Question

I am suspicious that "princess32604" is actually one of Derek's accounts, given the inevitability of getting around to mention of IHE's IPS and the discussion and information sharing that has arisen on this topic.

Seriously, I hope that the OP (see how current I am, there?), Stephanie McBaine, has been able to extract some useful information from this thread. Stephanie, I also hope that you might be able to share your research paper with us, when you are done.

Peter, I had a good chuckle at your reference to our SYNAPSE project 20 years ago!! Apparently, it's still in operation in the Yukon (last time I checked).

To the group: cross-border movement of patient information is currently best exemplified by the newly launched International Patient Summary (IPS), which was mentioned previously. Co-developed by 5 international digital health SDO's (including ISO/TC215), this initiative is getting a lot of attention worldwide, and also in Canada. Lots of info out there, but you might want to start with this: www.ihe.net/news/ihe-releases-the-international-patient-summary-ips-profile/

This was obviously a timely question, given the enthusiastic participation!

As Finnie hints, we all dream of the day that our Canadian health care teams can video conference with providers and patients in other countries and can share records back and forth with a gesture on a touch screen. (I think that that is the "cool" emoji, but I am old or, at least, old school; so, please forgive me if I have that wrong. )

About a decade ago, there was an ambitious pilot project in Europe, epSOS, that examined the logistics and technical issues of sharing actual personal health information across borders. Called The Large Scale Project, you can start your European Patients Smart Open Services journey with the linked article on the European Union's digital portal, if it could contribute to your research. Sadly, the epSOS project web site, itself, shut down in 2017, but Deloitte produced a nice report on the state of the EC's interoperable eHealth framework just before that project ended.

In 2019, the European Commission passed a recommendation on the European Electronic Health Record exchange format . A digestible article with lots of links can be found, here .

Within Canada, there are some intriguing examples of practical work on using EHR standards to share PHI between jurisdictions. It is a 36MB PDF, but this 2007 MBA thesis from SFU presents a good story about BC's SYNAPSE-EHR for mental health telehealth (full disclosure - I and some members on these forums were involved with SYNAPSE!). Within a jurisdiction, many of the same technological issues are encountered, and you can see some solutions in a set of standards like those used by eHealth Ontario .

Hi Stephanie,

Our response was based on our personal knowledge. Just to be clear, when we say that Canada does not yet share EHR-data, we don't mean sharing PHI on paper or even in digital format such as those carried by individuals through their PHR applications. What we are referring to is system-to-system sharing (for example sharing of ePrescribing information from Finland to Estonia e-estonia.com/first-eu-citizens-using-eprescriptions-in-other-eu-country/).

Hope this clarifies.

Hi Stephanie,

Just to build on that knowledgeable answer from Peter, the staff at SickKids work with international PHI every day through the International Patient Program (IPP) (www.sickkids.ca/en/care-services/international-patients/). Peter's answer provides great examples of Canada's international PHI sharing, and the IPP could be an example of Canada's international PHI collecting.

-Katie

It is not actually forbidden to exchange personal health information (PHI) internationally. In fact, Canadians who work outside of Canada (diplomats, military personnel) and other travellers ("snow-birds," anyone on vacation who has an accident) have paper and electronic records that are shared with health care providers and administrators in other national jurisdictions, in addition to having paper and electronic records in systems governed by the laws of other national jurisdictions. However, you might find some of the information for which you search by digging into the Health section of the Office of the Privacy Commissioner of Canada's Summary of Privacy Laws in Canada .

In Canada, there is a lot of talk about institutions not storing PHI in the USA (a couple of provinces ban it, outright), in particular, but PHI can be disclosed to anyone by any means with appropriate consent of the subject of care. Specific to Ontario, but generalisable to other Canadian jurisdictions, is this 2016 advice from the OIPC (again, to institutions).