JURISPRUDENCE EXAM QUESTIONS AND
ANSWERS VERIFIED 100% CORRECT
What legislation governs health care information privacy in Ontario? - ANSWER
-Personal Health Information Protection Act, 2004 (PHIPA)
TRUE OR FALSE? PHIPA permits the sharing of personal health information
among health care team members to facilitate efficient and effective care. -
ANSWER -TRUE
Which legislation provides a broad protection to quality of care information
produced by a health care facility or a health care entity, or for a governing or
regulatory body. - ANSWER -Quality of Care Information Protection Act
(QOCIPA)
What is the purpose of the Quality of Care Information Protection Act (QOCIPA)?
- ANSWER -To promote open discussion of adverse events, peer review activities
and quality of care information, while protecting this information from being used
in litigation or accessed by clients.
What is personal health information? - ANSWER -Personal health information is
any identifying information about clients that is in verbal, written or electronic
form.
TRUE OR FALSE?
Clients have to be named for information to be considered personal health
information. - ANSWER -FALSE.
Information is "identifying" if a person can be recognized, or when it can be
combined with other information to identify a person. Personal health information
can also be found in a "mixed record," which includes personal information other
than that noted above.
TRUE OR FALSE?
,When a nurse learns information that, if not revealed, could result in harm to the
client or others, she/he must keep this information confidential within the
therapeutic relationship. - ANSWER -FALSE. He/she must consult with the health
care team and, if appropriate, report the information to the person or group
affected.
TRUE OR FALSE? Nurses must explain to clients that information will be shared
with the health care team and identify the general composition of the health care
team. - ANSWER -TRUE.
TRUE OR FALSE. Nurses must report suspected child abuse. - ANSWER -TRUE
Child and Family Services Act, 1990 requires all health care professionals to report
suspected child abuse to the Children's Aid Society; the Health Protection and
Promotion Act permits reporting of certain conditions to the Medical Officer of
Health.
Your client with an acquired brain injury has been stabilized and is being
transferred to another hospital for continuing care. The client is unconscious. Her
husband is aware of the transfer, but does not know it is happening today. You
tried to reach him by telephone, without success. Before the client is transferred,
you want to share information about the care she received and the current plan of
care with the nurse who will receive her. The client's cost for this transfer is being
covered by private insurance, so you also need to share personal health information
with the insurance company. How much information can you share, and with
whom, under these circumstances? - ANSWER -1. the receiving hospital nursing
staff. These nurses are members of the health care team; therefore, there is implied
consent for the sharing of information with them to provide health care. You can,
therefore, share her personal health information.
2. the insurance company. Express consent is required because this disclosure is
not to a custodian and is not required to treat the client. Because the client is
incapable of providing this consent, her husband (the substitute decision- maker)
must provide express consent either in writing or verbally, before you share
information. Since you cannot reach him, you may arrange her transfer. Once you
,obtain express consent from the husband, you may provide the information to an
insurance company staff member.
A man who received severe facial injuries in a motor vehicle crash arrives in your
emergency room (ER). He is unable to communicate. No next of kin has come
with him. A woman calls in distress and asks if her husband is a patient in your
ER. She provides you with details that match the information on the man's
identification. You believe she is the wife of the man with the facial injuries. Can
you tell this woman that he is in the ER? - ANSWER -Normally, a client would
have an opportunity to request that the hospital not disclose that he is a client in the
facility or his location within the facility. This information may be given out in this
case, however, because it is reasonably necessary to provide care. Because the law
permits disclosure that a person is a client in a facility, and his/her location and
general health status, you may provide this information to the woman. PHIPA
allows you to contact a friend or relative of an injured client for consent. You may
provide more information if the woman indicates she is the person who can act as a
substitute decision-maker for consent to treatment.
