- What is ‘personal health information’?
- Why does Unity Health Toronto collect personal health information?
- How does Unity Health Toronto use personal health information?
- Does Unity Health Toronto use personal health information for research?
- Does Unity Health Toronto disclose personal health information externally?
- Do I have the right to access my personal health information?
- If the patient, resident or client is not capable of providing consent to collect, use or disclose their personal health information, who can give consent?
- My relative is a patient, but they are not capable of asking to see or review their own health record. As the Substitute Decision Maker, am I allowed to access my relative’s records?
- What kind of information can staff members provide to family and friends if they call or ask about my condition?
- What happens to my health record after I am discharged?
- Does any of my health information leave Canada?
1. What is ‘personal health information’?
‘Personal health information’ is any information that identifies an individual and connects that individual to receiving care at Unity Health Toronto. It includes information that relates to an individual’s physical or mental health, diagnoses, testing, treatment, family health history, Substitute Decision Makers, and/or care providers.
2. Why does Unity Health Toronto collect personal health information?
In order to provide the best possible care for you and your family, it is necessary for us to collect, use and disclose personal health information. We collect only information that is needed to provide health care and support to our patients, residents and clients. If we need information for other reasons (e.g. to get your feedback, to understand our patient population, to do some types of research), we will ask for your consent before collecting this information.
3. How does Unity Health Toronto use personal health information?
In addition to using your personal health information to treat and care for you Unity Health Toronto is also allowed to use it to:
- Conduct risk management activities
- Educate our agents
- Conduct research
- Compile statistics
- Comply with legal and regulatory requirements
- Fulfill other purposes permitted or required by law
- Plan, administer, and manage programs, services and internal operations, and enhance your safety and security in the hospital
- Get payment for your treatment and care (from OHIP, WSIB, your private insurer or others)
- Conduct quality improvement activities (such as sending patient satisfaction surveys)
4. Does Unity Health Toronto use personal health information for research?
Yes, Unity Health Toronto uses personal health information for research. The rules for research are set in the law (PHIPA) and must be followed. Often you are asked for your consent to participate in research, but some types of research (that carry a very low risk of harm to you) may be approved by the Research Ethics Board to begin without your consent.
Our St. Michael’s site also houses the Li Ka Shing Centre for Healthcare Analytics Research and Training (LKS-CHART) research program, which uses the personal health information stored in Unity Health Toronto’s enterprise data warehouse. The enterprise data warehouse contains a copy of all of the major sources of personal health information in the hospital. With that, we can do program planning, risk management and research. With the proper approval of the Research Ethics Board, this data may be used as part of retrospective research studies (where we look at personal health information created in the past and over time). In some studies, we use ‘predictive analytics’, where machines help us identify patterns that are occurring and inform decisions around a diagnosis or treatment.
You can see which studies are being conducted in the LKS-CHART research program by visiting https://www.chartdatascience.ca/
If you do not want your personal health data to be used in any retrospective LKS-CHART research, please contact the Privacy Office. Please note that if you register to be excluded from retrospective research, you may still be asked in the future if you would like to participate in prospective studies, such as clinical trials.
5. Does Unity Health Toronto share my personal health information externally?
We may send your information externally for the following reasons:
a. To support your care
Unless you tell us not to, your personal health information is disclosed to care providers outside of Unity Health Toronto who are involved in your ‘circle of care’, only if the information is needed to provide you with care or assess whether it is appropriate to provide you with care (for example, to refer or transfer you).
This may include sending your personal health information to a care provider outside of Unity Health Toronto to get a consultation or second opinion on your situation, without you having to visit that care provider yourself. If you are capable of consenting, we will talk to you about this consultation. If you can’t consent, and need urgent care, we may share your information without your consent to get the expert opinion we think that you need. In both cases, we record what the consulting care provider said in your Unity Health record.
Often we use electronic systems that are shared (accessible) by health care organizations across Ontario. When you are referred to or go to visit a new care provider, these systems allow us to share your personal health information with your care providers at other institutions and to see the information that they produce about you. These systems securely share electronic information to provide timely and coordinated patient care.
At Unity Health Toronto, the following shared electronic systems are used to support patient care:
|Connecting Ontario (cON)||eHealth Ontario||ConnectingOntario (cON) is a central repository that stores core elements of patient’s health records (e.g. common diagnostic test results, discharge summaries) that another provider could use for continuity of care. The system is used for patients of any age, experiencing all types of conditions.
For more information please visit the ConnectingOntario website.
|Patient Results Online (PRO)||University Health Network||Patient Results Online (PRO) enables many sites throughout the Toronto Central Local Health Integration Network (TCLHIN) to access core elements in the health records at each site. The system is used for patients of any age, experiencing all types of conditions.|
|Ontario Laboratory Information System (OLIS)||eHealth Ontario (on behalf of the Ministry of Health and Long Term Care)||Ontario Laboratories Information System (OLIS) allows hospitals and community laboratories to share laboratory, cytology and pathology test results.
For more information please visit the eHealth Ontario website.
|Digital Health Drug Repository (DHDR)||eHealth Ontario (on behalf of the Ministry of Health and Long Term Care)||Digital Health Drug Repository (DHDR) allows care providers to see medications recorded in MOHLTC repositories.
