Doctors Nova Scotia concerned about proposed changes to health information law

The organization that represents more than 3,500 physicians, medical students and residents in Nova Scotia is concerned with provisions in legislation introduced by the minister of finance on March 5 as part of the budget process.

Doctors Nova Scotia said clauses in the Financial Measures Act to amend the Personal Health Information Act would grant the minister of health and her department expanded access to the health records of Nova Scotians.

“The way that the legislation is written is quite broad and it’s not entirely clear the information they might be accessing,” Dr. Colin Audain, president of Doctors Nova Scotia, told CBC Radio’s Information Morning on Thursday.

The second last clause in the 35-page bill would amend the law governing health records by including an additional obligation for doctors and other care providers “to disclose personal health information to the minister or a person acting on behalf of the minister for the purposes of planning and management of the health system, resource allocation and creating or maintaining electronic health record programs and services.”

Audain said Health Department officials have told his organization that the purpose is to allow patients to access their own records through the YourHealthNS app the province launched last November.

The department also said it wants to collect aggregate information in order to better plan services or reallocate resources.

A woman with dark hair and glasses sits at a podium.
Michelle Thompson is Nova Scotia’s health minister. (Robert Short/CBC)

“As far as we know, the information that they’re looking for right now is fairly narrow, and it includes things like the date of a visit, the provider’s name, the reason for the visit and the results of diagnostic imaging, blood and other lab tests,” said Audain.

“But I think what we’re concerned about is the broad nature of the legislation, and the fact that if there were other information, beyond what’s currently being looked at in the app, that it could compromise the therapeutic relationship between doctors and their patients.”

In a letter sent to physicians last week, Audain tried to reassure his colleagues Doctors Nova Scotia was working with the government to ensure there would be limits on what information physicians would have to submit to the province.

“I’ve had many conversations with senior government leaders and with Premier Tim Houston directly,” said Audain. “I’ve raised the importance of putting in place protections that support physicians as custodians of the data and protect the confidentiality inherent in the therapeutic relationship between physicians and our patients.”

“Doctors Nova Scotia has secured a commitment from the premier that ensures the minister’s access to data will be appropriately restricted.”

Despite that commitment, Doctors Nova Scotia plans to call on the government to modify the proposed law to restrict the information that can be passed on to the minister and the department when the bill moves from the floor of the House to the Law Amendments Committee, on Monday.

But Health Minister Michelle Thompson doesn’t believe the clause needs to be changed, nor does she think people should be concerned about the kind of information she and future health ministers will be able to access.

“The information that people share with their physician is not the information that’s going to be collected by government,” Thompson told CBC News. “There’s no need for us to know, at an individual level, what is discussed or anything like that with physicians. That’s not the point.

“We’re not interested in individual information, we’re interested in that big number that tells us how many people are utilizing and moving through the system at any given time.”

Nova Scotia’s opposition leaders share the concerns expressed by doctors. During Friday’s question period Liberal Leader Zach Churchill pleaded with the health minister not to push ahead with the change.

“Will the minister please pause this part of the legislation to ensure that she has the chance to talk to patients and doctors before they move forward with this potentially very dangerous change,” said Churchill.

Speaking to reporters outside the chamber Churchill said his caucus has been hearing from doctors concerned this change could create serious risks for them and their patients and that the minister already has access to the data she needs to manage the system.

NDP Leader Claudia Chender took a different tack, questioning the minister’s assurance that neither she or future ministers would not want information related to individual appointments.

“It doesn’t matter what she thinks some future minister of health will or will not do,” said Chender. “What matters is what is written in the legislation and … this provision gives the minister access to every Nova Scotians’ very personal details that they share with their physicians.”

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