Canada: Can Paramedics Learn About Their Patient's Diagnosis? The Law On Patient Disclosures And Paramedics

Last Updated: December 23 2016
Article by John Schuman

The relationship paramedics have with patients is only supposed to last one day. Every day, paramedics are exposed to first time patients suffering new challenges under different conditions. As time progresses and paramedics are exposed to more and more patients, paramedics begin to see trends in the similar problems them and become better able to alleviate their patient's needs. The thinking is, once a paramedic has seen a problem once, they are better able to identify that problem when they see it again.

As a paramedic's relationship with their patients ends as soon as the patient leaves their care, the paramedics cannot follow up on the wellbeing of their patients. The consequence is that paramedics often never know what their patients are suffering from. If paramedics are supposed to benefit from repeat exposure to different problems so they can learn from the experience, there is a huge deficiency if paramedics are often left in the dark as to what the patient are actually experiencing.

If paramedics learn the details on what their patient's are really experiencing, they would have a better understanding of what that condition looks like enabling them to better diagnose those problems going forward. The issue is, how can they get this information disclosed to them.

Medical records are an intensely private, and personal set of documents. Medical professionals are only capable of sharing personal health details under a very limited set of circumstances, or with those the patient consents to sharing the information with. The limits on who and when medical professionals can disclose patient's health concerns with is set out in the Personal Health Information Protection Act1.

Section 37(1) of the PHIPA says that a health information custodians may disclose personal health information about patients for the purpose of education.

The College of Nurses of Ontario issues a Practice Standard called the Confidentially and Privacy – Personal Health Information2 which addresses these concerns. In it, it says of the PHIPA:

"PHIPA permits the sharing of personal health information among health care team members to facilitate efficient and effective care. The health care team includes all those providing care to the client, regardless of whether they are employed by the same organization.".

Despite this, paramedics are still not able to access medical records for educational purposes.

In Bluewater Health v. Ontario Nurses' Assn.3, the arbitrator ruled that just because a health care worker was previously involved in a file and her hospital was still dealing with the patient, she lost the right and ability to learn about the patient's health care records as soon as she stopped working with the patient, even if it was educational to her.

In the same case, the arbitrator ruled that individuals can only access personal health information for the purpose of education if the hospital gives them explicit permission to do so.

In Ontario Nurses' Association v Norfolk General Hospital4, the court determined that: "The circle of care does not include:

  • A physician who is not part of the direct or follow-up treatment of an individual;"

In North Bay Health Centre v Ontario Nurses' Ass'n. (McLellan Grievance)5, Arbtirator Abramsky stated:

"40 Further, if accepted, the Association's argument that all "health care practitioners" are health information custodians entitled to rely on Section 37(1) would undermine the goals and purposes of the legislation. If a nurse (or any health care practitioner – and there are many health care practitioners at a hospital) is a health information custodian and may freely access patient health information for personal educational purposes, the privacy of patient health records could be significantly undermined. The Act does allow for the use of health information for "educating agents to provide health care" but it must be done by the health information custodian, not by an agent for his or her own purposes."

PHIPA states in regards to agents in section 37(2) agents can only access health care information for educational purposes if its on behalf of the heath care custodian. This would indicate that paramedics are not able to learn about health care records for educational purposes, as they are not being educated for the goal of implementing the custodians service. As paramedics do not work for hospitals, they cannot be seen as their agents.

Under the provisions of the PHIPA paramedics are only able to learn about their patient's diagnoses if they receive consent from their patients to do so. The Act provides the following requirements for consent:

Elements of consent

  1. (1) If this Act or any other Act requires the consent of an individual for the collection, use or disclosure of personal health information by a health information custodian, the consent,

    1. must be a consent of the individual;
    2. must be knowledgeable;
    3. must relate to the information; and
    4. must not be obtained through deception or coercion.

The Act goes on to further state that if the disclosure is not for the specific purpose of providing another health care worker assistance in providing care, then the consent given must be explicit. Based on this, it seems clear that if paramedics want to learn about the diagnosis of their patients, they must receive express consent from their patients. The act does not make clear what classifies as express consent, but the most obvious form of consent would be the patient writing a note, providing clear evidence of their explicit consent.

This is problematic and is unlikely to assist paramedics in obtaining the knowledge they require. When a patient is with a paramedic, things are hectic and the patient often is in great distress. The last thing a patient wans to think about, if it is even possible, is to sign a form allowing their medical information to be disclosed.

It would be very helpful for paramedics to learn about their patient's diagnosis, but under the current framework of the PHIPA, paramedics are prohibited from learning this valuable information.

Footnotes

[1] http://canlii.ca/t/32t

[2] https://www.cno.org/globalassets/docs/prac/41069_privacy.pdf

[3] Bluewater Health v. Ontario Nurses' Assn. (Hardy Grievance) [2010] OLAA No. 660

[4] Ontario Nurses' Association v Norfolk General Hospital, 2015 CanLII 62332

[5] North Bay Health Centre v Ontario Nurses' Ass'n. (McLellan Grievance) [2012] O.L.A.A. No. 11, 216 L.A.C. (4th)

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 Mondaq.com.

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

Authors
Similar Articles
Relevancy Powered by MondaqAI
 
In association with
Related Topics
 
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
 
Up-coming Events Search
Tools
Print
Font Size:
Translation
Channels
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
Password
Confirm Password
Position
Mondaq Topics -- Select your Interests
 Accounting
 Anti-trust
 Commercial
 Compliance
 Consumer
 Criminal
 Employment
 Energy
 Environment
 Family
 Finance
 Government
 Healthcare
 Immigration
 Insolvency
 Insurance
 International
 IP
 Law Performance
 Law Practice
 Litigation
 Media & IT
 Privacy
 Real Estate
 Strategy
 Tax
 Technology
 Transport
 Wealth Mgt
Regions
Africa
Asia
Asia Pacific
Australasia
Canada
Caribbean
Europe
European Union
Latin America
Middle East
U.K.
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

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 or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.

Disclaimer

The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq 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 of the Content or performance of Mondaq’s Services.

General

Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions