Collection of Personal Health Information (PHI)
The purpose of collecting personal health information is to provide health services to clients. In all but exceptional circumstances, Hospice Toronto uses consent to collect, modify, use and disclose personal health information. In general, the information collected consists of:
- The client’s name, address and/or Ontario Health Card number
- Facts about health, health care history and the health care that the client has been provided
Personal information is collected through face-to-face meetings with Hospice Toronto staff, over the telephone, and through written or electronic documents. Information is collected at an initial meeting and/or through initial submission of admission applications, over time as care and service is provided and when follow-up is completed. The documentation of personal health information by Hospice Toronto on paper and in electronic format must comply with internal standards, policies and procedures related to confidentiality, the security of information and professional practice standards.
Personal health information of clients is collected in a number of ways:
- Personal Health Information is received as a referral, care planning process, and as a component of ongoing assessment of health status from Community Care Access Centre, clients, family members, friends, or other community support service agencies
- Through ongoing documentation and communication in clients’ health records
Use of personal health information
The main purpose of using personal health information is to plan, deliver and evaluate care and service for our clients. It is also used to make decisions about the types of services required and to communicate with other service providers involved in that person’s care. When necessary, personal health information may be used to investigate and manage potential risks for others who may be affected by a health risk.
Non-identifying information related to residents’ and clients’ care and service is used for administration, management, strategic planning, decision-making, research, fundraising and allocation of resources within the home to meet legal and regulatory requirements.
Disclosure of personal health information
Personal health information is disclosed to other health care workers involved in the circle of care, based on clients’ implied consent, to provide the health care workers with the information they need to provide appropriate care when a client is referred and care is transferred. Other than to those in the circle of care, personal health information is usually disclosed only when the client gives consent. If a client wishes to refuse consent to disclose information, he/she may do so by notifying the Director, Clinical Services. Personal health information will be disclosed without consent in exceptional circumstances. These situations include emergency situations in which consent is not possible and the disclosure of personal health information that is required to meet legal and regulatory requirements [e.g., mandatory reporting requirements of the Ministry of Health and Long-Term Care (MOHLTC) and Public Health, law enforcement requests]. Personal health information is sent to hospitals through Emergency Medical Services or in emergency situations, by phone and fax.
Consent for the collection, use and disclosure of personal health information
Requiring consent means that clients must give specific permission for the collection, use and disclosure of personal health information. Consent is ordinarily required:
- Upon admission to Hospice Toronto’s programs and services
- Upon sharing of information with the clients’ circle of care including the interdisciplinary professional team, and clients’ family, friends and caregivers
- To assess suitability and obtain information about the client’s needs for community- based services programs
- Upon referral of a client to other community-based services programs
When clients give consent, they are informed of how their personal health information will be used. Clients may give consent that is limited to certain uses of their personal health information. Clients may also withdraw their consent for Hospice Toronto to use their personal health information for particular purposes. Personal health information is not disclosed without consent unless the sharing of this information is required or permitted by law. In some situations, implied consent may be used by Hospice Toronto, such as in situations in which health care is required but it is not reasonably possible to obtain consent.
Consent to disclose personal health information is also not ordinarily required:
- In situations of imminent harm and risk to the person or others directly affected
- To the Medical Officer of Health for public health protection purposes
Consent is not required for the disclosure of non-identifying information:
- For the purposes of research to be performed in accordance with a research plan approved by a research ethics board
- To a prescribed entity for the purpose of analysis with respect to the management of the health care system
- If the MOHLTC directs a health information custodian to disclose information to a health data institute for the purposes of analysis with respect to the management or evaluation of the health system
- For fundraising purposes.
Access to personal health information
Clients have the right to request access to their personal health information, subject to the provisions of PHIPA. Hospice Toronto’s policy states that individual clients or the legally authorized substitute decision-maker may make a request for access to the client’s personal health information. A designated Hospice Toronto staff member will be provided, at a mutually convenient time, to explain and help the client understand Hospice Toronto procedures. However, access to this information may be denied, for specific reasons outlined in the legislation, including situations in which the sharing of the personal health information could reasonably be expected to harm the client’s or others’ mental or physical health and safety.
Clients also have the right to ask Hospice Toronto to correct a record if it is inaccurate and to ask for and receive, with limited exceptions, a copy of their personal health record or portion thereof, as described in PHIPA. Although clients have the right to see their personal health information, this right does not automatically extend to their family members and/or friends. If consent is provided to let a family member or friend see personal health information, then the family member or friend may be allowed access to the part(s) of the personal health record that the client has consented to let them see. If the client is unable to give consent and/or has a legally authorized substitute decision-maker, then this person may be allowed access to the personal health information, in accordance with their legal authority. This person is bound by law to act on the client’s behalf and must make decisions based on their knowledge of what the client would wish done if he/she were able to decide.
Questions about access to or correcting personal health information can be directed to the Director, Clinical Services. However, individuals may also make a written request for access or to correct personal health information under PHIPA, through the City of Toronto Corporate Access and Privacy (CAP) Office at (416) 392-9684.
Family and friends
Personal health information is private. Unless the law authorizes sharing it with others, Hospice Toronto cannot and will not give out any personal health information without consent. However, it is understood that the client’s family and friends may inquire about their well-being from time-to-time. Unless the client consents to specifically share information to identified family and friends, no information will be provided to anyone making an inquiry about a client.
Formal requests and complaints
Hospice Toronto is committed to resolving all concerns or complaints and encourages individuals to first contact the department involved. Concerns or complaints about access or privacy practices within the organization can be directed to the Director, Clinical Services. For concerns or questions about access or privacy practices in community-based service programs, contact the Director, Clinical Services.
For general concerns or complaints about privacy practices, individuals are encouraged to contact the Executive Director. You can also lodge a complaint regarding access or privacy practices of Hospice Toronto directly with the Office of the Information and Privacy Commissioner (IPC) at 416-326-3333, or through their Web site at www.ipc.on.ca.