Protecting confidentiality of users’ health information in the Connected Health Record
Expertise of CIUSSS’s top medical archivist helps safeguard personal information
Like a sports club battling for a championship, the team that’s building the Connected Health Record (CHR) for CIUSSS West-Central Montreal is fielding star players in positions that are both offensive and defensive.
These days, the spotlight is often pointed at the offense, where members of the Digital Health team are designing dynamic features to revolutionize the way the CIUSSS’s health data is recorded, stored, retrieved, displayed and shared.
Ultimately, this mega-project will enable staff to use a single digital platform to gain quick, easy access to complete, integrated updated information about the users of health care and social services at all CIUSSS sites.
The result will be workflows that are more efficient, since users’ health information will be much more readily available to staff.
However, realizing the CHR’s potential also depends on the efforts of key players on defense—those who have an active role in enhancing the quality of this complex project by making certain it functions securely. They ensure that the confidentiality of sensitive information is maintained at every stage, from initial documentation to long-term storage.
Occupying an essential defensive slot is Chantal Desmarais, the CIUSSS’s Coordinator of Medical Records, who is working with Dr. Justin Cross (Chief Digital Health Officer) and the CHR’s designers to incorporate safeguards that keep users’ information out of the hands of anyone who has no right or need to see or use it.
“We’re in the planning phase of developing something that will not only be unique, but will conform to Quebec’s privacy laws and guidelines, which aren’t always the same as regulations elsewhere in Canada or in the United States,” Ms. Desmarais explains.
“As we work within our province’s legal framework, we’ll determine not only who has access to the medical information, but how that data can be stored and handled securely in the new infrastructure.”
More about the Connected Health Record
Interested in reading about the CHR in more detail? The following JGH News articles explore the major improvements that the CHR will bring to the safety of users and the daily routines of staff.
- Part 1 of a question-and-answer session about the CHR with Dr. Justin Cross, Chief Digital Health Officer for CIUSSS West-Central Montreal.
- Part 2 of the interview with Dr. Cross.
- The role of Elliott Silverman, Associate Director of Digital Health, in developing the CHR.
- How Mike Shulha collaborates with clinical practitioners and staff.
Since joining the CIUSSS in 2016, Ms. Desmarais has been responsible for managing and protecting users’ personal information and for continuously raising awareness about confidentiality, regardless of whether the data appears on a computer screen or on paper.
In addition, her duties include overseeing the medical record-keeping activities, auditing access to the records, connecting with researchers, and validating the quality and coding of data that is sent by the CIUSSS to the Ministry of Health and Social Services.
Ms. Demarais says all of these activities will be upgraded when the CHR is launched, and she is working enthusiastically with the planning team to evaluate options that will make the new tool function more smoothly and easily for all members of staff.
For Ms. Desmarais, this is one of the most significant projects in her 34 years as a medical archivist and manager of health information. Previously, she spent most of her career at the MUHC—specifically, at the Montreal Children’s Hospital—as well as at St. Mary’s Hospital, the Clinical Research Institute, Hôpital Charles-Le Moyne and facilities in Chicoutimi and Jonquière.
“There’s nothing more satisfying for me than knowing users feel confident and secure about the integrity, safety and confidentiality of their health information,” she says.
“When you have a health problem, you already have more than enough stress to deal with. But it’s a big, big source of comfort to know that you can entrust your information to the people who are looking after you. Users can put their trust in us and be confident we will help them.”
To a large extent, Ms. Desmarais says, her functions will remain the same once the CHR goes into full operation, except that the new tools will help her do her work more efficiently.
However, extra vigilance and oversight will be needed, since the CHR will be used by many more people who will require support to easily share much-needed and valuable information across the CIUSSS.
As a result, staff—and even users—will have to be trained in how to maintain the legally required standards in the new digital environment.
The benefits of the CHR are clear, Ms. Desmarais explains: When all of the data about each user is eventually centralized in the CHR, care teams will have the most accurate and up-to-date information at their fingertips, making it easier for them to arrive at thoughtful, well informed decisions about the plan for each user’s care.
However, she adds, the potential risks must also be dealt with in advance. Of major importance is the fact that the centralized charts can be opened not only within a particular CIUSSS facility, but at any of the CIUSSS’s 30-plus sites.
While this is a major advantage for better, safer clinical care (charts will be accessible regardless of where users are transferred within the CIUSSS), there must be strict security features in the CHR—as well as effective organizational practices and training—to ensure that confidentiality is maintained.
Once these protective measures in place, each digital chart will be viewed only by staff members who are involved in the user’s trajectory of care. This will be achieved through a combination of technical controls and security settings in the CHR, as well as the CIUSSS’s policies and procedures that deal with access to information.
At the same time, the CHR must be capable of maintaining an accurate and detailed record of the identity, time and location of every person who views each chart.
Ms. Desmarais says she’s confident all of the bases will be covered, since the CHR is being built not only by seasoned IT professionals, but by members of the CIUSSS’s Department of Legal Affairs, specialists in information security, and experts such as herself.
“When I speak with concerned users and explain to them what their rights are and what is being done to keep their information secure, they thank me, and that makes me feel very happy about what I do.”