMA is an agreement with a single vendor about the services that the vendor provides.

ISA IMA

An ISA may include things related to the services that a vendor provides but is not limited to just vendor services.

It also includes decisions about the process to ensure appropriate role based access to personal health information in the EMR, computer network, and paper formats; the regular review of health information privacy and security policies and procedures, ensuring privacy and security awareness training, the regular review of administrative, technical, and physical safeguards in the practice, and so on.

In larger organizations or when several smaller organizations participate in an information sharing initiative, a Data Management Committee may provide oversight and facilitate this process.

An ISA is a requirement of the College of Physicians and Surgeons of Alberta.

Identifying a successor custodian is also a requirement of the College of Physicians and Surgeons (CPSA).

3. Successor Custodianship Agreement

As a business owner, you need to plan a successor to the business. This might be an interim or short-term decision to ensure continuity during an absence or future retirement planning or unexpected illness or death.

In healthcare, physicians and custodians have the added responsibility as the ‘gatekeeper’ for patient records. In the event of a sudden inability to meet these responsibilities, physicians need to identify a successor custodian to ensure appropriate and continued access by patients to their health information for their continuing care and treatment and to ensure that the continuing confidentiality, security, and access to patient records continue to be fulfilled.

Have you identified a successor custodian? Each of the physicians in your group practice should also identify their own successor custodian.

This is a CPSA requirement and should also be included in the Privacy Impact Assessment if you have this information available. See CPSA, Patient Record Retention, s.5:

A regulated member acting as a custodian must designate a successor custodian to ensure the retention and accessibility of patient records in the event the regulated member is unable to continue as custodian. (Reference: Health Information Act Section 35(1)(q)

If you are a chiropractor, the Alberta College and Association of Chiropractors (ACAC) further requires its members to name a chiropractor as the successor custodian to maintain the status of ‘chiropractic’ records. (See the ACAC’s Standards of Practice s5.3 Custodianship of Health Records.)

A chiropractor, as a custodian of health records, is responsible for the care and control of the health records in their practices as required by the Health Information Act of Alberta. A custodian of active chiropractic files must be under the custody or control of an active, registered member of the ACAC.

Note that under the Health Information Act, a chiropractor may disclose files to another custodian who is not a chiropractor, and only a chiropractor may have custody or control of chiropractic files. Chiropractic files disclosed to a non-chiropractor should no longer be considered chiropractic files.

A custodian must implement technical and physical safeguards to protect the confidentiality of the information and privacy of individuals as well as protections against reasonably anticipated threats to the security or integrity of the information. A custodian must also defend against unauthorized uses, disclosures or modifications of the information. Safeguards must be periodically assessed and documented in policies and procedures.

If you are working in an owner/custodian scenario discussed above, clearly identifying a successor custodian becomes imperative. An unplanned absence of the owner / custodian can seriously jeopardize the business and the continuing care and treatment of patients.

The custodian can, but is not required to, name another custodian in the same practice to be their successor. Whatever your decision, ensure that this is well documented and easily accessible to the other custodians and key decision makers in your organization in the event of an emergency.

The best time to create IMA, ISA, and Successor Custodianship Agreements is when you start your healthcare business.

The second best time in now.

What are you waiting for?

If you need assistance, contact Jean L. Eaton, Your Practical Privacy Coach and Practice Management Mentor with Information Managers. I’m here to help you with your Practice Management Success.

Download the FREE Report - Top 3 Agreements Your Healthcare Practice MUST Have

If you are a member of Practice Management Success, login here to access the Top 3 Agreements.

When we know better, we can do better…

Jean L. Eaton is constructively obsessive about privacy, confidentiality, and security especially when it comes to the handling of personal health information. If you would like to discuss how I can help your practice, just send me an email. I am here to help you.

Jean L. Eaton
Your Practical Privacy Coach
INFORMATION MANAGERS 

chiropractors, dentists, health care, Health Information Act, healthcare, HIA, IMA, information management agreement, information manager agreement, information sharing agreement, ISA, medical, physicians, Practice Management Success, successor custodian

What is an Information Manager Agreement (IMA)?

Posted on October 25, 2017 by Jean Eaton in Blog

Having a clear agreement of how patient records will be maintained to ensure privacy, security, and confidentiality in a paper based patient record or in a shared EMR database is the objective of an Information Manager Agreement. This may also be called a Data Sharing Agreement, Information Sharing Agreement, or Business Associate Agreement.

Prenuptial Agreement

In a group healthcare practice, have a clear understanding in writing that sets out how patient records will be collected, used, and disclosed during the group practice is critical to the security of the patient information, health service provider information, and good will between members of the group practice. Think of this as the ‘prenuptial' agreement in your business relationship.

Who is an Information Manager?

