Canada: What Health Facilities Need To Know About QCIPA 2016

Last Updated: May 18 2016
Article by Kathryn M. Frelick and Lauren Parrish

The Quality of Care Information Protection Act, 2016 (QCIPA 2016) is one step closer to becoming law.  Bill 119, the Health Information Protection Act, 2016 (HIPA), passed third reading in the Ontario legislature on May 5, 2016.  Once proclaimed into force, HIPA will repeal the Quality of Care Information Protection Act, 2004 (QCIPA) and replace it with QCIPA 2016.  HIPA will also amend the Personal Health Information Protection Act, 2004.   In light of the broad overhaul of QCIPA, health facilities will need to undergo a comprehensive review of their risk and quality policies, processes and systems. 


Since QCIPA came into force, one of the main criticisms of the legislation has been its stringent restriction on the disclosure of quality of care information, even in circumstances where a health facility may wish to disclose. In September of 2014, a committee was established to review QCIPA and offer advice to the government on how to improve the legislation. The committee's extensive research culminated in a report entitled the QCIPA Review Committee Recommendations.  Many of the recommendations advanced in that report have been incorporated into QCIPA 2016.

Key Definitions and Overview of Changes

  • Preamble and Purpose – QCIPA 2016 incorporates a new preamble and purpose statement, which balance the need for health facilities to engage in confidential discussions about errors, systemic issues and opportunities for quality improvement in health care delivery, with the right of patients to access information about their health care.
  • Critical Incident – QCIPA 2016 includes a new definition of "critical incident."  A critical incident is defined as, "any unintended event that occurs when a patient receives health care from a health facility that, (a) results in death, or serious disability, injury or harm to the patient, and (b) does not result primarily from the patient's underlying medical condition or from a known risk inherent in providing the health care."  This is the same definition that is applicable to public hospitals, which are already subject to disclosure of critical incident requirements.
  • Health Facility – QCIPA 2016 applies to a "health facility," which is defined as a public hospital, private hospital, psychiatric facility, independent health facility or a "prescribed entity that provides health care."  Current regulations under QCIPA provide that long-term care homes, laboratories or specimen collection centres are "prescribed entities" for the purposes of QCIPA.  Regulations will need to be developed pursuant to QCIPA 2016, including in regards to "prescribed entities". 
  • Quality of Care Committee (QCC) – This is defined as a body of one or more individuals that performs quality of care functions and that is established, appointed or approved by a health facility or a combination of health facilities. This definition is largely the same as under QCIPA.  However, under QCIPA 2016, a QCC can be established jointly by more than one health facility.
  • Quality of Care Functions – QCIPA 2016 defines quality of care functions to include "activities carried on for the purpose of studying, assessing or evaluating the provision of health care with a view to improving or maintaining the quality of the health care."  In addition, QCIPA 2016 explicitly includes conducting reviews of critical incidents.
  • Quality of Care Information – "Quality of care information" has been redefined under QCIPA 2016 and expressly includes information that "relates to the discussions and deliberations of a [QCC] in carrying out its quality of care functions," as well as, "information contained in records that a [QCC] creates or maintains related to its quality of care functions."

    The definition explicitly excludes information relating to a patient in respect of a critical incident that describes: the facts of what occurred; what the QCC has identified as the cause or causes of the incident; the consequences of the critical incident to the patient as they become known; the actions taken and recommendations made to address the consequences; and, the systemic steps, if any, that a health facility is taking or has taken to avoid or reduce the risk of further similar incidents.
  • Critical Incident Reviews – In conjunction with these changes, amendments to Regulation 965 under the Public Hospitals Act have been proposed that would impose additional requirements on hospitals with respect to critical incident reviews.  These amendments require the establishment of a system for ensuring that a committee appointed by the hospital reviews every critical incident as soon as is practicable after the critical incident occurs.  This committee must include a patient relations coordinator.  In addition, there is a requirement to offer to interview the patient during the review process. Health facilities cannot withhold critical incident information from affected patients.

    Under QCIPA 2016, investigations of critical incidents can involve multiple health facilities.  QCIPA 2016 explicitly permits the sharing of quality of care information between QCCs. However, this information sharing process cannot disclose more personal health information than is reasonably necessary to conduct quality of care functions.

    QCIPA 2016 allows the Minister of Health and Long-Term Care to make regulations restricting or prohibiting the use of QCCs for the purposes of reviewing critical incidents.

Implications for Health Facilities

In light of the broad overhaul of QCIPA, we recommend that health facilities conduct a comprehensive review of their risk and quality improvement policies, particularly with respect to critical incident reviews and disclosure.  Health facilities will need a system in place to consider the threshold issue of whether a particular incident is a "critical incident" within the QCIPA 2016 definition. 

In addition, despite the ability to share more infomation with patients, the restrictions against disclosure of quality of care information still apply in the context of legal proceedings and limit the ability of health facilities to use such information in the context of related professional practice, credentialing and performance management processes. Health facilities must ensure that processes are in place so that identified discrepancies or professional practice issues can be investigated and reviewed outside of the QCIPA 2016 framework.

The scope of the regulation-making authority poses a number of questions in terms of how this legislation will be rolled out.  Miller Thomson's National Health Industry Group has extensive experience advising clients with respect to QCIPA and related processes.  We will be following any new developments closely. 

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

Kathryn M. Frelick
In association with
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at and we will use commercially reasonable efforts to determine and correct the problem promptly.