• What is the Emergency Department (ED) Access to Drug History initiative?
• Who will have access to a patient's drug claims history?
• Why would the Ministry make ODB recipients' drug claims history available to an emergency department?
• How will the sharing of this information with emergency departments benefit ODB recipients?
• Will all Ontario hospitals, regardless of whether or not they have an emergency department, have access to the drug claims history of ODB recipients?
• When will these emergency departments have this access?
• Is using the DPV System by hospital emergency departments mandatory?
• Will this electronic access apply to other emergency department patients?
• What information will be provided?
• Will the Drug Profile Viewer System be available anywhere else outside the emergency department? Will an ODB recipient's family doctor have access to the system?
• When will the drug claims history information be expanded to cover all Ontario residents and all drugs?
• Can ODB recipients receive a copy of their drug claims history?
• Can the hospital provide an ODB recipient with a copy of their drug claims history?
• Can an ODB recipient's drug claims history be updated by an emergency department?
• What if an ODB recipient stopped taking a drug, will this be reflected in the drug claims profile?
• How accurate is the drug claims information provided in the Drug Profile Viewer system?
• What should an ODB recipient do if s/he believes that their drug claims profile is inaccurate or incomplete?
• What should the health care provider do, if s/he has questions related to information available through the DPV System?
• What should the health care provider do, if the recipient information listed under an ODB recipient’s health number is incorrect or needs to be updated? E.g. address, name, date of birth etc.

• What about the confidentiality and security of personal health information?
• Under what authority is the Ministry disclosing ODB and TDP drug claims history to Ontario emergency departments?
• Does the Ministry require the consent of ODB recipients to disclose their drug claims history to emergency departments?
• How secure is the DPV System which provides emergency departments with access to ODB recipients' drug claims history?
• What are the hospital’s responsibilities if the ODB patient’s drug claims profile is lost?
• Can ODB recipients find out who accessed their drug claims history?

Consent Questions

• What if an ODB recipient does not want their drug claims history shared with a hospital emergency department?
• Are ODB recipients who withdraw consent still eligible for Ontario Drug Benefit Program or Trillium Drug Program benefits and other insured health care services?
• What if an ODB recipient does not want some of their drug claims history disclosed to an emergency department?
• Where can ODB recipients get a consent withdrawal form?
• How will ODB recipients know that the Ministry processed their request to withdraw consent?

• What if an ODB recipient withdraws consent and then changes their mind?

• Can ODB recipients reinstate their consent during a visit to a hospital emergency department?
• How can an ODB recipient who is unable to communicate or unconscious in the ED reinstate their consent?
• Can ODB recipients reinstate consent for a partial list of their drug claims history while at the emergency department?
• How long does a temporarily reinstated consent last?

What is the Emergency Department (ED) Access to Drug History initiative?

The ED Access to Drug History initiative will provide an electronic information system, known as the Drug Profile Viewer (DPV) System, which will enable the Ministry to share the prescription drug claim histories of Ontario Drug Benefit (ODB) recipients with healthcare providers in some hospital emergency departments (EDs).

Starting in October 2005, authorized staff in most Ontario hospital emergency departments will have electronic access to the drug claims history of patients who receive benefits through the Ontario government’s Drug Benefit Program and the Trillium Drug Program.

This initiative is being undertaken by the Ministry of Health and Long-Term Care in collaboration with Canada Health Infoway, an independent, not-for-profit corporation formed as a federal-provincial-territorial initiative.

Who will have access to a patient's drug claims history?

Emergency departments in Ontario hospitals which are connected to the Smart System for Health Agency (SSHA) secure network and have entered into an agreement with the Ministry will have access to the Drug Profile Viewer, the electronic information system.

Only authorized emergency department staff including physicians, ED intake personnel, triage staff and nurses, and health care providers on-call to the emergency department such as specialists can view and print ODB recipients' drug claim histories.

Why would the Ministry make ODB recipients' drug claims history available to an emergency department?

This will help health care providers to quickly identify and prevent harmful drug reactions and provide more informed emergency care.

