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Bill 119 promotes transparency and patient-centred process

Ontario’s newly passed Bill 119 is designed to provide more transparency to patients and their families, as well as promote information-sharing between health organizations about critical incidents, says Toronto health lawyer Michael Gleeson.

The new legislation, passed in May, amends the Personal Health Information Protection Act (PHIPA) and replaces the Quality of Care of Information Protection Act (QCIPA), 2004.

“Bill 119 is important because there has been much criticism of QCIPA. It was often seen as being used to prevent patients and/or their loved ones from getting information about a critical incident — an unintended event that has a negative outcome for a patient and occurrs in the course of the patient receiving health care,” he tells AdvocateDaily.com. “Obviously, patients and their loved ones would like to have an understanding of what happened.”

Gleeson, who is senior corporate counsel with DDO Health Law, says the changes to QCIPA are designed to make the law more patient-centred.

“It stresses transparency and a patient’s role in the investigation of incidents,” he says. “It also promotes the sharing of information between health-care organizations so that lessons learned by one can be shared with other health-care organizations within the province and everyone can benefit.”

Gleeson and his colleagues at DDO instruct hospitals and other health-care organizations about Bill 119 to ensure they are in compliance with the new law. 

“Right now, some hospitals are unclear about what information can be shielded and designated as ‘quality of care information,’” he says. 

“We can help them interpret the legislation to make sure they understand what information can be held confidential and what should be shared with patients. We also help them understand what role patients should play in the investigation of critical incidents. Part of this legislation says that nothing in QCIPA should interfere with a health facility’s requirement to offer to interview patients as there should be a definite role for patients to play in the investigation.”

Gleeson says health-care organizations need to know how QCIPA interacts with other legislation, including the Public Hospitals Act, which instructs on the investigation of critical incidents. 

Bill 119 also brings new definitions for “critical incident,” “quality of care functions,” and "quality of care information.”

“Together, these new definitions decrease the likelihood of QCIPA being an impediment to individuals receiving information about a critical incident that occurred to them,” Gleeson says. “The law states that certain information can’t be shielded by confidentiality and must be shared with the patient.”

In addition, there have been changes to the definition of "health facility." In the old QCIPA, health facilities were restricted to public and private hospitals, psychiatric facilities and independent health facilities. In the new Act, the definition includes those entities, as well as allows the ministry to designate other health facilities to comply with the regulations. 

“That makes us think that the ministry is contemplating expanding the application of QCIPA to a greater number of health-care providers so we want to keep an eye on the regulations that are issued under this Act because the Act may soon be made to apply to other health-care providers,” Gleeson says. 

"It would be useful because if other health-care providers could share information about critical incidents, those lessons would be available to a greater number of facilities and improvements to care could be made on a wider scope," he says. 

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