Information and Privacy Commissioner, Frank Work, has confirmed that individuals can ask that disclosure of their health information through Alberta Netcare, Alberta’s electronic health record, be limited. On conclusion of a recent investigation, it was recommended that Alberta Health and Wellness take steps to fully implement the technology that will allow custodians to limit the disclosure of health information through Alberta Netcare and communicate the availability of this option to Netcare users and Albertans.
The case involves a woman who asked her pharmacist to limit the disclosure of her health information through Alberta Netcare, but was told the pharmacist could not refuse to disclose information to AHW. The woman then contacted AHW to request that her information be “masked” in Alberta Netcare, but was directed to make her request to other custodians.
The Health Information Act (HIA) section 58(2) requires custodians to consider the expressed wishes of individuals when deciding how much health information to disclose. AHW has decided to manage expressed wishes in Alberta Netcare by masking information. Masked information is hidden until an authorized user who is providing care to a patient decides to unmask the information.
The investigation found that AHW built masking capabilities into Alberta Netcare as early as 2006, but did not did not formalize the processes required to allow Netcare users to apply masking until April 2008. The investigation also found that AHW had not adequately communicated the availability of masking as a means to manage an individual’s expressed wishes to health care providers nor had they developed the administrative tools required to fully support implementation of masking.
Mr. Work says “While I commend Health and Wellness for building important privacy features like masking into the system, it is not very useful to develop a masking system and not support its implementation or advise end users that it is available to them. In principle, AHW’s approach to masking information in Alberta Netcare is sound but implementation has been weak. The Department acknowledges this gap and has committed to developing an enhanced masking implementation plan for my review and comment before the end of the month. We will continue to work with AHW on this issue.”
Other recommendations that have been accepted by AHW include the recommendation to respond to the complainant’s request that her information be masked and expand Alberta Netcare communications materials to inform and educate patients about how a masking request can be made. The Department has taken immediate steps to implement these recommendations.