Minister disputes dual narratives on eHealth evaluation, privacy concerns

Health Minister Eric Hoskins says no one else has it right on eHealth — at least not the New Democrats, who believe he’s trying to sell it, and not the Star’s sources who are whispering about damage control.

Hoskins’ letter to “privatization czar” and government adviser Ed Clark, asking the former banker to evaluate the province’s public and private digital health record-related assets, has sparked concern from the opposition and doctor groups that the Minister is planning to privatize eHealth, and that that will compromise the privacy of patient records.

“Let’s be honest: His experience in valuing public assets means selling public assets,” said NDP MPP Catherine Fife in Question Period on Monday. “After all, in 2014 when the Premier asked Mr. Clark to maximize the value of government business enterprises, we know that that was a public-relations-friendly way of saying: ‘Sell off Hydro One.’ Is this Premier looking for a way to hide a Liberal plan to privatize digital health assets?”

When Premier Kathleen Wynne denied that, Fife went on to say that the Premier had also denied plans to sell-off Hydro One, prior to selling off a majority stake in Hydro One.

Meanwhile, sources have told the Toronto Star that the government really wants Clark to count up how much eHealth is worth because officials are worried about an auditor general report coming that’s likely to be quite critical of the beleaguered agency, and they want to have a positive message about what the agency is worth, to counter any suggestion of wasteful spending.

Hoskins weighed in on the Star report for the first time Tuesday, while on a brief break from the federal-provincial-territorial health ministers meeting at the King Edward Hotel in Toronto.

So who’s right?

“Well, neither of them,” Hoskins said. “I’ve been absolutely clear, as the Premier has, on Ed Clark’s review of the value of the assets of eHealth. That eHealth is not for sale, it will not be sold, its assets will not be sold. Any decisions on eHealth will be made for the benefit of Ontarian patients.

"The reason why I asked Mr. Clark to review the assets is simple. The mandate of eHealth is due to expire in December of next year and I felt it prudent in advance of making any decisions in regards to that mandate that we have an expert, supported by individuals like the Information and Privacy Commissioner and experts in digital health, to conclude an inventory of the assets and how we might leverage those assets going forward, and how that might feed into a transformed digital health strategy, which will focus more on patient-focused, patient-friendly, consumer-oriented digital health opportunities and continue to build on the progress we’ve made so far.”

Hoskins said he’s not worried about what the auditor general might say about eHealth.

“As I have on home and community care and other topics, I’ve always welcomed the auditor general’s work on health care, it informs my decision-making,” he said.

Meanwhile, the Health Minister’s office is also disputing a privacy concern raised by the Ontario Medical Association (OMA) concerning the Patients First Act. The OMA, in an interview with QP Briefing and in an open letter to Clark, has said doctors are worried that the bill allows for “unprecedented access to patient records through Health Services Providers (HSPs), which could include physicians practising in Family Health Teams (FHTs).”

Specifically, the OMA raised a concern about the ability for Local Health Integration Networks to appoint investigators to look into health service providers, and access the patient health records they control.

The minister’s office said, in a statement, that could occur in cases where wrongdoing is suspected, but qualified that the bill doesn’t allow the investigators to have access to doctors’ records, as doctors aren’t considered health service providers under the bill.

“In rare instances, there may be quality of care, safety or governance/management concerns in the public interest‎ that warrant investigation by the LHINs,” said a statement from the minister’s office.

“In these instances, an investigator may need to review the quality of care/treatment by a Health Service Provider and could require access to personal health information. A physiotherapy clinic, for example, collects personal health information about a patient’s health condition and treatment provided. Nursing staff at hospitals or in the community collect personal health information in assessing patients and noting the treatments provided.

“Under the proposed legislation, the LHINs would not be authorized to investigate physicians because physicians would not be HSPs as defined in this legislation; consequently, LHINs would not be able to use any of the proposed powers to investigate physicians and thereby gain access to physician offices and records,” the statement said.