Your client has reviewed his health record. You ANSWERed his questions to
ensure he understood the record, but he wants corrections made to a consulting
physician's note. What do you do? - ANSWER -The issue is correcting a health
record made by another health care professional. If the client requested a correction
to your note, and you agreed with the correction the client requested, you could
have the client write a correction and include it with the record or make the
changes yourself. If you did not agree with the correction the client requested, then
you can have the client make a note and append it to the record. You can then
make a separate note regarding the client's request in the health record. A client
does not have the right to correct an opinion or professional judgment by a health
care professional.
Because this is a note by another health care professional (the consulting
physician), you cannot be certain about the accuracy of the information that the
client wants corrected. You have two options in this case: you can either contact
the health care professional who wrote the note and have this physician speak with
, the client about the corrections; or you can speak with the person responsible for
ensuring compliance with PHIPA in your practice setting.
You are an OHN. The manager of an employee who is your client has asked
questions about the client's health condition. The manager has also asked if the
client has medical notes to substantiate absences on particular dates. Can you
provide this information to the manager? - ANSWER -There are two issues here.
The first is what is included in the definition of personal health information; the
second is if a manager has access to personal health information.
Medical notes to substantiate the employee's absences may be held in an
employee's health file. If the medical note does not contain other personal health
information (e.g., symptoms, treatment, diagnosis), then this information can be
provided to the manager. Information concerning accommodation for the
employee's needs may be given so the employer can make provisions to meet these
needs. Accommodation information does not include the nature of the illness or the
diagnosis.
If there is personal health information included in the note, then the OHN can only
provide the information that there were notes to substantiate the absences on the
applicable dates. The manager is not entitled to any personal health information.
This includes information about the nature of the illness, the diagnosis, the plan of
treatment or any care provided; therefore, you cannot respond to any questions
about the nature of the illness(es) or health condition(s).
In this example, the nurse is the custodian and is responsible for maintaining the
confidentiality of the client's personal health information. Providing information to
the employer without the client's express consent is a breach of PHIPA. However,
if a client would like personal health information to be given to the employer, then
the client must give express consent to the nurse. In obtaining express consent, the
nurse needs to clarify exactly which information the client is requesting be
disclosed, and obtain written express consent that includes the employee's specific
request.
DEFINITION
ANSWERS VERIFIED 100% CORRECT
What legislation governs health care information privacy in Ontario? - ANSWER
-Personal Health Information Protection Act, 2004 (PHIPA)
TRUE OR FALSE? PHIPA permits the sharing of personal health information
among health care team members to facilitate efficient and effective care. -
ANSWER -TRUE
Which legislation provides a broad protection to quality of care information
produced by a health care facility or a health care entity, or for a governing or
regulatory body. - ANSWER -Quality of Care Information Protection Act
(QOCIPA)
What is the purpose of the Quality of Care Information Protection Act (QOCIPA)?
- ANSWER -To promote open discussion of adverse events, peer review activities
and quality of care information, while protecting this information from being used
in litigation or accessed by clients.
What is personal health information? - ANSWER -Personal health information is
any identifying information about clients that is in verbal, written or electronic
form.
TRUE OR FALSE?
Clients have to be named for information to be considered personal health
information. - ANSWER -FALSE.
Information is "identifying" if a person can be recognized, or when it can be
combined with other information to identify a person. Personal health information
can also be found in a "mixed record," which includes personal information other
than that noted above.
TRUE OR FALSE?
,When a nurse learns information that, if not revealed, could result in harm to the
client or others, she/he must keep this information confidential within the
therapeutic relationship. - ANSWER -FALSE. He/she must consult with the health
care team and, if appropriate, report the information to the person or group
affected.
TRUE OR FALSE? Nurses must explain to clients that information will be shared
with the health care team and identify the general composition of the health care
team. - ANSWER -TRUE.
TRUE OR FALSE. Nurses must report suspected child abuse. - ANSWER -TRUE
Child and Family Services Act, 1990 requires all health care professionals to report
suspected child abuse to the Children's Aid Society; the Health Protection and
Promotion Act permits reporting of certain conditions to the Medical Officer of
Health.
