Ministry of Health
The Ministry of Health has a mandate to support Saskatchewan residents in achieving their best possible health and well-being. With direction from the Minister of Health, Saskatchewan Health establishes policy direction, sets and monitors standards, provides funding, supports regional health authorities and other organizations, and ensures the provision of essential and appropriate services.
The Ministry is the trustee for
• Pharmaceutical Information Program (PIP) and
• co-trustee with the Regional Health Authorities of the Saskatchewan Laboratory Results Repository (SLRR)
• Medical Services Branch (MSB) data
• Saskatchewan Immunization Management System (SIMS) eHealth Saskatchewan
eHealth (formerly the Saskatchewan Health Information Network) was established on December 14, 2010, pursuant to Order in Council 734/2010.
eHealth’s prescribed objects and purposes are as follows:
(a) to lead Saskatchewan Electronic Health Record (EHR) planning and strategy for the Province of Saskatchewan;
(b) to procure, implement, own, operate or manage the Saskatchewan EHR and the associated provincial components and infrastructure;
(c) where appropriate, to procure, implement, own, operate or manage other health information systems for the benefit of the Province of Saskatchewan;
(d) to facilitate improved health provider and patient access and use of electronic health information for the purpose of enhancing the delivery of health care services in the Province;
(e) to establish the provincial health information and technology standards necessary for connecting local electronic health information systems to the Saskatchewan EHR and associated provincial components and infrastructure;
(f) to work and cooperate with regional health authorities, other health care organizations, providers, other organizations providing related services as agents, contractors or partners in health information systems and the public in the development and delivery of the Saskatchewan EHR and where appropriate, other health information systems;
(g) to provide data stewardship for the Saskatchewan EHR and where appropriate, other health information systems and databases, including, without limitation:
i. administering the rules for EHR data collection, use and disclosure;
ii. establishing and administrating provincial standards to protect the quality, confidentiality and security of EHR data;
iii. protecting the EHR data as a strategic resource; and
iv. acting as trustee and information manager for Saskatchewan EHR databases and services; and
(h) to pursue consistent funding for the Saskatchewan EHR, and where appropriate, other health information systems from all available resources, including, without limitation, Canada Health Infoway Inc.
and to be accountable for the spending of such funds.
eHealth Saskatchewan, is an IMSP. It provides information technology and information management services to the Ministry of Health, RHAs and other health service providers and delivery agencies within Saskatchewan.
Regional Health Authorities
Health services are primarily delivered through 12 regional health authorities often referred to as health regions. The Regional Health Authorities (RHA) were established under The Regional Health Services Act. The Act came into force August 1, 2002 and sets out the powers and responsibilities for both the Minister of Health and the RHA. Each regional health authority has a governing board.
The major areas of responsibility for the RHAs include:
• Hospitals;
• Health centres, wellness centres, and social centres;
• Emergency response services, including first responders, ambulance;
• Supportive care, such as long-term care, day programs, respite, palliative care and programs for patients with multiple disabilities;
• Home care;
• Community health services, such as public health nursing, public health inspection, dental health, vaccinations, and speech pathology;
• Mental health services; and
• Rehabilitation services.
The RHAs are the trustees of the personal health information in their custody or control in the above settings and also are source trustees for SLRR and the Radiology Information System (RIS) and Picture Archiving and Communications System (PACS)
Saskatchewan Cancer Agency
Cancer care services are primarily delivered by the Saskatchewan Cancer Agency. The Agency was established under The Cancer Agency Act. The Saskatchewan Cancer Agency has a governing board appointed. Its major areas of responsibility include:
• Assessing the cancer care and health care needs of the persons to whom the agency provides cancer care services;
• Co-ordinating the cancer care services it provides with health services, provided by regional health authorities and other providers of health services;
• Evaluating the cancer care services that are provided in Saskatchewan;
• Establishing provincial protocols and standards for cancer care services;
• Educating health care providers in the prevention, diagnosis, treatment and post-treatment of persons at risk of cancer or diagnosed with cancer;
and
• Promoting and encouraging health and wellness.
The Cancer Agency is the trustee of personal health information in their custody or control.
Information Management Service Providers (IMSP)
There are many IMSPs in the eHealth environment. eHealth Saskatchewan is the largest IMSP, performing this role for PIP, SLRR, RIS-PACS, SIMS and other provincial information systems. EMR vendors are IMSPs when physicians select the ASP model for their EMR. Physicians may also use a local IT company to provide services to store or manage EMR data. Local companies that store paper and electronic information are also IMSPs. IMSPs must be fully aware of their responsibilities under HIPA and as set out in the agreement with the trustee whose information they are managing.
IMSPs are not trustees of the personal health information managed on behalf of trustee.
Designated Archives
When physician-trustees cease to practice they may wish to assign responsibility for their records to someone else. They may enter into an agreement with another physician or HIPA allows them to archive the records with designated organization. There are ongoing discussions between the Ministry of Health and the designated organizations as to their role. More advice is expected from the Ministry in the future.
The organizations designated as archives for records of personal health information under HIPA are:
• affiliates, as described in the Regional Health Service Act
• Department of Health
• Health professional bodies that regulate members of a health profession pursuant to an Act
• Regional health authorities
• Saskatchewan Archives Board
• Saskatchewan Health Information Network (eHealth Saskatchewan)
• University of Regina Archives
• University of Saskatchewan Archives
Health Professionals
In addition to physicians these other health professionals can be trustees when not employed by another trustee:
• Dentists
• Dietitians
• Licensed Practical Nurses
• Medical Laboratory Technologists
• Medical Radiation Technologists
• Midwives
• Speech-language Pathologists and Audiologists
• Physical Therapists
• Podiatrists
• Psychologists Third Parties
Third parties are those individuals and organizations who provide a service to the practice that does, or has a significant chance of, seeing or using personal health information, but who are not trustees, employees, health professionals, medical students or residents. Physicians should enter into a written agreement with third parties that includes an obligation to protect the personal health information at the standard of the medical practice or higher.
Office of the Information and Privacy Commissioner
The Information and Privacy Commissioner is not a trustee but is an independent officer of the Saskatchewan Legislative Assembly. He oversees three different Saskatchewan statutes:
The Health Information Protection Act
The Freedom of Information and Protection of Privacy Act
The Local Authority Freedom of Information and Protection of Privacy Act
The OIPC has jurisdiction over Saskatchewan government departments; Crown Corporations; provincial agencies; health regions; universities, colleges and schools; municipalities; health information trustees such as physicians,
pharmacies, laboratories, diagnostic clinics, and a number of other organizations.
The OIPC has no authority over the federal government or the private sector other than private businesses that are health information “trustees”.
The OIPC ensures the privacy and access rights of the people of Saskatchewan are respected by:
• Informing members of the public of their information rights
• Mediating access and privacy disputes between individuals and public bodies
• Making recommendations on appeals from access to information decisions by public bodies
• Investigating and resolving privacy complaints
• Issuing recommendations on public bodies’ policies and practices
• Commenting on proposed laws and policies