Information sharing is about how health data is collected, accessed, used, disclosed, and exchanged.
The size and reach of the Connect Care initiative will challenge traditional ways of thinking about information sharing. To the extent that the Alberta Health Services (AHS) Provincial Clinical Information System (CIS) integrates health records across domains with different legislation (e.g. Health Information Act, Hospitals Act, Health Professions Act), regulations (e.g. CPSA charting standards) and policies (e.g., medical staff bylaws), a new approach to information sharing is needed for all stakeholders in all settings.
AHS has been working closely with Alberta Health, Covenant Health, the Alberta Medical Association (AMA), the College of Physicians and Surgeons of Alberta (CPSA), the University of Alberta, the University of Calgary and other stakeholders to develop an Information Sharing Approach ('Approach') equal to the needs and opportunities of Connect Care. These efforts are founded on mutual trust and respect, engaging all health care professionals for the benefit of all Albertans.
The Approach replaces a prior Information Sharing Framework that applied to AHS-provisioned ambulatory care Electronic Medical Records. The broader Approach is accepted by all stakeholders with plans for full implementation by January 2018.
The Approach emphasizes clear statements of principles, interests and expectations for complex shared information environments. It uses a “compact” to expose the rights and responsibilities of health information users, irrespective of whether they might previously have been considered a “custodian” or “affiliate”. Those terms, prominent in Alberta’s Health Information Act, did not work well in situations where clinicians and health authorities considered themselves “co-custodians” of the same health information.
Although patients are unequivocally ‘owners’ of their personal information, the Approach more clearly outlines AHS custodial accountabilities for the protection of that information, including appropriate access and disclosure. Users of AHS CISs are affiliates of AHS, with expectations defined, participation in information stewardship governance assured and issue resolution pathways provisioned. This will change the way some physicians understand information sharing in AHS CISs.
The Approach promotes responsible information sharing to improve improvement of health care and the health care system. This includes uses for training, administration, quality improvement, outcomes tracking, research and instruction.
Alberta’s health education and health research institutions, including Universities and Colleges with health professional training programs, are key stakeholders in AHS CIS initiatives. The Information Sharing Approach principles apply to all users of the AHS CISs, including all health disciplines and professions. Clinicians currently use AHS Clinical Information Systems for a number of key functions, including:
Recognizing that different healthcare professionals may have unique information sharing needs or constraints, the Approach provides for profession-specific memoranda of understanding. The unique trust and confidentiality accountabilities of all healthcare professionals are respected.
The academic medical community has a specific interest in the information shared within the AHS CISs. Alberta’s Faculties of Medicine and AHS are partners in ensuring physicians navigate the various regulatory requirements when accessing AHS CISs for research, quality improvement, innovation or instructional purposes.