How will the sharing of this information with emergency departments benefit ODB recipients?

Emergency department access to drug claims history can help patient care by :

• Allowing quicker identification and prevention of adverse drug reactions
• Making faster medical assessment and treatment possible
• Assisting those who may not remember their medication name and dosage
• Helping to ensure a patient's current medications are continued in hospital if needed
• Reducing duplication - repeating patient drug information to multiple health care providers involved in their care

Will all Ontario hospitals, regardless of whether or not they have an emergency department, have access to the drug claims history of ODB recipients?

No.  Only Ontario hospitals with emergency departments which are connected to the Smart Systems for Health Agency's secure network and which have entered into an agreement with the Ministry will have access to the drug claims history of ODB recipients.

When will these emergency departments have this access?

Phased implementation began in October 2005. Full provincial roll-out is expected to be completed by Summer 2006.

Is using the DPV System by hospital emergency departments mandatory?

No. The DPV System is being provided as an additional tool to help health care providers deliver more informed emergency care. The use of the DPV System is at the sole discretion of the health care provider.

Will this electronic access apply to other emergency department patients?

No.  Emergency department staff will only have access to the drug claims history of recipients of the Ontario government's Ontario Drug Benefit or Trillium Drug Program.

What information will be provided?

Only drugs that are covered by the ODB program or drugs for which patients have received special approval and which have been dispensed by a pharmacist in Ontario will be on an ODB recipient's drug claims history. Emergency department staff will be able to view the names, dosage forms, strengths and quantity of the drugs which have been dispensed to a patient. In addition, the prescriber and pharmacy information will be displayed.

Drug products that are not benefits of the ODB program – including over-the-counter medication or herbal products – will not be on the drug claims history. It is important that patients taking these types of products let the staff in the emergency department know so they are fully informed.

Will the Drug Profile Viewer System be available anywhere else outside the emergency department? Will an ODB recipient's family doctor have access to the system?

No.  Access to ODB drug claims history information through the DPV System is currently limited by regulation to hospital emergency departments.

When will the drug claims history information be expanded to cover all Ontario residents and all drugs?

Once the DPV System is fully deployed and operational in most Ontario hospital emergency departments, the Ministry may explore options for broadening access, such that drug claims history for all Ontarians might become available to their authorized health care provider at the point of care.

Can ODB recipients receive a copy of their drug claims history?

Yes.  Every individual has a right of access to their record of personal health information in the custody or control of a health information custodian. In the case of ODB drug claims history information, the health information custodian is the Ministry. The right to access one's health records is set out in the Personal Health Information Protection Act, 2004, S.O. 2004, c.3 Sched. A which has some limited exceptions.

ODB recipients may exercise this right by writing to the Ministry. The request should be sent to :

Director
Drug Programs Branch
Ministry of Health and Long-Term Care
5700 Yonge Street, 3^rd Floor
North York ON M2M 4K5

If an individual does not receive access to their ODB drug claims history or the Ministry does not respond to an access request within a reasonable amount of time, that individual can make a complaint to the Information and Privacy Commissioner. Access requests will be processed on an urgent basis where circumstances warrant.

Can the hospital provide an ODB recipient with a copy of their drug claims history?

If a patient’s ODB drug claims profile becomes part of his/her hospital record, the hospital may grant access to that hospital record in accordance with the hospital’s access policies/procedures.

Can an ODB recipient's drug claims history be updated by an emergency department?

No. The drug claims history is a record of all the prescriptions that are covered by the ODB program that were dispensed by pharmacists in Ontario and submitted to the Ministry for payment. Although this DPV System enables authorized users in an ED to view and print an ODB recipient’s drug claims profile, it does not enable these users to update or modify it.

What if an ODB recipient stopped taking a drug, will this be reflected in the drug claims profile?

The drug claims history is a record of prescriptions dispensed by pharmacist’s in Ontario. ED staff will be able to view the names, dosage forms, strengths and quantity of the drugs which have been dispensed to a patient. The information may not reflect changes in the patient’s drug treatment. Patients should communicate changes in their medication to emergency department staff.

