New bill reforming health information management tabled at the National Assembly

In December 2021, Christian Dubé, minister of health and social services, tabled an initial bill (Bill 19) to regulate access to and use of health and social services information (HSSI). Bill 19 was terminated when the last parliamentary session was suspended (for more information on this topic, see our previous publication).

On December 7, Éric Caire, minister of cybersecurity and digital technology, tabled a new bill also aiming to provide a framework for access to HSSI by users, professionals, health system managers and researchers (Bill 3).

Purposes of Bill 3

Bill 3’s main objective is to ensure the protection of HSSI, while enabling optimization of the use made of it as well as its timely communication.

In support of this second point, the minister pointed out at his press conference that the proposed legislative framework will make it possible to: (1) increase the mobility of HSSI by, among other things, linking it to patients rather than to the institutions in which health services are provided, and (2) allow HSSI to be used by and communicated to researchers, whether they work in the public or private sector or are located in Quebec or elsewhere, subject to applicable legal requirements.

Finally, the minister confirmed that Bill 3 will implement and shape one of the main pillars of Quebec's Plan pour mettre en œuvre les changements nécessaires en santé regarding access to data, and is intended to be complementary to Bill 95 and to Bill 64 (for more information about Bill 64, see our publications here).

What is specified in Bill 3

As was the case with Bill 19, Bill 3 does the following: (1) creates a new Act respecting health and social services information, (2) repeals the Act respecting the sharing of certain health information, thereby abolishing the Québec Health Record, and (3) amends a number of existing laws, including some additional laws.

In fact, Bill 3 aims to provide Quebec with a full-fledged legislative framework for HSSI, which already existed in several other provinces, and institutes a new "national information filing system" in place of the Québec Health Record.

The Act first broadly and liberally defines the concept of HSSI as any information: (1) about a person; (2) that directly or indirectly allows the person to be identified; and (3) that concerns the person’s state of physical or mental health or his or her health determinants, material collected in the context of treatment, the services provided or any other characteristic determined by law or by regulation.

It also implements the lessons learned from the pandemic by providing a better overview of HSSI at the national level and local management of information. To this end, an HSSI access authorization manager will be appointed within the Ministère de la Santé et des Services Sociaux to oversee HSSI access authorizations, as required.

The Act also recognizes enhanced rights of access, use and communication of HSSI, while confirming that such information will be used or communicated, to the greatest extent possible, in a form that does not allow the person concerned to be identified directly. These rights will exist not only for the benefit of third parties, particularly in a research context, but also for the benefit of the persons concerned. In this regard, Bill 3 recognizes various rights for a person concerned by HSSI, including the right to access his or her HSSI and have it rectified where necessary. 

Finally, the Act establishes several rules and measures that must be put in place to protect HSSI. For example, organizations will have to respect a policy governing their management of HSSI, appoint a person in charge of its protection, log such HSSI and monitor the logs created.

Key takeaways

As part of a reform process that began several months ago, Bill 3 essentially reiterates many of the principles introduced by Bill 64, including confidentiality incidents, anonymization and privacy impact assessments, and pursues the same objectives as those proposed in Bill 19, namely to provide timely and broad access to HSSI while acknowledging the importance of protecting it. 

It will be interesting to see how Bill 3 will proceed in the National Assembly and, if adopted: (1) the scope of the regulations, procedures and other mechanisms that will be adopted by the government, in particular to specify the governance and security rules surrounding the access to HSSI; (2) the list of certified technologies that can be established and used in managing HSSI; and (3) the approach to be taken by the Commission d’accès à l’information in exercising its monitoring and investigative powers.