Alberta's privacy and information commissioner is urging the government to amend a new health care bill or put it on hold, so the public can look at proposals she feels could put the personal information of nearly every Albertan at risk.
In a letter sent to Health Minister Tyler Shandro on Friday, Commissioner Jill Clayton laid out out her concerns with Bill 46, which proposes amendments to three pieces of legislation, including the Health Information Act (HIA). She also listed 10 ways the HIA could be improved.
Clayton has questions about measures in the bill that would grant out-of-province providers full access to patients' electronic health records through Netcare and expand the purposes the information could be used for beyond the provision of health care.
She calls it "shocking and disappointing" that the bill ends a requirement for Alberta Health, Alberta Health Services and the Health Quality Council of Alberta to perform privacy impact assessments when they share information.
Clayton argues the changes have wide-reaching effects for many Albertans and need to be examined more carefully before they are passed into law. She wrote to Shandro both to raise concerns and to understand the reasons for the proposals.
"The bill is out there. It makes significant, substantive changes to a really important piece of legislation that affects a lot of people in this province," Clayton said in an interview with CBC News.
"But it seems to me it introduces risk and we need to make sure that Albertans' health information is being protected."
In an email to CBC News, Shandro's press secretary Steve Buick said the government will talk to Clayton about her concerns.
"Alberta Health will be working on updates to the Electronic Health Record regulation for 2021, which covers the key areas addressed in the commissioner's response," Buick wrote. "We'll work with her and other stakeholders as we develop those amendments.
"Protecting the privacy of health information remains a critical value to the government, as it is to Albertans. The proposed amendments would not change Alberta's obligations under law to safeguard patient health information."
Bill 46 was introduced for first reading on Nov. 5 just before the legislature took a one-week constituency break.
The day after the bill was introduced, Clayton revealed the government had not consulted her about the bill.
Clayton said she isn't interested in a prolonged consultation period, but she wants privacy issues raised by Bill 46 to be discussed and fully understood by the public before it becomes law.
"This is about all of the individual Albertans whose health information is in that system. This about the literally thousands upon thousands of custodians who are impacted by some of these proposed amendments," she said. "I would like to see a public debate about these changes. This is important legislation."
Virtual health apps
After introducing the bill last week, the government said in a news release that allowing out-of-province access to Netcare could improve health care for people who live in border communities like Lloydminster.
Clayton said the changes could also allow out-of-province or out-of-country virtual health-care providers to access Albertans' health records. Jurisdictional issues would leave Clayton without much power to investigate a provider that committed a privacy breach.
Clayton also expresses disbelief in her letter that Bill 46 proposes removing a requirement for privacy impact assessments (PIA) when patient information is shared between Alberta Health, Alberta Health Services and the Health Quality Council of Alberta.
PIAs help identify risks and allow providers to put guard rails in place to protect privacy, she said.
Clayton said jurisdictions around the world are tightening up their privacy laws. Alberta, which was a leader in this area, seems to be going the other way.
Clayton also has questions about how the government intends to expand the uses for Netcare beyond the provision of health care to Albertans.
Bill 46 proposes allowing access for research, education, investigations, disciplinary hearings, inspections of health professions or disciplines, and planning and management of the health care system.
Increasing the number of uses increases the number of users. Clayton says more access to sensitive health information increases the privacy risk for Albertans. She said she is opposed to expanded access that isn't accompanied by robust assessment of the risks and strong mitigation measures.
Clayton supports some changes in Bill 47 including a proposed change to the limitation period and measures to increase accountability for researchers.