| A | B |
|---|
| Elements of a contract | an offer is made and accepted; consideration is given (something of value changes hands) |
| Requirements of the physician-patient contract | physician must provide reasonable care; patient must keep financially up to date (OHIP card) and demonstrate willingness to follow advice |
| Requirements for a physician to end a patient relationship | must document in the patient chart and in a letter to the patient why they are ending the relationship; must give reasonable time to find another physician; can end relationship immediately in the case of violence, threat or illegal activity |
| Requirements for the patient to end a physician relationship | patients can changes physicians at any time, however, if they are rostered, they should let the physician know they are leaving or contact the MOH to end their enrolment with the physician |
| Obligations held by physicians to their patients | to provide prudent and diligent care; not to abandon the patient; to preserve confidentiality; to obtain informed consent |
| Requirements for legal contract | consideration must be given; both parties must be legally able to enter into a contract; contract must involve legal subject matter |
| Parts of the Health Information Protection Act | Personal Health Information Protection Act (PHIPA); Quality of Care Information Protection Act |
| Information protected under PHIPA (Personal Health Information) | anything identifying: physical or mental health; family medical history; who provides care; how medical care is provided; payments or eligibility for health insurance; donation of any body part or substance; health card number; substitute decision makers for patient |
| Requirements for access to personal health information by patients | may request orally or in writing; if in writing, physician must provide access within 30 days; physician is allowed to charge for cost recovery |
| Who PHIPA applies to | Health Information Custodians (physicians, hospitals, anyone with responsibility for records) and their agents (MOA, other employees with records access) |
| Requirements for protection of patient information | There must be documented information protection policies; individuals must be informed at the first opportunity if their information may have been accessed or stolen |
| Requirements for consent | must be knowledgeable, relate to the use of the information; and be in the form appropriate for the situation |
| Forms of consent | Express and Implied |
| Express consent | in writing or affirmed orally (patient says "yes") |
| Implied consent | consent assumed by a patient's actions (patient didn't say "no" or refuse explicitly) |
| Circle of care | consent for sharing information can be assumed when the provider is sharing with another health information custodian (or their agent) for the purposes of providing care to the patient. |
| Who is assumed to be in the circle of care? | specialists and other physicians; long-term care facilities; community care access centres; hospitals, labs; pharmacies; ambulance services; public health |
| Who is not in the circle of care? | any individual not providing professional care; includes family members, lawyers, insurance companies, etc |
| When can consent be given by someone on another person's behalf? | if the patient authorizes someone in writing to provide consent and/or if the patient is incapable of providing consent |
| who can give consent to information sharing or treatment if the patient is incapable? | authorized guardian or attorney; spouse or partner; child or parent; sibling; any other relative; public guardian or trusteee |
| When is consent to collect or use information not required? | when disclosure is required by law; when it is not reasonably possible to collect consent (emergencies when the patient is unable to respond); when the hospital or physician needs to determine OHIP eligibility or health insurance coverage and the patient is unable to respond |
| Quality of Care Protection Act | protects information collected by an organization or committee for the purposes of improving quality of care (stats used to improve performance) |
| Regulated Health Professions Act | determine which professions should be regulated and advise on legislation related to regulation |
| Health Care Consent Act | governs consent with respect to physician treatment |
| Requirements for informed consent | individual is capable of consenting and aware of nature of treatment; expected risks and benefits; alternative courses of action and consequences of not being treated |
| when in someone capable of providing consent? | usually must be 16 or older and must be mentally capable of understanding information regarding what they are consenting to (exceptions can be made for mature individuals under 16 at the physician's discretion) |
| Workplace Safety and Insurance Act | facilitates return to work after injury and provides compensation and other benefits to injured workers; physicians must report workplace injuries if the patient will be filing a WSIB claim |
| Highway Traffic Act | requires physicians to take driver's license (and report to the MOT) if a patient is a danger to themselves or others on the road |
| child and Family Services Act | requires physicians to report suspected child abuse |
| Vital Statistics Act | requires physicians to report births and deaths they attend to the government |
| Health Protection and Promotion Act | requires physicians to report cases of diseases of pubic concern to the public health unit |
| Mandatory Gunshot Wounds Reporting Act | requires physicians to report gunshot wounds to the police |