In Alberta, the Health Information Act (HIA) defines an information manager.  Generally, it is a special kind of an affiliate, usually a business or a vendor, who provides a service that does some specific task (authorized by the custodian) with health information.  This could be a billing agent, accredited billing submitter, outsourced transcriptionist, EMR vendor or other service provider.

If you are using an EMR vendor, the named individuals on the IMA are the only persons that the software vendor can receive instructions on how to manage the records in the database. Often, this is the physician lead and business owner.

Sometimes, the custodian is also the information manager. For example, a physician (custodian) and business owner may assume the responsibility of ensuring the security of all the patient records authored by other custodians in the group practice.  The physician / custodian / business owner / information manager must follow all the rules of the IMA and HIA.

Not every healthcare practice has an information manager.  Some group practices have many information mangers providing different services.  There are many details and options to consider.  The discussion–and then putting it in writing–is the key to positive business relationship and secure records management.

Avoid surprises – and nasty exits

Some tips to prevent surprises:

  • Take a pro-active privacy role and inform patients how their information will be protected during the routine practice operations and when healthcare providers are added to – or leave – the practice.
  • Decide how you are going to decide about the on-going operational changes to how the software will be used in your practice.
  • Identify in the EMR software who is the primary (or default) healthcare provider for each patient. Talk with your software vendor how best to record this.

It’s never too late to start! If you missed creating an Information Management Agreement or Data Sharing Agreement in your group practice, do it now!

See the Digital Resources for samples that you can use.

Infographic_IMA_Patient_Records_Image

Clinic on the Infographic to download

Download our Infographic, “What is an IMA?”

 

 

 

 

 

 

Watch the Video

business arrangement agreement, data sharing agreement, Health Information Act, HIA, IMA, information manager agreement, information sharing agreement, PIA, Practical Privacy Coach, Privacy Impact Assessment

Can You be Charged Under the Health Information Act ?

Posted on December 2, 2015 by Jean Eaton in Blog

If you access personal health information without authorization, this is a privacy breach.

You can be charged with a fine under the HIA and can face penalties, fines, and sanctions from your professional association.

How frequently are people being charged under the Health Information Act in Alberta for improper access to health information?

“This year alone, there has been one conviction and two charges for improper access of health information. The office is also investigating more than a dozen cases, and they all have the potential to become offence investigations.” Medical record privacy breaches an ‘epidemic' in Alberta,' says commissioner CBC News Posted Oct 15, 2015.

An investigation by the Alberta Office of the Information and Privacy Commissioner (OIPC) has resulted in 26 charges being laid against an individual under the Health Information Act (HIA) as reported in a OIPC News Release December 1, 2015. An incident at the Alberta Children’s Hospital in Calgary was reported by Alberta Health Services to the OIPC. The OIPC conducted an investigation and upon completion of the investigation charges were laid against the individual who allegedly gained access to health information in contravention of HIA.

This is the sixth time charges have been laid under provisions of HIA. The maximum penalty for each offence is $50,000.

Who is a custodian?

The custodian (as defined by HIA a ‘custodian' includes physicians, pharmacists, dentists, chiropractors, optometrists, Alberta Health Services, Minister of Alberta Health and more). The custodian is responsible to take reasonable steps prevent privacy and security breaches including providing privacy awareness training.

Do you have a privacy awareness program?

Do you have a privacy awareness program in your practice that everyone must attend? This includes healthcare providers, students, residents, office staff and, yes, even the non-patient care employees like cooks, cleaners, and maintenance staff.

Have you seen this?

Do You Need Privacy Awareness Training for Your Healthcare Practice?

 

 

fines, Health Information Act, HIA, privacy awareness training, privacy breach

Netcare access to Registered Nurses as Custodians

Posted on September 22, 2014 by Jean Eaton in Blog

Are you a Registered Nurse and work in occupational health, at a First Nations care centre, at a remote nursing station, for a federal jurisdiction or for an authorized homecare service? Are you self employed?

If any of these describe your practice setting, you may be eligible to apply for access to Netcare as a custodian.

One of first things you need to do is submit a Privacy Impact Assessment (PIA) to the Office of the Information and Privacy Commissioner (OIPC).

Privacy Impact Assessment for Netcare (often bundled with EMR implementation Privacy Impact Assessment) must refer to Alberta Netcare Portal (ANP) Privacy Impact Assessment H3879. OIPC will not accept any PIA's referencing the ‘old’ Netcare PIA H1124.

If custodians (physicians, pharmacists, registered nurses, etc) have a PIA accepted prior to August 2012 and they want new / continued access to ANP they must amend their PIA and submit to OIPC.

Netcare (ANP) now requires all Provincial Organization Readiness Assessement (pORA) including completing “Section Two: Mandatory Security Requirements for S2S Sites”.

For more information, see

CARNA website and resources.

Information Mangers blog post, Do you have Netcare

 

Alberta, CARNA, HIA, Netcare, Registered Nurses

Do you have Netcare?

