Friday, April 3, 2020
In 2016, Steven Tam began advocating changes to Canada’s Freedom of Information and Protection of Privacy Act, or FIPPA, to allow a wider scope of technology use in health care.
A pandemic has made some of those changes at least a temporary reality as the Vancouver Coastal Health Authority and other provincial health authorities are able to use new methods and platforms to combat COVID-19.
In a March 29 statement, the Ministry of Citizens’ Services announced British Columbia public health agencies would allow personal information of provincial citizens to be stored and accessed outside Canada.
“The public-health emergency has made it necessary for government to temporarily enable the use of technologies that would otherwise be restricted under FOIPPA’s current rules,” the ministry said in a statement.
“This is definitely a review process on hyper speed. We also have a virtual health EOC that’s been looking into all the requests about enabling virtual and digital care.” – Steven Tam
Tam, the VCH general counsel and chief privacy officer, provided reasons and examples to the Ministry of how using various digital technologies would be crucial for the COVID-19 response, he says.
In a province where privacy rules are more stringent than the rest of Canada, or the U.S., where the Health Insurance Portability and Accountability Act, (HIPAA) does allow record storage on servers or cloud platforms outside the country, this step is significant, Tam adds.
Getting the data
As of April 1, there were just over a 1,000 confirmed COVID-19 cases in British Columbia leading to 25 deaths. VCH, a regional system providing care for about 1.25 million people, or 25 percent of British Columbia’s population, has reported about 500 cases, Tam says.
Now in place through June 30, the temporary order gives health care professionals more leeway in using data and records to coordinate care and treat patients as part of the response to the COVID-19 pandemic.
The order also opens the door for new platforms for better communication and processing prescriptions, saying “Doctors, nurses, first responders and other front-line health-care providers are in urgent need of tools that will help them improve their ability to share information quickly and respond effectively to emerging needs.”
By expediting the review process to introduce those technologies into daily work, Tam says health care professionals can use tools like Slack texting formats to better share data and information.
“We’ve definitely had to be thoughtful about communication strategy,” he explains. “There was some talk about whether Slack could be implemented quickly. Not everyone is set up for that app, so we’ve focused on using it for clinical care as we look at how to support physicians in our hospitals.”
And when prescriptions are needed, physicians can now write them, take a picture, and text them to pharmacists, Tam says. It’s a process both faster and more up to date than using a fax machine or even emails.
There’s been plenty to do inside the system, too, he adds. VCH set up a system-wide emergency operations center as well as smaller ones throughout its coverage areas in mid-March—members meet seven days a week, mostly by video conferencing.
“Because we operate in such a large geographical area, we’ve needed both a broad regional one and ones to address specific areas,” says Tam who’s been working from home since VCH implemented rules for social distancing and working remotely.
To make that happen, VCH has implemented ZOOM software, but again, needed Tam and his team to set the protocols and privacy protections for the meeting. Once created, those guidelines were adopted by other provincial health authorities, he adds.
Though Tam has long advocated for changes to FIPPA and expedited reviews, the pace now is accelerated beyond what he may have imagined.
“This is definitely a review process on hyper speed,” Tam says. “We also have a virtual health EOC that’s been looking into all the requests about enabling virtual and digital care. We’ve definitely had to take an approach of establishing what needs to be done against managing the potential risk.”