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A sickening side-effect of the eHealth revolution

Ontario privacy commissioner Ann Cavoukian

The digital revolution is poised to transform Canadian health care, promising more timely access to doctors and streamlined service that is expected to improve the patient experience while reducing waste and unnecessary testing.

But the technological changes – from an app that connects surgical patients to their doctors, wherever they are, to the dream of a single electronic health record a patient has for life – also come with a downside: the possible breach of privacy.

Ontario's Privacy Commissioner Ann Cavoukian says she is a huge supporter of electronic health records but stressed they must be done in a secure manner, adding that nothing deserves greater protection than a patient's medical information.

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In 2011, her office received 135 reported health-information privacy breaches – ranging from a lost USB key to a paper medical record found in a garbage can in a back alley – of which 122 were informally resolved, one was closed by an order and another 12 are being probed.

"Of course we need innovation, but you have to wrap a layer of privacy and security around the innovation," Ms. Cavoukian said in an interview. "Additional layers of protection are so important," she added, saying it's paramount to address privacy concerns early on, with the creation of the device, app or other new technology.

While there are no national figures comparable to Ontario's, a new survey suggests that more than 3 per cent of Canadian patients have already experienced breaches of medical information by a hospital employee, health-care provider, family member or some other person.

And many who have endured such a breach have become targets of gossip, had the information used against them in a lawsuit or required personal time to recover, according to the online survey of 1,002 Canadian patients done in October on behalf of FairWarning Inc., a software company that provides privacy-breach detection for the health-care industry.

"That causes a loss of trust," Kurt Long, FairWarning's chief executive officer, said in a telephone interview from St. Petersburg, Fla. "…We are moving towards a digital era, where more and more things are electronic so more so than ever before, the health-care provider needs to know everything about it."

By the end of 2016, the medication, diagnostic imaging, laboratory results and immunization records of every Canadian will be available electronically to doctors, nurses and other clinicians, according to Dan Strasbourg, spokesman for Canada Health Infoway.

Gail Perry, senior legislative and policy assistant for the Ombudsman of Manitoba, a province that has embarked on an electronic system called eChart, said "everybody's a pioneer in this." She recognizes that a leak of health information could be devastating.

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"If something goes awry, they can lose their job, benefits, and their relationships," Ms. Perry said.

In the survey, 83.9 per cent of patients agreed that, if the chief executive and senior management were made aware of risks but failed to act – and there is a serious breach – they should be fined or lose their jobs.

Mr. Long of FairWarning points out that privacy breaches can occur with paper records as well. And he argues that "electronic health records provide a huge cost benefit if done right."

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