HUMBOLDT — The privacy of some patients from the Humboldt Broncos crash was breached when a Humboldt doctor, Moose Jaw clinic worker and three Nipawin doctors accessed their medical files.
In three reports issued Jan. 29, the provincial privacy commissioner gave details on how patient privacy was breached.
In Saskatchewan, health privacy legislation allows access to patient records on a need-to-know basis, not a circle-of-care basis. In need-to-know, medical professionals are allowed to know only what’s needed to treat patients in their care. A circle-of-care model is less defined and could mean, in its most extreme interpretation, a medical professional has the right to know all available medical information about a patient they are treating.
The Humboldt doctor named in the report, who works at the Humboldt Clinic and was only identified by an initial, accessed the files of two people that were in the crash. Both had been the doctor’s patients in the past, but were no longer by the time of the crash.
“For one of the individuals, Humboldt Clinic explained to eHealth that [the doctor] wanted to know what injuries the individual sustained, if the individual received care, or if it was an instant fatality,” said the privacy commissioner’s report. “For the other individual, Humboldt Clinic explained to eHealth that [the doctor] was concerned.”
Based on those explanations, the privacy commissioner said, the doctor didn’t have a need to know. The report explained there had to be a trigger, like a request for service or a requirement of the patient by the doctor for care, for the doctor to be allowed to access patient records.
“Neither individuals requested nor required care from [the doctor] as both were deceased,” the report said.
After the breach happened, the two individuals’ next of kin were informed. The privacy commissioner said the next step was for the Humboldt Clinic to conduct an investigation into the breach. He said the clinic sent a letter to him dated Oct. 30, 2018 that said it hadn’t done so.
The privacy commissioner said that since the clinic didn’t find out what went wrong, it would be difficult to take steps to prevent it from happening again.
The clinic does have a privacy policy and ensures its staff has proper training, the report said, leaving the privacy commissioner with the conclusion the clinic has the proper tools in place to prevent a similar breach in the future.
In Moose Jaw, a clinic employee accessed the files of three people involved in the crash. She wanted to verify if one of them had died, verify a detail reported in the media about another, and thought the other was a patient at her clinic.
None were reasons why she would need to know the information.
The employee, who is no longer working at the clinic, had not been given training on privacy.
However, in August, the clinic arranged for training from the Saskatchewan Medical Association.
In Nipawin, three doctors who provided emergency care to patients from the crash accessed information about the individuals they treated after they had left their care. In this case, the doctors believed they were still in the individuals’ circle of care.
Circle of care has no basis in Saskatchewan privacy legislation, but was a term used by the former Kelsey Trail Health Region before it was merged into the Saskatchewan Health Authority. Bryan Salte, the College of Physicians and Surgeons of Saskatchewan’s associate registrar, said this creates confusion among physicians in the province.
“Our privacy legislation referred to a need-to-know principle, not a circle-of-care principle, so there’s confusion about circle of care commonly used in other provinces,” he said. “Our privacy legislation is somewhat different than some other provinces.”
Salte said he doesn’t dispute the finding of the privacy commissioner, but pointed out the commissioner, in a previous report, recommended that physicians be able to access the records of patients they performed medical procedures on so they can gather information about how effective their work was.
“That change hasn’t been instituted,” he said.
