Traditionally, information was passed between the patient and the clinician in two ways. One would be a telephone call – typically from the receptionist – and the other would have been face-to-face in the clinic room. Until recently, we had been limited from using many modern techniques due to privacy concerns.

Now, there is a secure way of contacting you through text messaging (SMS) and email. Both of these are generated within our EMR. With this, you will receive a message that has a link and a five-figure, one-time access number. Upon clicking the link, a page either on your smartphone or computer will open. You will be prompted to enter in the five-digit code which will take you to a secure page that has the message as well as any attachments/results.

You can also visit the patient portal on our website, enter in your identifying numbers as prompted, and enter into your portal which will have all your messages stored. We hope in the future that this portal will have access to more of your clinical results.

There are also virtual appointments available as generated securely within the EMR, and has a similar setup as our SMS and email messaging. The link sent to you requires entering a one-time unique code which opens to the EMR system. The virtual visit is run through the EMR and you can speak to your provider via video over your cell phone or home computer!

Additionally, you now have the possibility of booking your own appointments on the patient portal (on a limited basis based on the provider’s availability). You will receive a confirmation text and/or email, as well as a reminder on the day of or day before your appointment. Your total clinical notes are always secure and cannot be accessed by other means.

There is an Open Health Niverville Facebook page in which we use for clinic announcements, office closures, snow days, and general information about our clinic and community. This is not used as a two-way communication tool between the clinic and patients. We will never communicate with our patients directly through Facebook, Instant Messaging, etc. regarding anything relating to appointments or personal medical information. We also ask that patients use our phone lines and/or patient portal in order to communicate with our clinic. Requests, questions, and other communication via Facebook or any future social media outlets will not be answered/viewed.

This Policy is intended to reflect the content of Legislation including the Personal Health Information Act (PHIA) and the Personal Information Protection and Electronic Documents Act (PIPEDA) as well as Guidelines of the College of Physicians and Surgeons of Manitoba and the Canadian Medical Association.
The Staff of Open Health Niverville (OHN) will ensure the protection of the confidentiality of any personal health information (PHI) accessed in the course of providing patient care. We will only collect, use and disclose health information that is required for the purposes of providing care.

Consent is implied for the collection, use, and disclosure of PHI for ourselves and to other health professionals accessed in the routine process of care of patients associated with this clinic.
No consent from the patient is required when the disclosure is mandated by legislation.
Written consent is required for PHI to be shared with a third party for reasons other than care and treatment (i.e. insurance). Consent can be withdrawn at any time.
All staff are required to sign a confidentiality agreement, including persons using the clinic’s electronic medical records (EMR) in the course of providing patient care.

RETENTION OF RECORDS:
Open Health will retain patient records as required by law, and regulation of the College of Physicians and Surgeons of Manitoba. All charts are retained for a minimum of 10 years after the last entry, or 10 years after the patient has reached the age of majority.

DESTRUCTION OF RECORDS:
Open Health will destroy the records only after the requirements for retention have been fulfilled. Destruction will occur in a way that protects patient privacy in accordance with regulations made by the College of Physician and Surgeons of Manitoba.

PATIENT ACCESS TO RECORDS:
Requests for access or copies of medical records can be made in writing to Open Health Niverville from another health care provider the patient is seeing or their new health care provider. This can be done by faxing a signed consent by both provider and patient. Chart transfers will be done adhering to the Guidelines of the Manitoba Medical Association, within one month after receiving payment of the fee (see fee guidelines for more information).

Refusal of access to medical records will occur in the following circumstances:
If the individual requesting access is someone other than the patient to which the record refers, with the exception being the legal guardian of a minor, unless written consent is obtained from the patient naming the specific designated individual or third party.
If the information could reasonably endanger the mental or physical health or safety of the patient to which the record refers, or any other individual.
If the disclosure would reveal PHI about another person who has not consented to the disclosure.

PATIENT COMPLAINTS:
A patient who feels that Open Health Niverville (OHN) has not provided appropriate access to their PHI, or has handled their PHI in an inappropriate manner is urged to address their concerns to the OHN Office Manager in writing. If the outcome of this process is not satisfactory, a complaint may be forwarded to the College of Physicians and Surgeons of Manitoba.

PROTECTION VIA COMMUNICATION:

ANSWERING MACHINES / MESSAGES: In the event that Open Health Niverville (OHN) needs to contact a patient for any reason and communication is occurring via an answering machine or through another individual via a message, the only information transferred by OHN staff will be a request for a call back. Exceptions to this will include:

• If the patient is a minor and the telephone contact is made with the legal guardian.
• If a consent to leave PHI on an answering machine or with another individual has been documented in the patient’s record.
• If the physician concludes there is a risk to personal health or safety that is grave enough to warrant breach of the patient’s right to privacy.

FAX: The fax machine and copier will be located in a secure, non-patient access area. Any PHI that is sent by Open Health Niverville (OHN) will carry a cover sheet with a disclosure of confidentiality instructing the recipient to destroy the document and contact us in the event that is was sent to a non-intended recipient.

