Patient Privacy

At Michael Garron Hospital (MGH), we take your privacy seriously. We are committed to ensuring that staff and patients understand the importance of privacy rights and obligations. The Personal Health Information Protection Act (PHIPA) balances an individual’s right to privacy with the need of healthcare providers to access and share this information. PHIPA gives an individual the ability to control how their own personal health information is collected, used and disclosed.

Personal Health Information

At MGH, we collect personal health information about you directly from you or from the person acting on your behalf. The personal health information we collect may include your name, date of birth, address, health card number and extended health insurance numbers, health history, records of your visits to MGH and the care that you received during those visits. Occasionally, we collect personal health information about you from other sources, if we have obtained your consent to do so or if the law permits.

How Personal Health Information Is Used and Shared

We use and disclose your personal health information to:

• Provide you with quality healthcare and follow-up care
• Conduct quality improvement activities (such as patient satisfaction surveys)
• Get payment for your treatment and care (from the Ontario Health Insurance Plan [OHIP], Workplace Safety and Insurance Board [WSIB] or others)
• Plan, administer and manage our internal operations
• Teach new healthcare providers and for education of current providers
• Conduct research (chart review)
• Compile statistics
• Conduct risk management activities
• Fundraise to improve our healthcare services and programs (only your name and address are given)
• Comply with legal and regulatory requirements, and fulfill other purposes permitted or required by law

How Personal Health Information is Protected

• We take steps to protect your personal health information from theft, loss and unauthorized access, copying, modification, use, disclosure and disposal.
• We conduct audits and complete investigations to monitor and manage our privacy compliance.
• We take steps to ensure that everyone who performs services for us protects your privacy and only uses your personal health information for the purposes you have consented to.

Limiting Disclosure of Personal Health Information

Personal health information is disclosed as necessary for the purpose for which it is collected, with consent, and as required or permitted by law. This includes disclosure to your care providers to ensure continuity and coordination of care. If a patient has provided the doctor’s name, they will be notified if the patient is admitted to hospital and when they are discharged. Copies of reports and diagnostics are also sent to the family doctor. Please tell us if you do not want your family doctor to be notified or provided information about your hospital visit. For more information on global consent directives, please contact Ontario Health.

Disclosure is also permitted or required to the following:

• You, your legal guardian or substitute decision-maker
• To care providers to determine suitability for transfer to another facility and to provide for ongoing care
• To care providers to improve/maintain the quality of your care and of those provided similar care
• Registries and entities prescribed in regulation, such as the Better Outcomes Registry and Network (BORN), Cancer Care Ontario, Canadian Stroke Network, Cardiac Care Network, Inscyte, Paediatric Oncology Group of Ontario (POGO), Institute for Clinical Evaluation Services, Canadian Institute for Health Information (CIHI), Children’s Hospital of Eastern Ontario (CHEO), Ontario Institute for Health Research (OICR) and health regulatory agencies
• Health information networks, such as the Electronic Child Health Network (eCHN), Hospital Diagnostic Imaging Repository Services (HDIRS), Ontario Laboratories Information System (OLIS), Integrated Assessment Record (IAR) and ConnectingOntario
• Ministry of Health e-health projects, such as the Enterprise Master Patient Index (EMPI) Wait Time Information System and Diabetes Testing Report
• Researchers if the research has been approved by our Research Ethics Board or authorized Board of Review, such as the Ontario Cancer Research Ethics Board (OCREB)
• The Medical Officer of Health to report communicable diseases
• The Workplace Safety and Insurance Board (WSIB)
• Law enforcement officers who present a warrant or subpoena, or to aid in an investigation
• The Children's Aid Society where child abuse is suspected; the Office of the Children's Lawyer
• The Public Guardian and Trustee
• The Coroner

MGH is a member of the health information networks noted above. These networks permit care providers, with patient consent, to securely share electronic patient health information for the purpose of providing timely and coordinated patient care.

