P-9.0001 - Act respecting the sharing of certain health information

Updated to 15 April 2013

This document has official status.

chapter P-9.0001

Act respecting the sharing of certain health information

TITLE I GENERAL PROVISIONS

1. The purpose of this Act is to establish information assets allowing the sharing of health information considered essential to primary care services and the continuum of care, in order to improve the quality and security of health services and social services, and access to those services.

A further purpose of the Act is to improve the quality, efficiency and performance of the Québec health system by allowing the management and controlled use of health and social information.

2012, c. 23, s. 1.

2. The provisions of this Act must be applied in a manner consistent with

(1)  respect for a person’s right to privacy and for professional secrecy;

(2)  transparency, in that persons must be informed of the purposes of the information assets established by this Act, particularly the Québec Health Record, and of the rules governing their operation;

(3)  a person’s right at any time to refuse to allow the release through the Québec Health Record of his or her health information;

(4)  non-discrimination, in that a person’s decision to refuse to allow the sharing of his or her health information must in no way imperil the person’s right to have access to and receive the health services required by the person’s state of health;

(5)  the right to information, in that a person has the right to be informed of the nature of the health information concerning him or her that is collected, used, conserved and released under this Act;

(6)  the protection of health information, in that the information conserved must only be used for the purposes provided for and may only be released in accordance with this Act;

(7)  the right of access and correction, in that a person has a right of access to his or her health information contained in the information assets established by this Act, and is entitled to request that inaccurate, incomplete or equivocal information or information whose collection, conservation or release is not authorized by this Act be corrected;

(8)  a right of redress with the Commission d’accès à l’information;

(9)  responsibility and accountability, in that the Minister and the Régie de l’assurance maladie du Québec must make sure the information assets they establish operate properly in order to ensure the security, confidentiality, availability, integrity, accessibility and irrevocability of the information governed by this Act.

2012, c. 23, s. 2.

3. In this Act, unless the context indicates otherwise,

(1)  “information asset” means any database, information system, telecommunications system, technological infrastructure or combination of such, or any computer component of specialized or ultraspecialized medical equipment;

(2)  “private physician’s office” means a consulting room or office, situated elsewhere than in a facility maintained by an institution, in which one or more physicians, individually or as a group, regularly practise their profession, privately and solely on their own account, without directly or indirectly providing their patients with lodging;

(3)  “local record” means a user’s record held by an institution under the Act respecting health services and social services (chapter S-4.2), a beneficiary’s record held by an institution under the Act respecting health services and social services for Cree Native persons (chapter S-5) or a person’s record held by a health professional in accordance with the Act constituting the professional order governing the health professional or a regulation under that Act, whatever the medium;

(4)  “Québec Health Record” means an information asset that makes it possible to release to authorized providers and bodies, in a timely fashion, health information concerning a person receiving health services or social services that is held in the health information banks in the clinical domains; and

(5)  “source system” means an information system used to release or receive information held in a health information bank in a clinical domain, in the electronic prescription management system for medication or in a common register.

2012, c. 23, s. 3.

4. The specific information management rules defined by the health and social services network information officer and approved by the Conseil du trésor in accordance with section 10 of the Act respecting the governance and management of the information resources of public bodies and government enterprises (chapter G-1.03) apply to the following persons and partnerships in the performance of any act under this Act:

(1)  the operations manager of a health information bank in a clinical domain;

(2)  the operations manager of a clinical domain register;

(3)  the operations manager of the register of refusals;

(4)  the operations manager of the electronic prescription management system for medication;

(5)  access authorization managers;

(6)  source system managers;

(7)  the operations manager of the register of bodies;

(8)  health and social service providers entered in the register of providers;

(9)  persons or partnerships who host, operate or use an information asset referred to in this Act;

(10)  persons or partnerships who operate a medical biology laboratory, a medical imaging laboratory or a medical diagnostic radiology laboratory within the meaning of the Act respecting medical laboratories, organ and tissue conservation and the disposal of human bodies (chapter L-0.2) or a regulation under that Act;

(11)  the Régie de l’assurance maladie du Québec;

(12)  institutions governed by the Act respecting health services and social services (chapter S-4.2);

(13)  health and social services agencies governed by the Act respecting health services and social services;

(14)  the Cree Board of Health and Social Services of James Bay established under the Act respecting health services and social services for Cree Native persons (chapter S-5);

(15)  persons or partnerships operating a private physician’s office;

(16)  persons or partnerships operating a community pharmacy; and

(17)  persons or partnerships operating a specialized medical centre defined in section 333.1 of the Act respecting health services and social services.