Posted on September 22, 2014 by Jean Eaton in Blog

Netcare's PIA Process

When we provide our personal and sensitive information to a healthcare provider, we want assurances that the confidential information will be respected. We expect that our information will only be shared with people who need to know the information to provide health services to us. Alberta's Health Information Act requires healthcare providers (custodians) to put appropriate safeguards in place to protect the privacy, confidentiality, and security of health information.

Alberta Netcare, also known as the Alberta Electronic Health Record (EHR), is a network of information systems that allows authorized users to see prescriptions, lab results, diagnostic images (e.g. x-rays and ultrasounds) and hospital reports (e.g. hospital discharge summaries). Netcare is used throughout Alberta in hospitals run by Alberta Health Services and Covenant Health and in medical clinics and pharmacies. This is managed by Alberta Health, Government of Alberta. Alberta Health Services (regional health authority), community pharmacies, labs and diagnostic imaging centres and other agencies upload patient information to Netcare.

Netcare Portal PIA

Each custodian is required by Health Information Act to submit a Privacy Impact Assessment to the OIPC. Alberta Health submitted a Privacy Impact Assessment (H1124) in 2006 for Alberta Netcare Portal (ANP) and an updated Privacy Impact Assessment (H3879) in March 2013.

Healthcare providers (custodians) who request access to Alberta Netcare Portal (ANP) must submit a Privacy Impact Assessment to the OIPC that documents the healthcare providers’ computer systems integration with Alberta Netcare.

If you have a previous Privacy Impact Assessment that was accepted by the OIPC regarding your access to Alberta Netcare Portal and it is less than two years old, you can submit a Privacy Impact Assessment Addendum. If you have previously completed a Provincial Organization Readiness Assessement (pORA) you will need to review and update the pORA including completing “Section Two: Mandatory Security Requirements for S2S Sites” and return it to Alberta Health for review and approval.

If you have not yet submitted a Privacy Impact Assessment

You need to submit a PIA to the OIPC for acceptance. This must reference the ANP Privacy Impact Assessment (H3879). You must also complete and submit a pORA including “Section Two: Mandatory Security Requirements for S2S Sites”.

Questions to ask:

1)         When was the last time we reviewed our PIA? (This should be reviewed annually.)

2)         Do we have / do we want access to Alberta Netcare Portal (ANP)? If ‘yes’, then:

3)         Was your Privacy Impact Assessment accepted more than two years ago (before August 2012)? If ‘yes’, then

  • Review and amend your PIA and submit to OIPC including reference to ANP Privacy Impact Assessment H3879 and
  • Review your pORA including “Section Two: Mandatory Security Requirements for S2S Sites”. You will likely need additional support from your computer network vendor and your EMR vendor.

4)         If you are a Registered Nurse and work in occupational health, at a First Nations care centre, at a remote nursing station, for a federal jurisdiction or for an authorized homecare service or self employed, you may be eligible to apply for access to Netcare as a custodian. The above steps also applies to you.

Please share this information with colleagues and your computer network support, EMR vendor, and privacy officer in your organization.

PS

Not all healthcare providers are custodians as defined by Health Information Act. For more information, see our blog, HIA Amendments and Document Management Tip

For more information see:

Alberta OIPC. Bulletin Health Information Act Bulletin August 2014 Update.

Alberta Netcare, Your System Integration with Alberta Netcare.

CARNA Netcare Access to Registered Nurses as Custodians.

Need to do a Privacy Impact Assessment or a Privacy Impact Assessment amendment? We have a course for that!

Protect Your Practice, Your Assets, and Your Patients with Privacy Impact Assessments – A Complete Step-by-Step Course

Alberta, E-course PIA; privacy impact assessment, HIA, Netcare, PIA, pORA, Practical Privacy Coach, privacy officer

Alberta’s Health Information Act (HIA) Amendment

Posted on October 3, 2013 by Jean Eaton in Blog

The Health Information Act (HIA) was amended  was approved by Orders in Council on September 3, 2013.

The amendment includes:

Naming  a non‑regional health authority Family Care Clinic approved by the Minister as a custodian. (HIA s2(1)(g)).

Disclosure of registration information – For the purposes of section 36(c) of the Act, a custodian may disclose individually identifying registration information about an individual without the consent of the individual

(a)    to an ambulance attendant or ambulance operator under the Emergency Health Services Act,

(b)    to the Minister of Health or Minister of Human Services for the purpose of administering the Aids to Daily Living Program, or

(c)    to the Minister responsible for the Seniors Benefit Act and the Seniors’ Property Tax Deferral Act for the purpose of administering those Acts.

Remember to update your policies and procedures!  See our Document Management Tip for a sample policy update that you can use to insert into your Health Information Management and Security Manual.

Alberta, Alberta HIA Amendment, amendment, custodian, Family Care Clinic, HIA, policies, templates
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