About Health Information Networks

Electronic Child Health Network (eCHN)

The Electronic Child Health Network (eCHN) is a secure electronic system for children's medical records. About 40 hospitals in Ontario are members of eCHN. Members provide eCHN with laboratory results, doctor's notes, x-rays and visit information as well as name, age, address and contact information. This means that if your child is provided care at any of these 40 facilities, or if your paediatrician has access to the system, the care provider may access their medical record on the electronic system. If you do not want your child's records included in the system, please tell us.

For more information, please visit the Electronic Child Health Network website.

Hospital Diagnostic Image Repository Services (HDIRS)

Hospital Diagnostic Image Repository Services (HDIRS) permits hospitals to securely share exams and diagnostic images electronically. This protects patients because it avoids duplication of tests and thereby decreases the number of x-rays and other tests that expose patients to radiation. If you do not want to participate, please tell us.

For more information, please visit the eHealth Ontario website.

Ontario Laboratories Information System (OLIS)

Ontario Laboratories Information System (OLIS) is an electronic system managed by eHealth Ontario. It allows hospitals and community laboratories to securely share your lab test results with your healthcare providers. If you do not want your lab tests to be stored in OLIS, please tell us or call Service Ontario at 1-800-291-1406; TTY 1-800-268-7095.

For more information, please visit the Ontario Ministry of Health's website.

Diabetes Testing Report (DTR)

Diabetes Testing Report (DTR) is designed to assist people living with diabetes. People with diabetes need to have three tests done every year. Healthcare providers notify the Ministry of Health & Long-Term Care when tests are done and a DTR is created. A paper copy of the DTR is sent to your primary care provider to help ensure you receive the necessary tests every year. If you do not want to participate, please tell us or call Service Ontario at 1-800-291-1405; TTY 1-800-387-5559.

For more information, please visit the Ontario Ministry of Health's website.

GEMINI

GEMINI is a collaborative hospital data and analytics initiative that helps physicians, healthcare teams and hospitals use data to gain insights into patient care and improve patient outcomes. The GEMINI study collects, formats, standardizes and analyzes clinical data from hospitals with the aim of improving how healthcare is delivered. It means, for instance, when you visit MGH your data may be collected and shared for research purposes to improve the future care of our patients.

Data collected from the GEMINI study supports the Ontario General Medicine Quality Improvement Network (GeMQIN), a program of Ontario Health (Quality). This network brings general medicine physicians and care teams together to learn new ways to improve patient care. It also helps address provincial priorities, such as reducing the time patients need to wait for hospital beds. Data is housed at Unity Health Toronto’s St. Michael’s Hospital. If you do not want your information shared through GEMINI, please tell us. If you have questions about GeMQIN, please contact @email.

For more information, please visit the GEMINI website.

Integrated Assessment Record (IAR)

Integrated Assessment Record (IAR) is an electronic system that permits authorized health service providers to securely view a consenting client's assessment information for the purpose of planning and delivering the appropriate services. It supports a client-centred approach to service delivery by strengthening the ability of care providers to collaborate and to coordinate care. Assessments are only shared with consent. Please tell us whether or not you want to participate or call the IAR Consent Management Centre at 1-855-585-5279.

ConnectingOntario

ConnectingOntario is an electronic system which includes a central clinical data repository that stores patient health information collected from multiple healthcare sources. The system is designed to permit healthcare providers to securely share patient information if the patient consents.

It means, for instance, that when you visit MGH, your care provider will be able to view your health records from previous visits to other healthcare organizations that are participating in ConnectingOntario. Access to ConnectingOntario is restricted to those who provide or assist with providing patient care.

This enhanced access will make it easier for patients and their care givers to move more easily through the care journey. The goal is to deliver better, timelier and more coordinated care to each patient. If you do not want your information shared through ConnectingOntario, please tell us.

For more information, please visit the ConnectingOntario website.  

Canadian Triage and Acuity Scale (CTAS)

Patients in the emergency department are sorted based on their level of urgency. This means that the sickest patients will see a doctor first. Nurses use the Canadian Triage and Acuity Scale (CTAS) to let them know how long a patient can safely wait before they see a doctor. 