Your client with an acquired brain injury has been stabilized and is being
transferred to another hospital for continuing care. The client is unconscious. Her
husband is aware of the transfer, but does not know it is happening today. You
tried to reach him by telephone, without success. Before the client is transferred,
you want to share information about the care she received and the current plan of
care with the nurse who will receive her. The client's cost for this transfer is being
covered by private insurance, so you also need to share personal health information
with the insurance company. How much information can you share, and with
whom, under these circumstances? - ANSWER -1. the receiving hospital nursing
staff. These nurses are members of the health care team; therefore, there is implied
consent for the sharing of information with them to provide health care. You can,
therefore, share her personal health information.
2. the insurance company. Express consent is required because this disclosure is
not to a custodian and is not required to treat the client. Because the client is
incapable of providing this consent, her husband (the substitute decision- maker)
must provide express consent either in writing or verbally, before you share
information. Since you cannot reach him, you may arrange her transfer. Once you
,obtain express consent from the husband, you may provide the information to an
insurance company staff member.
A man who received severe facial injuries in a motor vehicle crash arrives in your
emergency room (ER). He is unable to communicate. No next of kin has come
with him. A woman calls in distress and asks if her husband is a patient in your
ER. She provides you with details that match the information on the man's
identification. You believe she is the wife of the man with the facial injuries. Can
you tell this woman that he is in the ER? - ANSWER -Normally, a client would
have an opportunity to request that the hospital not disclose that he is a client in the
facility or his location within the facility. This information may be given out in this
case, however, because it is reasonably necessary to provide care. Because the law
permits disclosure that a person is a client in a facility, and his/her location and
general health status, you may provide this information to the woman. PHIPA
allows you to contact a friend or relative of an injured client for consent. You may
provide more information if the woman indicates she is the person who can act as a
substitute decision-maker for consent to treatment.
Your client has reviewed his health record. You ANSWERed his questions to
ensure he understood the record, but he wants corrections made to a consulting
physician's note. What do you do? - ANSWER -The issue is correcting a health
record made by another health care professional. If the client requested a correction
to your note, and you agreed with the correction the client requested, you could
have the client write a correction and include it with the record or make the
changes yourself. If you did not agree with the correction the client requested, then
you can have the client make a note and append it to the record. You can then
make a separate note regarding the client's request in the health record. A client
does not have the right to correct an opinion or professional judgment by a health
care professional.
Because this is a note by another health care professional (the consulting
physician), you cannot be certain about the accuracy of the information that the
client wants corrected. You have two options in this case: you can either contact
the health care professional who wrote the note and have this physician speak with
, the client about the corrections; or you can speak with the person responsible for
ensuring compliance with PHIPA in your practice setting.
You are an OHN. The manager of an employee who is your client has asked
questions about the client's health condition. The manager has also asked if the
client has medical notes to substantiate absences on particular dates. Can you
provide this information to the manager? - ANSWER -There are two issues here.
The first is what is included in the definition of personal health information; the
second is if a manager has access to personal health information.
Medical notes to substantiate the employee's absences may be held in an
employee's health file. If the medical note does not contain other personal health
information (e.g., symptoms, treatment, diagnosis), then this information can be
provided to the manager. Information concerning accommodation for the
employee's needs may be given so the employer can make provisions to meet these
needs. Accommodation information does not include the nature of the illness or the
diagnosis.
If there is personal health information included in the note, then the OHN can only
provide the information that there were notes to substantiate the absences on the
applicable dates. The manager is not entitled to any personal health information.
This includes information about the nature of the illness, the diagnosis, the plan of
treatment or any care provided; therefore, you cannot respond to any questions
about the nature of the illness(es) or health condition(s).
In this example, the nurse is the custodian and is responsible for maintaining the
confidentiality of the client's personal health information. Providing information to
the employer without the client's express consent is a breach of PHIPA. However,
if a client would like personal health information to be given to the employer, then
the client must give express consent to the nurse. In obtaining express consent, the
nurse needs to clarify exactly which information the client is requesting be
disclosed, and obtain written express consent that includes the employee's specific
request.
DEFINITION
