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As in life, the only constant in health care is change

“There is nothing permanent except change.” - Heraclitus

These famous words of the Greek philosopher, Heraclitus, have never rung truer than they do today.

As with everything else in life, the delivery of health care continues to change and evolve, especially over the last two decades, during which we have seen exponential growth in digital technologies. Catapulted by the pandemic, the digitization of health care services has accelerated even more rapidly to adapt to the virtual world in which we all find ourselves currently living. The ravaging impacts of COVID-19 on peoples’ lives have reminded us all of the indispensable need to share health information in a coordinated, efficient and timely manner, and of the critical role that public health officials and researchers play in understanding illness and developing effective treatments.

That’s why my office selected Trust in Digital Health as one of the four strategic priorities that will focus our efforts now and into the future in order to enhance our positive impact and our value added for Ontarians. Our goal is to promote confidence in the digital health care system by guiding custodians to respect the privacy and access rights of Ontarians, and by supporting the pioneering use of personal health information for research and analytics to the extent it serves the public good.

While change is inevitable, custodians remain obligated to comply with Ontario’s health privacy law, the Personal Health Information Protection Act (PHIPA). But then, even PHIPA has undergone significant changes recently.

Ontario’s health privacy law is a living document that has transformed over time, adapting to changes in society and technology. Nearly twenty years ago, when PHIPA was first enacted, the most advanced features of smartphones — for those of us who even had one — were email and text, on a monochrome screen, no less. Today, you can browse the internet, watch movies, and order dinner on your smartphone. You can even use it to meet virtually with your health care provider. You can sync it to wearable devices that monitor your health and store biometric information about your heart rate, temperature, respiratory data, sleep patterns, movements, and exercise levels.  You can even share this data with clinical researchers or with your health care providers, and the sharing of digital health information among custodians to deliver more efficient and effective health care has become routine practice.

To reflect these advances in technology, various changes to PHIPA have come into effect. In March 2020, amendments were made to address the ways personal health information is increasingly being collected, used, and disclosed in digital formats. These changes may be incremental, but they are nonetheless consequential.

To further our goal of promoting trust in digital health, the IPC has issued a new publication called Digital Health under PHIPA: Selected Overview.

This new publication is designed to help health information custodians navigate the recent round of PHIPA amendments. It provides an overview and explanation of these recent changes, hopefully in a manner that custodians will find easily accessible. Topics include the electronic health record (EHR), interoperability of digital health assets, electronic audit logs, consumer electronic service providers, and access to records in electronic format.

Public trust in how our personal health data is processed for good purpose is critical for the successful adoption of digital health technologies and ultimately improving health care outcomes for everyone. I recommend that all health information custodians read our new publication and familiarize themselves with the new provisions to remain in compliance with PHIPA as they integrate digital information technologies into their health care delivery practices.

Our office is always here to help if you have any questions about this publication or other matters related to health information and privacy.



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