From the Canadian Medical Association

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Dr. Robert Ouellet
President
Canadian Medical Association

The details you provide to your doctor during an office visit are often some of your most personal information. You make these facts available so that you can receive the best care possible, and you do so with the knowledge that the information will remain confidential.

Confidentiality, after all, is the cornerstone of the doctor-patient relationship. To physicians, it is almost a sacred trust. Under certain circumstances, of course, physicians are obliged by law to provide details about your health or the care you have received. The list of these circumstances is not long. We have to provide proof that you have seen us in order to get paid, and we are obliged to report it if a patient has a highly infectious disease. In very rare cases, we must report it if we believe patients may be a threat to themselves or others.

I doubt that many Canadians would object to these exceptions.
Unfortunately, recent technological advances now mean that ensuring confidentiality is not quite as straightforward as we, the medical profession, or you,the patients, might wish. With the increasing proliferation and growth of electronic databases storing health information on hundreds of thousands of Canadians, the issue has become more complicated.

The switch from paper records to electronic medical records (EMRs) provides huge advantages for you and your doctors: fewer problems tracking down details about your past care, for instance. But many Canadian regional health authorities now require that physicians give them at least some of your information for storage in large databases. They provide easy access to vast quantities of raw information, which can be useful to researchers and planners. Demand for this access is growing.

The Canadian Medical Association (CMA) feels very strongly that information may be shared in this manner only after you have given your okay. Our opinion surveys show that you feel the same way.

Some argue that this type of health information can easily be made anonymous and will not be associated with specific patients. Therefore, you do not need to provide explicit permission for others to use it. But even if personal health information is stripped of facts that will identify you — your name and address, for example — it may still be detailed enough to indirectly reveal your identity by other parameters.

As the stewards of your health information, Canada’s physicians are worried. Regardless of the progress in data-management tools, we still consider your privacy one of our greatest responsibilities. To help us fulfill this responsibility, the CMA published its Health Information Privacy Code a decade ago. This document sets out important guidelines and recommendations for ensuring that the confidentiality of your health records will be maintained.

However, the world is changing rapidly, and as we enter a new electronic era, the code needs updating to meet emerging challenges. Right now, we are in the process of doing exactly that so we can produce a new document that will provide clearer guidance for your doctor on when, and how, to protect your personal health information.

Physicians want and need new knowledge so that they can improve the care they give their patients, and health researchers need more efficient ways to analyze the health data that can create such knowledge.

However, this must not come at the expense of your privacy and your right to determine who has access to your personal health information. As physicians, we won’t allow it.