For more information please visit the eHealth Ontario website.
|Hospital Diagnostic Image Repository Services (HDIRS)||Scarborough Health Network||Hospital Diagnostic Image Repository Services (HDIRS) allows hospitals to share diagnostic images and results. This protects patients because it avoids duplication of tests and may decrease the expose of patients to radiation.|
|Diagnostic Imaging Repository GTA West (DI-r West)||CGI||Diagnostic Imaging Repository GTA West (DI-r West) allows hospitals to share diagnostic images and results. This protects patients because it avoids duplication of tests and may decrease the expose of patients to radiation.|
|Resource Matching & Referral (RM&R)||University Health Network (on behalf of the Toronto Central LHIN)||Resource Matching & Referral (RM&R) allows care providers to match patients to the right health care and community services, through referrals and the transmission of some information to support the referral.
For more information please visit the RM&R website.
|electronic Child Health Network (eCHN)||eCHN/SickKids||Child Health Network (eCHN) is for children’s medical records. About 40 hospitals in Ontario provide eCHN with laboratory results, doctor’s notes, X-rays and visit information. Community pediatricians may have access to the system.
For more information please visit the Electronic Child Health Network website.
|Integrated Assessment Record (IAR)||CCIM (on behalf of the Ministry of Health and Long Term Care)||Integrated Assessment Record (IAR) enables the sharing of standard assessments completed in inpatient mental health units, long term care homes, community support services, community mental health services, and community addictions services.
For more information please visit the CCIM website.
|Provincial Hospital Resource System (PHRS)||Hamilton Health Sciences (on behalf of CritiCall Ontario)||The Repatriation Tool enables hospitals to share information necessary for the purpose of transferring patients from highly specialized acute care hospitals to other acute care hospitals for the remainder of their care.
For more information please visit the CritiCall website.
|Health Report Manager (HRM)||OntarioMD||Community-based physicians and nurse practitioners who use certain EMRs in their practice can receive hospital reports through HRM, rather than in the mail or through fax.
For more information please visit the OntarioMD website.
Please contact the Privacy Office or talk to the clinic/unit manager if you do not want your information to be shared with external care providers. We will discuss the positive and negative consequences of your decision with you.
b. To fundraise
Unless you tell us not to, we will give your name and address to our foundations for fundraising:
- St. Joseph’s Health Centre Foundation: https://supportstjoes.ca/
- St. Michael’s Hospital Foundation: http://www.stmichaelsfoundation.com/
- Providence Healthcare Foundation: https://www.providence.on.ca/foundation
You can also contact each foundation to be removed from their mailing list.
c. To enable a religious or spiritual advisor to visit you in the hospital or Houses
Unless you tell us not to, we may provide your name and location to an appropriate religious or spiritual advisor (based on the religion that you gave to us when you registered) to visit you in the hospital or Houses.
d. To communicate with your family or friends
If we have your consent, we will communicate your information to your next-of-kin, friends, or family.
e. To adhere to the law
The Personal Health Information Protection Act requires and permits us to give some of your personal health information, where appropriate, to a number of groups, including but not limited to:
- Ministry of Health and Long-Term Care e-health projects such as the Enterprise Master Patient Index (EMPI) Wait Time Information System
- Registries and entities prescribed in regulation such as Cancer Care Ontario, the Cardiac Care Network, INSCYTE, Pediatric Oncology Group of Ontario, the Institute for Clinical Evaluation Sciences, the Canadian Institute for Health Information, Children’s Hospital of Eastern Ontario, and the Ontario Institute for Health Research
- Researchers if the research has been approved by our Research Ethics Board
- The Medical Officer of Health to report communicable diseases
- The Workplace Safety & Insurance Board
- Law enforcement officers who present a warrant or subpoena, or to aid in an investigation
- The Children’s Aid Society where child abuse is suspected; the children’s lawyer
- The public guardian and trustee
- The coroner
6. Do I have the right to access my personal health information?
Yes. You also have the right to request corrections. See our How to Access Your Health Record page for more information.
7. If the patient, resident or client is not capable of providing consent to collect, use or disclose their personal health information, who can give consent?
A Substitute Decision Maker will be asked to make these decisions. According to the Personal Health Information Protection Act, the individual(s) who is/are highest on the following list will have the authority to approve or refuse consent to the collection, use and/or disclosure of your personal health information if that person is capable of consenting, is at least 16 years old or the parent, is not prohibited by court order, is available and is willing to assume the responsibility of making the decision.
- Court appointed guardian for personal care
- Attorney for personal care
- A representative appointed by the Consent and Capacity Review Board
- Spouse or partner
- Child or parent (or other person lawfully entitled to take the place of a parent)
- Parent who only has right of access
- Brother or sister
- Any other relative related by blood, marriage, or adoption
- Public guardian and trustee
8. My relative is a patient, but they are not capable of asking to see or review their own health record. As the Substitute Decision Maker, am I allowed to access my relative’s records?
Yes. A Substitute Decision Maker has the same right to access the patient’s record as the patient would if your relative were capable. You may be asked to complete a form requesting access or to provide evidence that you are the patient’s Substitute Decision Maker.
9. What kind of information can staff members provide to family and friends if they call or ask about my condition?
Unless you object, we will provide general information about your health status. This includes the name of the clinical program you are in, where your room is located, and your general health status, such as “doing well” or “no change.” If someone is seeking more detailed information on your health, they will require written consent from you or your Substitute Decision Maker.
10. What happens to my health record after I am discharged?
Upon discharge, health records are kept in for a minimum of 10 years, in accordance with provincial legislation.
11. Does any of my health information leave Canada?
While Unity Health Toronto takes steps to avoid processing or storage of data outside of Canada where possible, some support services are provided by vendors subject to U.S. laws or in the U.S. As a result, patient personal information will be subject to the laws of the foreign jurisdiction which may be different, and less protective, than those of Canada.