Provinces to Share Health Info With Feds Amid Concerns Surrounding Privacy, Vulnerability

Prime Minister Justin Trudeau meets with Canada's premiers in Ottawa on Feb. 7, 2023. The Canadian Press/Sean Kilpatrick

Canada’s provinces have agreed to facilitate the sharing of health information as a condition of receiving more federal transfers, a commitment that has potential benefits but which also raises concerns.

On Feb. 13, the provinces agreed to $196 billion in transfers from the federal government, of which $46 billion would be new money. To access the funds, Ottawa requires provinces and territories to “commit to improving how health information is collected, shared, used, and reported ... to promote greater transparency on results, and to help manage public health emergencies,” according to a statement issued by the prime minister on Feb. 7.

University of New Brunswick political science professor Herb Emery, a former program director of health policy at the University of Calgary’s School of Public Policy, says that a greater role for federal health care, including sharing more data, won’t bring the change the health system needs.

“Whether federal or provincial, the same basic flaws exist in an arrangement that is open-ended payment for services with no mechanisms to allocate [or] re-allocate resources when shifts are needed,” Emery said in an interview.

“The federal government has no further scale economies of administration over those of the larger provinces.”

Efforts to create a national health-care platform are old. The federal government first announced the Canada Health Infoway in 2000 to facilitate “a more connected and collaborative health system.” Emery says the enormity of the challenge is part of what has stalled its implementation.

“Health data has its own privacy and security challenges at the level of province that are not minor issues with respect to data-sharing, even with a trusted federal government. It’s also not clear if sharing of personal data from all provincial residents with the feds is even feasible or sensible in the absence of a common information system across provinces,” he said.

Trudeau’s Feb. 7 statement acknowledges the federal goal and the provincial alignment required to achieve it.

“Canadians should be able to access their own health information and benefit from it being shared between health workers, across health settings, and across jurisdictions. That is why provinces and territories are also asked to agree to adopt common standards and policies related to data,” the statement says.

Privacy, Information-Sharing

Susan Martinuk, a policy fellow with the Frontier Centre for Public Policy and author of “Patients at Risk: Exposing Canada’s Health-care Crisis,”, believes the Canadian Institute for Health Information (CIHI) already collects enough data to help Ottawa steer toward service targets.

“The government is just looking for some means of claiming to demand accountability. I don’t think it creates accountability at all. I have no idea why they think that this would add accountability,” Martinuk told The Epoch Times.

“But [as for] personal information, the benefit is that when a person goes to a different province, or if somebody falls sick in a different province and has to go to hospital, they would have access to their record. So it’s a huge benefit. The practical problem in implementing it is the cost and the labour involved.”

Jason Woywada, executive director of the BC Freedom of Information and Privacy Association, told The Epoch Times the federal plans don’t raise a red flag for him.

“On the privacy side of things it’s kind of a non-issue. The concerns exist now and wouldn’t really change unless the system entirely devolved to the provinces. I think it’s fair to say each province and the federal government strive to have similar controls and restrictions on the collection, use, access, and protections of personal health information,” Woywada said by email.

“From a patient perspective I would expect that if I go to a hospital in Newfoundland, Alberta, or Saskatchewan, the protections and records could be accessed by my doctor as I travel for work in any of those provinces.”

Woywada said that “standardized key performance indicators in health metrics” would help “improve patient service and monitor the system.” His primary attention is on limiting information-sharing abroad.

“Our concern would stem from how international trade agreements and data sharing agreements might impact the ability of corporations or foreign powers to access that information. Those concerns exist now and don’t really change if Ottawa standardizes collection,” he said.

“We would return to the key factor being transparency in these contracts and agreements because they are in the public interest, and those should trump corporate or foreign interests. This is particularly important as we see more private corporations entering health sectors in some provinces.”

Vulnerability

Martinuk, however, believes the new platform would be a big target for hackers and increase vulnerabilities for personal information.

“Ethical issues, obviously, [are] related primarily to security and privacy, and that is making people’s records very vulnerable to cyberattacks, or even just to people wanting to have a peek,” she said.

“Because it’s so much personal information it’s even more likely that people would want to, or would attempt, to make a ransom demand. Hospitals have had ransom demands, a lot of them, but they don’t make them public.”

The Epoch Times reached out to Health Canada for clarity on how it will handle health information. Senior media relations adviser Anne Genier pointed to 30 years of federal-provincial participation sharing information with CIHI while preserving privacy.

“Canadians should be able to access their own health information, while protecting their privacy and improving the quality and safety of their care. This is why, to access their share of the federal funding, provinces and territories (PT) are asked to commit to common standards and policies related to health information,” Genier said in an email.

“All PTs disclose health data to CIHI in accordance with applicable privacy legislation and under the terms of data sharing agreements. … The Government of Canada will continue to collaborate with partners to ensure that Canadians’ health data is protected and shared securely.”

The federal government must negotiate agreements on a province-by-province basis.

Prior to the agreement, both Saskatchewan Premier Scott Moe and Alberta Premier Danielle Smith had said they would not share personal medical information with the federal government.

Neither Moe nor Smith responded to requests for comment.

Moe also previously said he wouldn’t participate in a digital health ID scheme or accept it as a requirement for funding.

Contracts for Digital ID

A bid for a federal contractor to build a “digital health tech platform” closed on Jan. 3. A Digital Transformation Branch within Health Canada will guide standards and solutions for “pan-Canadian initiatives,” including “proof of vaccination credentials” as well as “immunization international interoperability.”

The contract also had a statement of work that called for a digital health credential such as a “medical qualification, competence, health status, record” by a relevant authority. “The credentials could include a verifiable digital identity of the issuer and the holder of the credential,” said the document.

At a recent campaign stop in Windsor, Ontario, Conservative Leader Pierre Poilievre pledged he would not implement a digital ID if he became prime minister.

However, Martinuk believes it will happen, given time.

“I’m trying not to sound like somebody walking around on the streets with a ‘The end is near’ sign,” she said. “It’s going to happen anyway, no matter what. That’s the kind of society that we’re moving towards rapidly.”