Thank you very much. We'll see how we do. Perhaps there should be a prize for the one who gets closest to ten minutes.
Good afternoon. The Canadian Pharmacists Association, or CPhA, welcomes this opportunity to present to you today during your review of PIPEDA. My name is Jeff Poston, and I'm the executive director of CPhA.
For those of you who are unfamiliar with our organization, the Canadian Pharmacists Association is the national voluntary organization of pharmacists, committed to providing leadership for the profession of pharmacy and improving the health of Canadians. Our members include pharmacists in all areas of practice: community pharmacies, hospitals, universities, governments, and industry.
We know that pharmaceuticals are a vital part of the Canadian health care system. Retail spending on drugs is forecast at just over $25 billion this year, or 17% of total health care spending. However, there's a recognized need to improve both the safety and outcomes of drug therapy. Pharmacists' scope of practice is changing so that they can better help their patients achieve optimal outcomes from drug therapy.
We would like to state the pharmacy profession's strong commitment to the protection of patient confidentiality and privacy. This is evidenced from our professional code of ethics, legal provincial standards of practice, and CPhA's own privacy code for pharmacists. Pharmacists have demonstrated their capacity to achieve this, using technology such as electronic patient files and the online transfer of prescriptions for payment to public and private drug plans for over 15 years.
Every day across Canada, pharmacists dispense over one million prescriptions. Many of these are for patients with mental illness, HIV/AIDS, infections, and serious illness—health information that is entrusted to us and kept confidential by us. Pharmacists strongly believe that Canadians' right to privacy protection of health information is fundamental.
At the time PIPEDA was drafted, we had three primary concerns. First, it did not make a distinction between the therapeutic purposes for which personal health information is used, even when it's paid for through private plans, and the commercial purposes for which personal information resulting from commercial transactions is normally used.
We were also concerned that it created two levels of privacy protection rights for Canadians, one for people covered by public drug plans paid for by provincial governments and one for those covered by private plans. Also, the impact on the health care system of the proposed changes was unanticipated. What the impact would be on patients' and providers' time, and the ensuing financial burden, was unknown.
We originally proposed amending the legislation so that it would not apply to the health care sector for a period of five years, to allow for the development of specific health privacy protection legislation by the provinces. After this five-year period, we proposed that the act would apply to the health care sector if provincial health privacy legislation were not in place.
Before PIPEDA came into effect, there were major concerns that PIPEDA could impede care. There was a lot of confusion about what it meant for everyday practice. Because of the pre-PIPEDA work done by the privacy working group of health provider and consumer associations, including all the groups before you today, the development by CPhA of the pharmacist's personal information privacy code, and the overriding provincial privacy legislation, PIPEDA has not had the negative effect on pharmacy practice that we first anticipated. However, there are three specific areas of concern that CPhA would like to raise during the review of the act.
First of all, the PIPEDA awareness-raising tools initiatives, or PARTs, was particularly important in interpreting the effect of PIPEDA on the health care sector and clarifying when the legislation was applicable. CPhA's development of the pharmacists' privacy code and other practice tools, such as guidelines, brochures, and posters, helped pharmacists prepare for PIPEDA.
The questions and answers of the PARTs initiative have served as the primary guideline for how this legislation affects the provision of health care. CPhA, like our colleagues here today, is concerned that PARTs still does not have legal standing. These guidelines are fundamental to the application of PIPEDA in the health sector.
CPhA would like to see the PARTs guidelines specifically referenced in the act so that they have official legal status. In particular, the principle of implied consent in the direct care and treatment of a patient, as defined in a circle of care, needs to be recognized under PIPEDA. This is recognized as a core concept in the pan-Canadian health information privacy and confidentiality framework.
There are a number of privacy issues that arise when patient information is being used for research purposes. Health information for research is produced and created by all sorts of health care professionals, and we have to allow appropriate exchange and use of such information. This data is particularly useful in helping to assure the appropriate use of health care services to measure outcomes and develop health policy. We believe health information data should not identify individual patients and should not be used for purposes outside of appropriate statistical scholarly study or health care research.
We support the appropriate collection, exchange, and use of health information, including prescribing data, for health care research. Specifically with respect to pharmaceuticals, this data could be used to support optimal prescribing and utilization. This is for quality assurance purposes, and it needs to occur within a peer-reviewed process. However, we do have concerns that sometimes this information is used inappropriately.
We must look to a future with electronic prescribing and electronic health records. Having patients' health information directly at the point of care will enable the appropriate health care provider to make better, more informed decisions concerning patient care. These electronic information systems will enhance patient health outcomes and safety and will maximize the efficient use of health care resources. In an e-health environment, pharmacists will need to read and write to the EHR in order to communicate and work collaboratively with other providers and make better-informed patient care decisions.
We have collaborated with the Canadian Association of Chain Drug Stores and the Canadian Society of Hospital Pharmacists to develop principles and elements to guide the development and use of these electronic drug information systems. One of the key principles is that health information systems, including pharmacy information networks, must employ rigorous, stringent security measures and comply with privacy legislation to protect the confidentiality of patient information, while not constraining the ability of health care providers to access information and to practise in a patient-focused and efficient manner.
The PARTs guidelines play an important role in clarifying PIPEDA for the health care sector. This will be even more significant in the future with the evolution of electronic patient records. It is important that the current interpretation of the legislation as it applies to health care is also extended to the future electronic transmission of health information. The pan-Canadian health information privacy and confidentiality framework is an important step to supporting such developments.
In conclusion, the protection of personal health information has and always will continue to be of paramount importance to pharmacists. The relationship of trust between patients and pharmacists is fundamental to the delivery of care.
Thank you again for the opportunity to allow CPhA to participate in this review of PIPEDA. I'd be pleased to answer any questions you might have.