How accurate is the drug claims information provided in the Drug Profile Viewer system?

ODB Data that is accessible through the DPV System:

1. is limited to those drug claims that pharmacies have submitted to the Ministry to date in respect of approved ODB drug products dispensed to ODB patients;
2. is only that portion of the drug claim information that the ODB patient has consented to release; and
3. may not necessarily contain all of the current medications that the ODB patient may be utilizing at any time.

A drug claim that is included in an ODB patient’s drug claims profile means that the claim was submitted to the Ministry by the dispensing pharmacy but, does not imply that, the patient has picked up the medication from the dispensing Pharmacy, or the patient is taking the medication as prescribed.

The information available on the DPV System is advisory only and is not intended to replace sound clinical judgment in the delivery of health care services.

Can an ODB recipient's drug claims history be updated by an emergency department?

If the drug claims information that was submitted by the pharmacist is not correct, please direct the patient to contact the Ministry in writing :

Director
Drug Programs Branch
Ministry of Health and Long-Term Care
5700 Yonge Street, 3^rd Floor
North York ON M2M 4K5

What should the health care provider do, if s/he has questions related to information available through the DPV System?

Health care providers are encouraged to contact the dispensing pharmacy or prescriber for any clarification regarding medications in the drug claims profile.

For all other inquiries health care providers can contact the e-health support desk at 1-877-346-2244.

What should the health care provider do, if the recipient information listed under an ODB recipient’s health number is incorrect or needs to be updated? E.g. address, name, date of birth etc.

Health care providers should direct the ODB recipient to their local Ministry OHIP office. For more information or to find out the location of their nearest OHIP office, recipients can call the ministry’s INFOline at 1-800-268-1154.

What about the confidentiality and security of personal health information?

Every ODB recipient's personal health information continues to be confidential and protected under the Personal Health Information Protection Act, 2004, S.O. 2004, c.3 Sched. A (PHIPA).

Under what authority is the Ministry disclosing ODB and TDP drug claims history to Ontario emergency departments?

The disclosure of ODB and TDP drug claims history to Ontario emergency departments is authorized under O. Reg. 150/05 made under the Ontario Drug Benefit Act, R.S.O. 1990, c.0.10 and PHIPA.

Does the Ministry require the consent of ODB recipients to disclose their drug claims history to emergency departments?

Under the health privacy legislation, PHIPA, the Ministry may rely on the implied consent of ODB recipients to disclose their drug claims history for the purpose of providing health care. To do this, the Ministry must inform ODB recipients of :

1. the reason why their drug history may potentially be disclosed, and
2. their right to withdraw consent to the disclosure of all, or part of, their drug history by notifying the Ministry.

Unless an ODB recipient expressly withdraws his or her consent, the Ministry may disclose that recipient's drug claims history to an emergency department at which he or she seeks health care on the basis of implied consent.

If an ODB recipient consents to the Ministry making their drug claims history available to an emergency department at which he or she seeks treatment, no action on the part of the ODB recipient is required.

How secure is the DPV System which provides emergency departments with access to ODB recipients' drug claims history?

It is very secure. Only those hospitals which have entered into a data access agreement with the Ministry and are connected to the Smart Systems for Health Agency's (SSHA) secure network will be provided access to ODB drug claims history.

This access will be through the DPV System which enables the secure sharing of information. All users of the DPV System must be identified, registered, and have proper authorization to gain access to ODB and TDP drug claims history. The DPV System will be maintained and operated on an ongoing basis under the direction of the Ministry. In addition, the Ministry will maintain a record of each authorization that is granted to view an ODB recipient's drug claims history at an emergency department.

What are the hospital’s responsibilities if the ODB patient’s drug claims profile is lost?

Pursuant to Section 12 of the Personal Health Information Protection Act, 2004 (PHIPA), all health information custodians are required to take reasonable steps to ensure that personal health information in the custodian’s custody or control is protected against theft, loss, and unauthorized use or disclosure and to ensure that the records containing the information are protected against unauthorized copying, modification or disposal.

