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Health Information Management > Lecture 3 > Flashcards

Lecture 3 Flashcards

Midterm 1

1
Q

What is the difference between paper and electronic health records?

A
  • Traditional collection of PHI was in paper format which was easy to maintain since the record could only be in one place at a time
  • There has been a movement to electronic health records
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2
Q

Benefits of EHR

A
  • Greater facilitation of PHI transmission
  • Can be viewed simultaneously by many
  • Tighter security possible
  • Easier data collection and transmission for research
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3
Q

Drawbacks of EHR

A
  • Loss of control of where the PHI goes
  • Easy and unauthorized access
  • Loss of control over how ones health info is used
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4
Q

How have EHR concerns been addressed?

A
  • Government put legislation in place to protect PHI
  • Collection and dissemination of PHI was already guarded under previous legislation
  • Legislation was updated under context of EHR
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5
Q

What is privacy

A

the ability of an individual to control their own personal information

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6
Q

what is security?

A

electronic and physical measures put in place to protect personal information

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7
Q

What is confidentiality?

A

the responsibility of an individual privy to personal information to not disclose

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8
Q

Mechanisms to protect privacy, security and confidentiality

A

Privacy: Signed consents for release
Security: Locked rooms and doors (paper), username and password (electronic)
Confidentiality: Organizational policies

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9
Q

Federal policies governing PHI

A
  • CSA 10 principles
  • PIPEDA
  • Provide a foundation and framework for legislation and policies governing PHI in Canada
  • Documents are not specific to PHI
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10
Q

CSA 10 Principles

A

-first published in 1996
-Preceded by OECD Guidelines on the Protection of Privacy and Transborder Flows of Personal Data
Two main categories of principles:
-How the organization should collect, use, disclose and protect personal information
-The individual’s right to access the information and correct it if necessary

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11
Q

What are the 10 CSA Principles?

A
  • accountability
  • identifying purpose
  • consent
  • limiting collection
  • limiting use, disclosure and retention
  • accuracy
  • safeguards
  • openness
  • individual access
  • challenging compliance
  • See descriptions in lecture 3*
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12
Q

What is PIPEDA

A
  • jan 1 2001- jan 1 2004
  • Covers: individual rights under the act and responsibilities of businesses/organizations
  • provinces were required to have substantially similar legislation otherwise PIPEDA would apply
  • includes 10 CSA Principles
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13
Q

What are jurisdictional variations?

A
  • jurisdictions adopted similar legislation for health information (QC, ON, AB, BC)
  • Jurisdictions adopt legislation according to what they hold inviolate
  • jurisdictional legislation governs our day to day activity
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14
Q

PHIPA

A
  • Based on CSA principles with specific requirements for Ontario
  • came into effect November 2004
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15
Q

Scope of PHIPA

A
  • Health information custodians that collect, se and disclose PHI
  • non-health information custodians where they receive PHI from a HIC
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16
Q

Strengths of PHIPA

A
  • implied consent for sharing of PHI within circle of care
  • Creation of health data institute to address criticism of ‘directed disclosures’
  • Open regulation-making process to bring public scrutiny to future regulations
  • Adequate powers of investigation to ensure that complaints are properly reviewed
17
Q

General record management processes (musts)

A
  • take reasonable steps to ensure accuracy
  • maintain security of PHI
  • have contact with a person who can ensure compliance with the Act and respond to access/correction requests and inquiries and complaints from the public
  • have information practices in place that comply with the act
  • make available a written statement of information practices
  • be responsible for actions of agents
18
Q

Concept of PHIPA ‘consent’

A
  • required for collection, use and disclosure of PHIPA
  • Must be the consent of the individual, knowledgeable, relate to the information, not be obtained through deception
  • expressed or implied
19
Q

What is implied consent?

A
  • custodians can imply consent when disclosing PHI to other custodians for the purpose of providing health care for the individual
  • exception is when the individual withdrawals consent (lock box concept)
20
Q

PHIPA Right of Access and Correction

A
  • expands and codifies the common law right of access
  • rights to access all records of PHI in custody of a HIC
  • right to correct records
21
Q

3 options to correct records

A
  1. Strike Out: Information in a manner that does not obliterate it
  2. Label: Information as incorrect and sever it from the record, maintaining a link to it
  3. Inform Persons: Accessing the record of information cannot be corrected and where to find the correct information
22
Q

What is a statement of disagreement?

A
  • if the correction is refused the individual is entitled to attach a statement of disagreement
  • custodian must make reasonable effort to notify everyone that correction was made
23
Q

CHIMA Position Statement

A
  • access and disclosure of personal health information
  • provides overview of collection, use and disclosure of health information and the professionals who carry this out
  • provides practical commentary on how to implement the CSA 10 principles
24
Q

General Practices for privacy control

A
  • security, monitoring and auditing of access
  • privacy impact assessments
  • privacy audits
  • information sharing agreements
25
Q

Practical tips from the IPC

A
  • don’t discuss confidential information in public areas
  • Don’t leave PHI where it can be viewed by the public
  • don’t leave computer terminals with PHI readily visible (log off before leaving terminal)
  • Access only the information required
  • Don’t reveal confidential information to others unless they need to know
  • Wear your ID badge at all times
  • Keep your password to yourself
  • Shred papers that contain PHI when no longer in use

Health Information Management (4 decks)

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