2012, c. 23, s. 4.

5. The health and social services network information officer or any person that officer designates may, to ensure compliance by the persons and partnerships listed in section 4 with the specific information management rules that officer defines, carry out verifications or audits and require those persons and partnerships to produce any information or document, provided the information cannot be associated with persons who have received health services or social services.

2012, c. 23, s. 5.

6. In order to assess the efficiency, performance and benefits resulting from the establishment of the information assets governed by this Act, in particular the Québec Health Record, the Minister may demand from the Régie de l’assurance maladie du Québec any information obtained for the carrying out of the Health Insurance Act (chapter A-29) or the Act respecting prescription drug insurance (chapter A-29.01), provided the information cannot be associated with a particular person.

2012, c. 23, s. 6.

Not in force

22. When health information governed by this chapter is released through a source system or when such information is received through a source system, the operations manager of a health information bank in a clinical domain logs, in addition to the elements listed in section 21, the source system’s identifier and the date and time the information is released or received. In such cases, the manager of the source system used to release or receive the information is deemed to be the manager that released or received the information.

2012, c. 23, s. 22.

Not in force

24. As soon as possible, an institution operating a centre where a pharmacist practises must release to the operations manager of a health information bank in the medication domain, in the cases determined by regulation of the Government, the health information listed in section 26 concerning any medication.

2012, c. 23, s. 24.

Not in force

§ 3 . — Release of health information

Not in force

39. At the request of an authorized provider or body, the operations manager of a health information bank in the immunization domain releases to them, in accordance with their access authorizations, the information that can be released through the Québec Health Record.

2012, c. 23, s. 39.

Not in force

DIVISION VI ALLERGY AND INTOLERANCE DOMAIN

Not in force

§ 1 . — Collection of health information

Not in force

40. As soon as possible, an institution operating a centre where a health professional who documents an allergy or an intolerance for a person’s file practises, a person or partnership operating a private physician’s office, or a specialized medical centre in which such a health professional practises must release to the operations manager of a health information bank in the allergy and intolerance domain the health information listed in section 41 concerning any documented allergy or intolerance that may have an impact on the person’s health.

2012, c. 23, s. 40.

Not in force

§ 2 . — Composition of domain

Not in force

41. The allergy and intolerance domain is made up of the following health information, if available:

(1)  the person’s unique user identification number;

(2)  the person’s age at the time the allergy or intolerance was documented;

(3)  the person’s sex;

(4)  the nature of the allergy or intolerance;

(5)  the symptoms of the allergy or intolerance;

(6)  the anatomical region where the symptoms of the allergy or intolerance appeared;

(7)  the name and unique provider number of the person who documented the allergy or intolerance; and

(8)  any other information prescribed by regulation of the Government.

2012, c. 23, s. 41.

Not in force

§ 3 . — Release of health information

Not in force

42. At the request of an authorized provider or body, the operations manager of a health information bank in the allergy and intolerance domain releases to them, in accordance with their access authorizations, the information that can be released through the Québec Health Record.

2012, c. 23, s. 42.

Not in force

DIVISION VII HOSPITALIZATION DOMAIN

Not in force

§ 1 . — Collection of health information

Not in force

43. As soon as possible, an institution operating a hospital centre must release to the operations manager of a health information bank in the hospitalization domain the health information listed in section 44 concerning the hospitalization of any person who has been discharged from the institution or transferred to another institution or who dies while hospitalized.

2012, c. 23, s. 43.

Not in force

§ 2 . — Composition of domain

Not in force

44. The hospitalization domain is made up of the following health information:

(1)  the unique user identification number of the person concerned;

(2)  the unique identification number of the location where services are provided and where the person was hospitalized;

(3)  the information on the hospitalization summary sheet whose content is prescribed by a regulation of the Government made under paragraph 24 of section 505 of the Act respecting health services and social services (chapter S-4.2) or subparagraph b of the first paragraph of section 173 of the Act respecting health services and social services for Cree Native persons (chapter S-5); and

(4)  any other information prescribed by regulation of the Government.

2012, c. 23, s. 44.