In the event that a loss, theft, or unauthorized disclosure of an individual’s personal health information occurs, the health information custodian that has custody or control of that information is required to notify that individual at the first reasonable opportunity.

Can ODB recipients find out who accessed their drug claims history?

Yes.   For security and auditing purposes, the Ministry retains a record of each authorization that has been granted to view an ODB recipient's drug claims history at an emergency department. ODB recipients can request a copy of a list of authorizations that were granted to view their drug claims history by sending a written request to :

Director
Drug Programs Branch
Ministry of Health and Long-Term Care
5700 Yonge Street, 3^rd Floor
North York ON M2M 4K5

A.  Withdrawing Consent

What if an ODB recipient does not want their drug claims history shared with a hospital emergency department?

Those ODB recipients who do not want their drug claims history disclosed to an emergency department may withdraw their consent.

• This can be done by submitting a Full Withdrawal of Consent Form to the Ministry.
• ODB recipients can also identify specific drugs they wish not to be disclosed. This can be done by submitting a Partial Withdrawal of Consent Form to the Ministry. The Ministry will not disclose information about those medications which have been identified on the form. If an ODB recipient changes their mind about the list of drugs they do not wish to be disclosed, they will need to resubmit a new list of drugs and another Partial Withdrawal of Consent Form.

ODB recipients are encouraged to consult with a healthcare provider about the benefits of disclosing their drug claims history to emergency departments at which they seek treatment and the potential health risks of fully or partially withdrawing consent.

Are ODB recipients who withdraw consent still eligible for Ontario Drug Benefit Program or Trillium Drug Program benefits and other insured health care services?

Yes.  A decision to withdraw consent will not affect an ODB recipient's eligibility to receive ODB or TDP benefits or any other health care service funded by the Province of Ontario.

What if an ODB recipient does not want some of their drug claims history disclosed to an emergency department?

They must complete and submit a Partial Withdrawal of Consent Form to the Ministry. The Ministry will not disclose information about those medications which have been identified on the form. If an ODB recipient changes their mind about the list of drugs they do not wish to be disclosed they will need to resubmit a new list of drugs and another Partial Withdrawal of Consent Form.

Where can ODB recipients get a consent withdrawal form?

Forms are available by calling the Ministry's Drug Programs Branch help desk at 1-866-752-6405 or by downloading from the Ministry's web site.

How will ODB recipients know that the Ministry processed their request to withdraw consent?

The Ministry will send them a letter confirming that their instructions have been processed.

What if an ODB recipient withdraws consent and then changes their mind?

The ODB recipient will need to submit a Consent Reinstatement Form to the Ministry.

This is necessary in cases where an ODB recipient has totally or partially withdrawn consent and then later wishes to provide consent.

ODB recipients' may also be able to temporarily reinstate consent while seeking treatment at an emergency department.

Can ODB recipients reinstate their consent during a visit to a hospital emergency department?

If the emergency department has the ODB recipient’s health number, that recipient can temporarily reinstate their consent by communicating (or having their substitute decision maker communicate) their wishes to a staff member of the emergency department.

How can an ODB recipient who is unable to communicate or unconscious in the ED reinstate their consent?

Consent cannot be reinstated if the patient is incapable of communicating and unaccompanied by a substitute decision maker who can give consent on their behalf.

Can ODB recipients reinstate consent for a partial list of their drug claims history while at the emergency department?

No. If an ODB recipient reinstates consent in an emergency department, staff will have access to all of that patient's ODB drug claims history.

How long does a temporarily reinstated consent last?

This authorization allows the individual health care provider to access the DPV System during that episode of care, i.e., more than once during an emergency department visit if necessary. It is recommended, however, that ED personnel print a copy of the drug claims profile for inclusion in the patient’s hospital record at the time the recipient/patient is admitted to the ED.

TTo have consent reinstated on a permanent basis the ODB recipient will need to complete a Consent Reinstatement Form and send it in to the Ministry.

Frequently Asked Questions English  |   French 8 pages | 69k | PDF format

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July, 2006