Search

Disclosure of health information under the Health Information Act

Alberta’s Health Information Act (HIA) enables the release of individually identifiable health information with or without the consent of an individual. AHS Information & Privacy has published Guidelines for the Disclosure of Health Information for use by AHS staff, physicians and contracted agencies or affiliates. The guidelines describe when information is authorized to be disclosed, if consent is required and in some circumstances what type of individually identifiable health information can be disclosed.

If consent is required under the HIA to disclose health information about a patient, you or someone legally authorized to act on your behalf will be required to provide AHS with your written consent prior to releasing the specified health information. HIA has six specific requirements for what is contained within a valid consent to disclose health information.

Those requirements are as follows:

  • A statement authorizing AHS to disclose the health information that is specifically listed in the consent
  • The purpose that the health information in needed for
  • The identity of the person/agency/group to whom the health information is to be given to
  • An acknowledgment that the individual providing the consent is aware of the reasons why the health information is needed and the risks and benefits to the individual of consenting or refusing to consent,
  • The date the consent is effective and the date, if any, on which the consent expires, and
  • A statement that the consent may be revoked at any time by the individual providing it.

AHS Information & Privacy has a valid consent for disclosure of health information available for use by any individual who is requesting AHS disclose information to them or on their behalf.

Disclosure Without Consent

The HIA also AHS as a custodian to disclose individually identifying diagnostic, treatment and care information to another custodian (such as a physician’s private office/clinic or Alberta Health) without patient consent. The disclosure may be done for any of the purposes listed in section 27(1) or (2) of the Act which is the same purposes for which a custodian may use individually identifying health information in its custody or under its control.

The purposes include:

  • providing health services;
  • determining or verifying an individual’s eligibility to receive a health service;
  • conducting investigations, discipline proceedings, practice reviews or inspections relating to the members of a health profession or health discipline;
  • conducting research (with the approval of a research ethics board);
  • providing health services provider education;
  • carrying out any purpose authorized by an enactment of Alberta or Canada; and for internal management purposes.

Alberta Health Services may also disclose information to AH for the additional purposes of:

  • planning and resource allocation;
  • health system management;
  • public health surveillance; and
  • health policy development.

Other examples of the more standard types of disclosure without consent are:

  • Disclosure to another government for payment of health services - (Section 35(1)(a.1))

This provision enables the disclosure of diagnostic, treatment and care information without the individual’s consent to the government of another province or territory or to the government of Canada. Disclosure is only permitted where the individual is a resident of the other province or territory or where the government of Canada is responsible for payments for health services provided to the individual.

  • Disclosure to a person providing continuing treatment and care to the individual - (Section 35(1)(b))

This provision permits the disclosure of individually identifying diagnostic, treatment and care information without the individual’s consent to the person (not limited to health-care providers) providing continuing treatment and care to the individual.

It should be noted that under section 8(4) of the Health Information Regulation, if a custodian is disclosing health information to a person in a jurisdiction outside Alberta, the custodian must enter into an agreement with the person to whom the health information is disclosed. However, this provision does not apply to health information about an individual that is used in a jurisdiction outside Alberta for the sole the purpose of providing continuing treatment and care to the individual.

  • Disclosure to family members or those in a close personal relationship - (Section 35(1)(c))

Under this section disclosure may be made about an individual’s location, presence, condition, diagnosis, progress and prognosis on that day to family members of the individual or to another person with whom the individual is believed to have a close personal relationship, without the individual’s consent. The disclosure must not be contrary to the express request of the individual. “Person in a close personal relationship” could include a common-law spouse, a close friend, an interdependent adult or other person who can demonstrate a relationship with the individual who is the subject of the information.

  • Disclosure to family members where an individual is injured, ill or deceased - (Section 35(1)(d))

Disclosure of individually identifying diagnostic, treatment or care information without the individual’s consent is allowed for the purpose of notifying or contacting family members of an injured, ill or deceased individual or another person with whom the individual is believed to have a close personal relationship or to be a friend of the individual. The disclosure must not be contrary to the express request of the individual.

  • Disclosure to family members where individual is deceased - (Section 35(1)(d.1))

This enables staff to disclose individually identifying diagnostic, treatment and care information relating to circumstances surrounding the death of the individual or to health services recently received by the individual, to family members of the deceased or another person with whom the individual is believed to have had a close relationship. The disclosure must not be contrary to the express request of the individual.

  • Disclosure to an official of a penal or other custodial institution - (Section 35(1)(e))

This provision enables staff to disclose diagnostic, treatment and care information that identifies an individual without the individual’s consent to an official of a prison or other institution where the individual is being held or detained but only to allow health services to be provided to the individual. “Custodial institution” would include a jail, holding cell, remand centre, Young Offender’s Centre or any other facility or institution where an individual is being lawfully detained.