E-MAIL: All computer terminals are kept confidential by use of passwords and any PHI that is sent or received via e-mail will contain a disclosure of confidentiality instructing the recipient to destroy the document and contact us in the event that it was sent to a non-intended recipient. No e-mails will be sent from unsecure accounts unless specifically requested and agreed upon with the patient.

POST / COURIER: All mail, by whatever method, will be sent using sealed envelopes via Canada Post or certified medical carriers.

OFFICE ENVIRONMENT:
The medical records, fax, photocopier and computers will be kept in areas to which the public is not granted access. Computers are password protected.
Patients will be treated only behind closed doors to ensure privacy.
A radio station or other sound will be broadcast at all times in the waiting room to minimize the ability to overhear conversations occurring between staff and patients, either directly or by phone.
Corridor consultation between members of the health care team is discouraged and all verbal communication will occur in a secure area or without the use of names whenever possible.
The office is monitored by alarm in order to prevent break in.

Electronic Medical Records

Electronic Medical Record (EMR) is essentially an electronic folder which contains all of your consults going back to 2006, as well as any lab results, x-rays and CT scans, and any consultation documents from specialists. We have been using an EMR since February 2006, and in recent years changed our EMR to InputHealth. InputHealth was purchased by Telus Health in 2020-21, but the changeover has been seamless.

InputHealth does a lot more than just store your medical information. We wanted something that would engage you, our clients, more actively in your management towards achieving your wellness goals.

This active engagement with our patients starts by asking if we can store your email and cell phone number. We can text results through the secure EMR and we can also send you copies of reports. Some of you also have been asked to fill out short questionnaires either on your cell phone or computer before your next visit. With your permission, we have the ability to send you questionnaires to be filled regularly through the year to provide us feedback. We need to stress that if you are uncomfortable giving us this access, you can decline.

What happened to your old records? These have been safely stored on a computer with a backup. If ever there is a concern, it can be interrogated and the original record displayed. We have successfully migrated the information from that previous application into this new application and we are happy with the integrity of this transfer.

We believe passionately in keeping the information that you have entrusted to us secure. We work as if this data is yours and we are purely entrusted with its storage. At any time, you can request to look at your own data. There are methods by which you can apply to have information corrected if you disagree with what is in a record of yours. This is covered under the legislation in Manitoba. Please see the “Transferring Records” section below.

Transferring Records
If the time comes to move on to a different provider, you can request a copy of your records.

There is a fee for this service, which covers the administrative time to prepare your records (typically digitally on an USB drive), as well as the cost to securely courier or mail your information.

We require written consent signed by the patient from the new care provider to request your medical information.

We do not destroy your records, however there is legislation that allows us to destroy paper records after 7 or 10 years, depending on the type of information. However, within an Electronic Medical Record there should be no need for destruction, as space is never an issue. We already have records on many of our clients that go back over 10 years on our EMR.

If you are new to our clinic and you wish to have your previous medical history transferred to us, please see the reception desk where a consent form will need to be signed. We can then fax this request to your previous physician’s office. We would also ask you to contact their office as they may request a fee from you to initiate the transfer.
We scan into our system copies of consultations and diagnostic results. We do not typically scan handwritten notes. Unless the documents are requested to be returned to the original clinic (at their expense only), the documents are securely shredded after they have been scanned in.

As healthcare in general moves to a province-wide data system that stores diagnostic results, the transfer of medical records will become less and less a necessity. It really is only important if you, the client, have an exceptional medical history that needs to be provided for relevant past information for our records. If you had not seen your previous provider for years or only had gone for the odd cough or cold, it is likely not worth the expense to transfer your medical records. Your new provider will review a thorough history with you on your first visits and can always request information on your behalf at a later time, if needed.

Open Health Niverville is committed to providing a safe, secure and respectful environment for all patients, visitors, providers and staff.

Words or actions that make others feel threatened or demeaned will not be tolerated and decisive action will be taken to protect patients and staff.

There is zero-tolerance for any conduct that causes any individual to feel at genuine risk of harm. In these situations, the offending individual will be asked to leave the premises. Patients exhibiting this conduct may be discharged from the practice with no option of returning in the future.

In circumstances of aggression involving physical contact, such as spitting, grabbing, striking, pushing or otherwise, a police report will be filed.

Generally speaking, the zero-tolerance policy extends to conduct which can be considered unacceptable in nature. This includes interactions in person, by phone, and/or in writing.

Examples of unacceptable conduct include (but not limited to): Violence, Intimidation, Throwing objects or damaging property, Inappropriate, demeaning, or abusive language, Discriminatory remarks, Threats or threatening behavior, Bulling or yelling, Sexual harassment

In limited extenuating circumstances, we may exercise our discretion to excuse a single lapse in judgment. In this case, the offending party will receive a written letter noting the circumstance, unacceptable conduct, zero tolerance policy and resolution expectations. This letter will be kept on file at minimum 24-months. Even with the one-time satisfactory resolution being met, no further warnings will be given and any future abusive conduct on the offending individual’s part will be grounds for immediate discharge from Open Health Niverville.