The electronic CTAS (eCTAS) is a tool that uses the guidelines from CTAS in Ontario hospitals. To improve patient safety and quality of care, some of your personal information will be shared with eCTAS. For example:

• Your age
• Why you came to the hospital
• Your vital signs

Your privacy is important to us. eCTAS has controls in place to make sure your information is safe. If you do not want to participate, please tell us.

Digital solutions, artificial intelligence and data matching 

MGH uses digital solutions to process personal information (PI) and personal health information (PHI) or other information for the purposes as described. Digital solutions include electronic devices, mobile/web applications, health information systems and assessment tools.

MGH may also use artificial intelligence (AI) applications that process PI or PHI for the purposes described above. The adoption of AI solutions enhances our ability to deliver optimal care. An example of this is the AI transcribing tool used by clinicians in some areas of the hospital.

Similarly, your PI or PHI may be used for data matching. Data matching involves the computerized comparison of databases to allow linkages to be made between your information from sources across the hospital. This activity supports the purposes listed above.   

Digital solutions and AI that process PI or PHI, and initiatives using PI or PHI for data matching, are reviewed by MGH's Privacy Office and Information Security Office to ensure they comply with internal policies, privacy laws, and best practices. 

about MGH’s use of AI transcription 

What is Ambient AI Scribe? 

The Ambient AI Scribe is a digital tool that uses artificial intelligence (AI) to listen during your visit with your physician and takes notes about the conversation to create a summary of the visit. Your physician will review these notes, make any needed changes, and then add them to your medical record. The Ambient AI Scribe doesn’t make decisions about your care, it simply ensures nothing important is missed during your visit.   

How does the use of Ambient AI Scribe improve my care? 

Ambient AI Scribe takes care of notetaking, so your physician can focus on you and spend less time documenting. It also helps your physician make detailed and accurate notes about your health.   

What privacy and security measures are in place?

We take your privacy very seriously. Physicians using Ambient AI Scribe must comply with Ontario’s privacy laws to safeguard your personal health information. No audio is ever stored during clinical encounters (patient-clinician conversations); the audio stream is processed in real-time and immediately discarded. Once finalized the note can then be copied into the electronic medical record system. Only your physician and healthcare team can access your information. All data processing activities are maintained within Canada.    

Are there risks associated with using Ambient AI Scribe? 

While safeguards are in place to protect your personal health information and ensure compliance with Ontario’s privacy laws, there are some risks to consider. Mistakes in how Ambient AI Scribe captures or processes information may occur. Each physician is responsible for reviewing, correcting and finalizing the notes to ensure accuracy and completeness. Despite safeguards, there is always a potential risk of data misuse, such as a data breach.  

Can I review my physician’s notes? 

You may access copies of your health records through your MyChart portal or by contacting our Release of Information team at @email.  

Do I have to consent to the use of AI scribe during my visit?

Our physicians' use of AI Scribe while interacting with you is your decision. If your physician uses Ambient AI Scribe, they will ask for your permission before interacting with you.

Who should I reach out to with questions?

If you have any questions, please let us know. Additional information can be obtained by contacting the Privacy Office at @email.

Use for de-identification and anonymization 

MGH may use your PI or PHI to de-identify or anonymize it. This entails modifying your information to remove details that can be used to identify you. De-identified information may be used for non-care purposes, such as quality improvement projects. We take steps to mitigate risks associated with the re-identification of PI and PHI. 

Your Choices

You may access, review and make necessary changes to your personal health records. If you are an inpatient, please speak to one of your healthcare providers. If you have been discharged, please contact the Health Records Department.

To withdraw your consent for any listed uses or disclosures, please contact the hospital’s Privacy Officer (subject to legal exceptions).

Fundraising

The Michael Garron Hospital Foundation raises money to enhance the hospital’s programs and services. The foundation may write to you when they are raising money or send you mailings about their services or upcoming special events. If you do not wish to be contacted by the foundation, please let us know at 416-469-6821.

Use of Video Recording and Photography Devices

MGH has a comprehensive policy with respect to the use of video recording and photography devices. No photography, video recording or audio recording without express permission is permitted while on hospital property. 

Information and Privacy Commissioner of Ontario

• Your Health and Your Privacy brochure