Accounting for Law

Paper health records can cause serious privacy issues: report

By Kate Dewhirst

new Canadian study published in the American Medical Association journal JAMA found that hospitals have a serious issue when it comes to throwing away paper copies of health records.

The study was undertaken by a group at St. Michaels Hospital in Toronto. They went through the recycling and garbage of five teaching hospitals.

The results were unsettling.

They found patient identifiable information from the recycling and garbage from all inpatient units, outpatient clinics, emergency units, Intensive Care Units, and physician offices. The information ranged from fairly low sensitivity to high sensitivity content including actual clinical notes, diagnostic test results, prescriptions, and financial information.

The new study made headlines in Canadian news outlets.

This is not a new issue. The Information and Privacy Commissioner of Ontario has reviewed similar cases in the past at a doctor’s office and when a health facility’s shredding got sold for scrap paper to a film crew.

But it is a big issue and one that every health information custodian in Ontario needs to act on.


  1. Teach your team to shred every piece of paper. Only recycle things like cups and cutlery. Shred every piece of paper in a clinical setting.
  2. Avoid using printouts for scrap paper. Calling all environmentalists! Be very careful about your instinct to reuse paper in the clinical environment. If you happen to reuse a piece of paper and that paper has patient information on the other side – you are setting yourself and your team up for mistakes.
  3. Don’t print. We are in a digital age – but what we find is that clinicians print out reports for easier viewing and review. Whenever you can, read clinical reports online without making a paper copy.
  4. Ensure there are lots of shredding bins available. Make it easy for team members to shred.

Postscript update:

Something amazing happened. One of my clients, an executive director in a family health team, shared this update with their team and reminded them to be careful about paper. She heard back that people were taking paper health records off-site with them. She’s now able to work with the team to prevent that and find alternatives. YAY!

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