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Healthcare Custodian/Private Sector Health Services

Image by National Cancer Institute

Project start date: January 2022
Project status: nearing completion
Project sponsor: Alberta Innovates

With the advent of digital health information technology there has been a steady growth in private-sector health information technology vendors. These vendors furnish much of the information technology that is employed in the Alberta health sector, and range from large companies (Epic, Telus) with a significant provincial footprint, to small independent start-ups. Some technology is procured and operated by health care custodians such as AHS (Epic), AH (Healthnet), and private health services (EMRs) to meet their information needs. Other technology platforms are owned and operated by the vendor themselves (Telus MyCare, Maple), who contract health providers to deliver health services on their platform. 

To provide health service through a digital platform in Alberta, the custodian of the service must - as dictated in the Health Information Act - complete a Privacy Impact Assessment (PIA) to assure that the confidentiality of personal health information is protected with the use of the novel technology. However, there is an absence of public policy in Alberta that requires that these technologies are interoperable, promote continuity of care, or fosters quality of care. As a consequence fragmentation of health information results in the formation of parallel, technology-based and custodian-based health services, and continuity and quality of care can be compromised. This issue has been magnified by the move to virtual care, notably in the context of Covid. Central to the issue is a lack of clarity around the respective accountabilities of private sector health information technology vendors and health service custodians and affiliates to the management and use of personal health information to promote quality care.

This project aims to address the interface between public and private sector health technologies and services as they apply to the provision of virtual care, with a mandate to provide concrete suggestions for assuring the provision of quality care irrespective of the business model of health information technology or health service provision.   

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