ConnectingOntario

Patient radiology reports and images such as hospital-based CT scans, ultrasounds, MRIs, mammograms and X-rays are included in our secure picture archiving and communications systems and DI repositories. The implementation of these systems has eliminated the need for film and paper diagnostic images.

The EHR gives patients, or their substitute decision maker(s), the option to allow or restrict access to patient data within DI common service, which enables the sharing and viewing of patients’ diagnostic images and reports from across Ontario. If a patient restricts access to his/her data by applying a consent directive, providers querying DI common service will be unable to access information relating to that patient information to which a consent directive has been applied.

Consent directives can be made, modified or removed to restrict or allow the following:

• All of a patient’s records (Domain Consent Directive) 
• A particular report (Record-level Consent Directive)
• All users from a particular organization (HIC-Agent Consent Directive).

Applying Consent Directives

If a patient contacts a health information custodian (HIC) and wishes to either place a restriction on access to his/her information, or reinstate access (remove the restriction), the HIC should:

• Capture the consent directive information on the EHR consent form, and
• Submit the consent directive information to us by faxing it to 416-586-4397 or 1-866-831-0107.

We will send the HIC a confirmation that the request has been fulfilled. The HIC should then provide notice to the patient that the consent directive has been successfully applied.

In instances where a patient requests to place a consent directive on, or reinstate access to, records contributed by more than one HIC, the patient should complete an EHR consent management form, or contact us directly at 416-946-4767.

In all instances, we will apply consent directives within seven days of verifying the identity of the patient making the request. The party who received the request for the consent directive then notifies the patient that his/her request has been fulfilled. If you cannot notify the patient, we will notify him / her on your behalf at your direction.

Overriding a Consent Directive

DI common service permits a health care provider to temporarily override a patient’s consent directive. If you perform a consent override, we will ask you to confirm the purpose of the override, and to subsequently notify the patient of the occurrence. An override can only be performed at the express consent of the patient, or to reduce the risk of bodily harm to the patient or persons other than the patient. Consent directive overrides are in effect for four hours.

A temporary override will be logged in DI common service, along with the identity of the overriding health care provider. We will notify the HIC if one of his/her agents overrides the consent directive. Once contacted by us, it is the HIC’s responsibility to:

Investigate the override to ensure it was for one of the reasons stated above, and notify the patient of the override at the first opportunity.

If a consent directive override is applied for the purpose of eliminating or reducing a significant risk of serious bodily harm to a person other than the individual to whom the personal health information relates or to a group of persons, the HIC should provide a written notice to the Information and Privacy Commissioner of Ontario as soon as possible indicating that this type of override has occurred.