PET Scans Ontario Program Positron Emission Tomography (PET) Scan Evidence Based (EB-PET) Program PIA Summary

Background

In April of 2010, the MOHLTC and Cancer Care Ontario (CCO) entered into an agreement for CCO to establish, manage and coordinate the EB-PET Program. The Program covers uninsured PET scan services. Uninsured PET scan services fall under one of three domains: the PET Registry domain, the PET Clinical Trials domain or the PET Access Program domain. 

The EB-PET Program will provide an information technology (IT) solution (“PET Scans Ontario web application”), which will be used to support the activities of the uninsured program domains (PET Registry, PET Clinical Trials and the PET Access Program) and insured PET scan services.

The PET Scans Ontario web application enables physicians, through the use of web-based forms, to request PET scans for their patients and enables PET Centres, through the use of web-based forms, to submit results from PET scans performed at their institutions. This use of the web application by the referring physicians and the PET Centres is expected to improve the efficiency of processes and increase the security and data quality of information exchange between physicians and PET Centres.

Key Findings

The PET Scans Ontario web application will be provided to referring physicians and PET Centres under the ss. 6(2) PHIPA Regulation authority of a HINP:

• Ontario Health will provide the secure PET Scans Ontario web application to referring physicians (HICs) to allow them to submit requests for PET scans, access results of completed PET scans and access their patient's PHI when the data is entered into the Ontario Health PET Scans Ontario web application by another HIC.
• Ontario Health will provide the secure PET Scans Ontario web application to PET Centres (HICs) to allow them to access requests for PET scans, submit results of completed PET scans and access their patient's PHI when the data is entered into the Ontario Health PET Scans Ontario web application by another HIC.

Ontario Health will be acting as an agent to the HICs (referring physicians and PET Centres), as that term is defined in s. 2 of PHIPA, for managing and operating all of the domains under the EB-PET Program.

Under the PET Access Program domain, physicians will obtain the express consent of patients to provide the patient’s information to Ontario Health via the PET Scans Ontario web application for the purposes of adjudication to determine eligibility for the patient to receive a PET scan.

Lastly, Ontario Health will use the PHI it collects from PET Centers to compile statistical reports for assessing the extent to which health care technologies such as PET scans should be used in the delivery of health care services. The PET scan reports, which do not contain PHI, will be provided by Ontario Health to the MOHLTC and the PET Steering Committee. PHIPA permits Ontario Health, as a section 45 prescribed entity, to collect, use and disclose PHI for the purposes of planning and management for the health system.

The PIA recommends several measures to ensure that any data collected, used or disclosed by the EB-PET Program complies with PHIPA as well as Ontario Health policies, procedures, standards and best practices.

Risks & Recommendations

In summary, the PIA provides the following recommendations:

1. Amendment to PHIPA and/or its Regulation, clarifying that FIPPA does not apply to Ontario Health's collection, use or disclosure of PHI, when acting under its various PHIPA authorities;
2. Agreements are required to be in place between Ontario Health and HICs using the PET Scans Ontario web application;
3. An Agreement is required to be in place prior to Ontario Health transferring data to external organizations as permitted under PHIPA;
4. All data linkages are to be performed in accordance with Ontario Health's Privacy Policy (4th edition);
5. Quality assurance practices are to be implemented;
6. A Threat Risk Assessment is to be conducted;
7. A threat model for HINP logging and audit requirements are to be developed; and
8. A plain language description of the EB-PET program and the safeguards it has implemented should be made available to HICs and the public.

Ontario Health is in the process of addressing all the recommendations which were identified in the 2010 EB-PET Program PIA.