  • Disclosure to a Quality Assurance Committee - (Section 35(1)(g))

This provision enables staff to disclose information to a quality assurance committee as defined under Section 9 of the Evidence Act.

  • Disclosure for a legal proceeding - (Section 35(1)(h))

This provision enables staff to disclose information for the purpose of a court or other legal proceeding in which AHS is a party.

  • Disclosure to comply with a subpoena, warrant or order - (Section 35(1)(i))

This provision enables staff to disclose information for the purpose of complying with a subpoena, warrant, or order issued by a court, or other body having jurisdiction in Alberta to compel the disclosure of information.

  • Disclosure to prevent imminent harm - (Section 35(1)(m))

This provision enables staff to disclose information if they have reasonable grounds to believe the disclosure will prevent an imminent danger to the health or safety of any person. Three criteria must be satisfied for “imminent danger” to exist:

  1. clarity-the intended victim or group of victims must be sufficiently identifiable;
  2. danger-the danger to the victim must be serious bodily harm or death;
  3. imminence-the risk must be serious and a sense of urgency must be created by the threat of danger. The risk could be a future risk but must be serious enough that a reasonable person would be convinced that the harm would be carried out.               
  • Disclosure when individual lacks mental capacity - (Section 35(1)(n))

This provision enables staff to disclose information about an individual when that individual lacks mental capacity to provide consent and staff believe disclosure is in the best interests of the individual. If the individual has a guardian or other person authorized to make decisions on their behalf, staff should try to obtain consent from that person before disclosing information.

  • Disclosure when authorized or required by law - (Section 35(1)(p))

This provision enables staff to disclose information for the purpose of complying with another law that authorizes or requires such disclosure.

  • Disclosure to a health professional body for the purpose of an investigation - (Section 35(4))

This provision enables staff to disclose information to a health professional body for the purpose of an investigation, discipline proceeding, practice review, or inspection.

Disclosure can only be made:

  1. if AHS has complied with any other enactment authorizing or requiring the custodian to disclose the information for that purpose and
  2. the health professional body agrees in writing not to disclose the information to any other person except as authorized by the legislation governing the health professional body.

Disclosure to police

There are two main provisions in HIA that allow disclosure to a police service. (Please also refer to the section on Mandatory Reporting of Gunshot and Stab Wounds). “Police Service” is defined in the Police Act as a regional, municipal or provincial police service.  The provisions are:

  • Disclosure to avert or minimize imminent danger to health or safety of any person - (Section 35(1)(m))

This permits the disclosure of individually identifying diagnostic, treatment and care information without the individual’s consent to any person including a police service if a staff member believes, on reasonable grounds, that the disclosure will avert or minimize an imminent danger to the health and safety of any person. Disclosure can be to any person so this can include joint police and mental health teams or other individuals considered to be in a position to assist in to avert or minimize imminent danger.

Generally, three criteria must be satisfied for “imminent danger” to exist:

  • clarity - the intended victim or group of victims must be ascertainable or sufficiently identifiable;
  • danger - the danger to the victim must be serious bodily harm or death; and
  • imminence - the risk must be serious and a sense of urgency must be created by the threat of danger. The risk could be a future risk but must be serious enough that a reasonable person would believe that the harm would be carried out.

These three criteria must be considered in the context of each situation and in view of the surrounding circumstances. There must be a clear and imminent threat of serious bodily harm or death to an identifiable group or person that creates a sense of urgency.

  • Disclosure to protect public health and safety - (Section 37.3)

This grants custodians the discretionary authority to disclose individually identifying health information, without the individual’s consent, to the police or Minister of Justice and Attorney General where the custodian reasonably believes:

  • the information relates to a possible commission of an offence under a statute of Alberta or Canada and
  • disclosure will protect the health and safety of Albertans,

Under this provision the health information that a custodian may disclose is:

  • an individual’s name;
  • an individual’s date of birth;
  • the nature of any injury or illness of an individual;
  • the date on which a health service was sought or received a health service;
  • whether any samples of bodily substance were taken from the individual (not the sample itself or the results).

The purpose of the provision is to give a police service sufficient information so that it may apply to a court for a search warrant or a production order.

If you require assistance in establishing if consent is or is not required, or if you believe your information was shared inappropriately by someone acting on behalf of AHS, contact the AHS Privacy Intake Line by e-mail at privacy@albertahealthservices.ca. If email is unavailable you may also call us toll-free at 1-877-476-9874.