Thank you.
Good morning. My name is Janet Cooper. I am a pharmacist and I am vice-president of professional affairs with the Canadian Pharmacists Association. I am pleased to be here today to discuss Bill S-4, an act to amend PIPEDA.
CPhA, the Canadian Pharmacists Association, is the national voice for Canada's 39,000 pharmacists. Pharmacists practise in a range of settings, including community pharmacies, hospitals, academia, industry, and government.
CPhA and the pharmacy profession have a long history of speaking out for the interests of patient privacy and confidentiality, and as far back as 2001 CPhA was involved with a privacy working group of other health care provider organizations that provided advice to Health Canada on privacy matters related specifically to health care. Since then we've appeared before parliamentary committees on numerous occasions to offer our perspective on PIPEDA changes.
Today pharmacists' commitment to privacy is reflected in the professional codes of ethics and standards of practice that guide our profession, as well as CPhA's own privacy code for pharmacists. Given that pharmacists routinely dispense more than 11 million prescriptions each week and they're conducting a range of new, expanded services for patients in almost all jurisdictions, the need for ensuring confidentiality of patients' personal information has never been greater.
Community pharmacists were very early adopters of digital records, having maintained computerized medication profiles for more than three decades. Most of the 600 million prescriptions that are dispensed each year, which is close to $30 billion in spending, are actually sent electronically for claims adjudication by public drug plans or private insurers. So there is a lot of electronic transmission of patients' medication information.
Increasingly, Canadians' medical records are maintained electronically by other health care professionals as well, including physicians' records, lab test results, and diagnostic images. The goal of electronic health records is to increase accessibility and sharing of patient information by those providers who need access to inform patient care and to support interprofessional collaboration.
For example, in several jurisdictions, drug information systems, or DIS, are in place to allow access to a complete profile of medications regardless of which pharmacy dispensed the prescription. This improves safety and efficacy of medications, supports improved prescribing, supports detection of adverse drug events, and deters prescription drug abuse. We hope that in the near future all prescriptions will be electronically created and then transmitted to the patient's pharmacy of choice. With this change to electronic health records comes increased need to ensure that Canadians' private health and medication records are protected.
Let me state up front that CPhA supports the amendments in Bill S-4 as they relate to protecting personal health information. There are two amendments in particular that we want to address.
First, CPhA supports the amendment in the bill in which personal information may be obtained without consent for the purposes of communicating with the next of kin or authorized representative of an injured, ill, or deceased individual.
Pharmacists, as well as any health care provider, may find themselves in the difficult situation of having to deal with patients who may be severely ill, unconscious, or incapacitated for any number of reasons. In such circumstances it may be imperative for the pharmacist or other health professional to immediately contact family members or next of kin to inform them of the patient's condition, or to seek valuable information on the patients' medical history. But seeking permission or consent to contact those individuals in advance may simply not be reasonable nor in some cases possible. This clause would provide pharmacists and other health care providers with the comfort and knowledge that in the case of a severe health emergency they will not be in contravention of PIPEDA for acting in the best interests of their patients by contacting next of kin or authorized representatives.
Second, CPhA also supports the amendment in Bill S-4 requiring organizations that have encountered a privacy breach to report that breach to the Privacy Commissioner and notify individuals, if it is reasonable in the circumstances to believe that a breach creates a real risk of significant harm to an individual.
For pharmacists who access a significant amount of sensitive information related to the medication and health of their patients every day, a breach or disclosure of this information has the potential to put the patient at risk. Patients who are on medications for HIV, mental illness, or infectious diseases would certainly not want all of that information to be known. As defined in the legislation, this risk could include threats to employment, reputation, or relationships. As a result, CPhA believes that, should a privacy breach occur, reporting this breach to the individual concerned and the Privacy Commissioner are reasonable steps to take in order to mitigate any risk that may occur.
It's also reasonable for the organization in question to maintain proper records of these occurrences as stated in the bill.
Although not specifically related to this bill, I want to thank Health Canada for introducing a regulatory change this past summer that will better enable pharmacies to protect privacy. There's a requirement in the Food and Drugs Act that requires pharmacists to maintain up to two years' worth of prescription records, and until last summer the regulation required prescriptions to be maintained in hard copy format even though more and more prescription records are now retained in electronic format. Last July Health Canada reinterpreted that regulation to allow for electronic retention of prescriptions. In addition to being more efficient for pharmacies, electronic retention is safer and more secure from a privacy standpoint.
Thank you, Mr. Chair and committee members, for the opportunity to meet with you today to discuss Bill S-4. I'd be pleased to respond to your questions.