Not in force

§ 3 . — Release of health information

Not in force

45. At the request of an authorized provider or body, the operations manager of a health information bank in the hospitalization domain releases to them, in accordance with their access authorizations, the information that can be released through the Québec Health Record.

2012, c. 23, s. 45.

Not in force

50. A refusal does not prevent the release of health information held in health information banks in the clinical domains to an authorized provider if there is imminent danger to the life or health of the person concerned.

The operations manager of the register of refusals must inform the person concerned of the release, in writing, as soon as possible.

2012, c. 23, s. 50.

Not in force

106. Provided the information cannot be associated with a particular person, the Minister may release health information held in the health information banks in the clinical domains, except unique identification numbers, to

(1)  the Institut de la statistique du Québec;

(2)  the Institut national de santé publique du Québec;

(3)  the Institut national d’excellence en santé et en services sociaux; and

(4)  a person authorized by the Commission d’accès à l’information to use the information for the purposes of study, research or statistics in the health and social services field, in accordance with the criteria listed in section 125 of the Act respecting Access to documents held by public bodies and the Protection of personal information (chapter A-2.1).

Any release of information under this section must be the subject of a written agreement.

2012, c. 23, s. 106.

Not in force

107. In the cases provided for in subparagraphs 1 to 3 of the first paragraph of section 106, the agreement is subject to section 70 of the Act respecting Access to documents held by public bodies and the Protection of personal information (chapter A-2.1), with the necessary modifications.

In the case provided for in subparagraph 4 of the first paragraph of section 106, before the information is released, the Minister must obtain a written undertaking by the person requesting the information to comply with all the conditions imposed by the Commission d’accès à l’information and specified in the authorization.

2012, c. 23, s. 107.

Not in force

108. The persons and bodies who receive health information under section 106 may only use it for the specific purposes for which it was released, and may only release it to a third person if that is provided for in the written agreement and if the information is needed to carry out a mandate or perform a service contract or a contract of enterprise.

The information must be destroyed as soon as possible after the purposes for which it was released are fulfilled.

2012, c. 23, s. 108.

TITLE VII REGULATIONS

120. The Government may make regulations to

(1)  prescribe the health information, in addition to that listed in sections 26, 29, 33, 38, 41 and 44, that makes up a clinical domain;

(2)  determine the cases in which an institution must release the health information listed in section 26;

(3)  prescribe the products, in addition to those listed in paragraph 2 of section 25, that constitute a medication and for which health information must be entered in a health information bank in the medication domain; and

(4)  determine the providers, in addition to those listed in section 69, who may act as authorized providers.

2012, c. 23, s. 120.

121. The Minister may make regulations to

(1)  prescribe the means by which a person may express refusal, in addition to those specified or provided for in the first paragraph of section 48;

(2)  determine the access authorizations that may be assigned to a provider listed in section 69, according to the professional order to which the provider belongs, the provider’s specialty or duties, or the information asset to which the provider is entitled to have access;

(3)  determine the access authorizations that may be assigned to a body described in section 96, depending on the services provided or the information asset to which the body is entitled to have access;

(4)  determine the cases in which the Régie de l’assurance maladie du Québec collects the information listed in section 89 from the person concerned; and

(5)  prescribe how long the health information that is held in a health information bank in a clinical domain is kept, which may vary depending on the case, conditions and circumstances, the clinical domain concerned, the information identified or the purpose specified in the regulation.

2012, c. 23, s. 121.

TITLE IX MISCELLANEOUS PROVISIONS

CHAPTER I APPLICATION

130. The provisions of this Act concerning the release, use and conservation of information and documents apply despite any provision to the contrary in a general law or special Act.

2012, c. 23, s. 130.

132. The role of the Commission d’accès à l’information is to see to it that health information governed by this Act is protected.

2012, c. 23, s. 132.

133. The Commission d’accès à l’information may, on its own initiative or following a complaint from an interested person, investigate whether health information governed by this Act has been protected.

2012, c. 23, s. 133.

134. On completion of an investigation concerning the matter referred to in section 133 and after giving the body or the person concerned an opportunity to submit written observations, the Commission d’accès à l’information may recommend or order that the body or person take any measure required to protect the health information governed by this Act.

2012, c. 23, s. 134.

135. The Minister of Health and Social Services is responsible for the administration of this Act.

2012, c. 23, s. 135.

CHAPTER III AMENDING PROVISIONS

HEALTH INSURANCE ACT

147. (Amendment integrated into c. A-29, s. 65.0.3).

2012, c. 23, s. 147.

ACT RESPECTING THE MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX

148. (Amendment integrated into c. M-19.2, s. 3).

2012, c. 23, s. 148.

149. (Amendment integrated into c. M-19.2, ss. 5.2-5.4).

2012, c. 23, s. 149.

PHARMACY ACT

150. (Amendment integrated into c. P-10, s. 21).

2012, c. 23, s. 150.

PUBLIC HEALTH ACT

153. (Amendment integrated into c. S-2.2, ss. 52-52.1).

2012, c. 23, s. 153.

154. (Amendment integrated into c. S-2.2, ss. 61-61.3).

2012, c. 23, s. 154.

155. (Omitted).

2012, c. 23, s. 155.

156. (Amendment integrated into c. S-2.2, ss. 63-66).

2012, c. 23, s. 156.

157. (Amendment integrated into c. S-2.2, s. 69).

2012, c. 23, s. 157.

158. (Amendment integrated into c. S-2.2, s. 138).

2012, c. 23, s. 158.

159. (Amendment integrated into c. S-2.2, s. 174).

2012, c. 23, s. 159.

ACT RESPECTING HEALTH SERVICES AND SOCIAL SERVICES

163. (Amendment integrated into c. S-4.2, heading of Part III.1).

2012, c. 23, s. 163.

164. (Amendment integrated into c. S-4.2, s. 520.1).

2012, c. 23, s. 164.

165. (Amendment integrated into c. S-4.2, s. 520.2).

2012, c. 23, s. 165.

166. (Amendment integrated into c. S-4.2, s. 520.3.1).

2012, c. 23, s. 166.

ACT RESPECTING HEALTH SERVICES AND SOCIAL SERVICES FOR CREE NATIVE PERSONS

168. (Omitted).

2012, c. 23, s. 168.

169. (Omitted).

2012, c. 23, s. 169.

170. (Omitted).

2012, c. 23, s. 170.

171. (Omitted).

2012, c. 23, s. 171.

172. (Omitted).

2012, c. 23, s. 172.

173. (Omitted).

2012, c. 23, s. 173.

174. (Omitted).

2012, c. 23, s. 174.

175. (Omitted).

2012, c. 23, s. 175.

CHAPTER IV FINAL PROVISIONS

176. A health and social services institution may not transfer to an information technology-based medium any information recorded between 1 January 1935 and 31 December 1964 in the file it holds on a person who was under the age of 21 at the time the person was admitted to a psychiatric hospital, formerly known as an insane asylum or a hospital for the treatment of mental illness, referred to in the Programme national de réconciliation avec les orphelins et orphelines de Duplessis established by Order in Council 1153-2001 dated 26 September 2001 (2001, G.O. 2, 7359, in French only) and Order in Council 675-2003 dated 18 June 2003 (2003, G.O. 2, 3182, in French only).

A user referred to in the first paragraph or, if that user is incapable, the tutor, curator or mandatary of the user is entitled to demand that the institution destroy his or her information described in the first paragraph. In such a case, the information concerned must be completely destroyed.

An institution that contravenes this section is guilty of an offence and is liable to a fine of $7,500 to $75,000.

2012, c. 23, s. 176.

178. No health information concerning a person that is held in a health information bank in a clinical domain may be released through the Québec Health Record before the expiry of 30 days after this Act takes effect in the area of jurisdiction of a health and social services agency in which the person resides, except information concerning a person who did not refuse to have a Québec Health Record during the experimental project implemented in the area of jurisdiction of the agency concerned.

2012, c. 23, s. 178.

179. The Government may specify the dates on which the provisions of this Act take effect according to the areas of jurisdiction of health and social services agencies, and the dates from which the obligation to release health information to the operations manager of a health information bank in a clinical domain applies, according to the types of bodies providing health and social services or the clinical domains it specifies.

The Minister must inform the people in the area of jurisdiction of the agency concerned of the aims and operational procedures of the Québec Health Record, including the right of a person to refuse to allow his or her health information that is held in the health information banks in the clinical domains to be released through the Québec Health Record, as well as the means that may be used to express refusal and the right of a person to have access to his or her health information and to request that it be corrected within 30 days prior to the effective date of this Act.

2012, c. 23, s. 179.

180. (Omitted).

2012, c. 23, s. 180.