6. Digital security (Orals)

Cybersecurity for the Digitized World: Building Cyber Resilience in Healthcare 

The advent of the Internet of Things (IoT) and demand for smart technology in an increasingly ‘connected’ world is a contributor to the expanding cybersecurity threat footprint. Across all industries there is a rise in smart devices. As buildings become more connected, they produce huge amounts of data susceptible to cyber attacks. A large percentage of companies – including hospitals – expect cyber risks to increase in the short to medium term. If organizations are to better protect themselves in the rapidly evolving threat landscape brought about by digitization, the need for education and action is here. In this session, LHSC and Honeywell will explore: Looking beyond standard IT and defining the importance of protecting Operational Technology (OT) like building automation systems; OT risks and why we should care; Enabling decision makers to pinpoint practical steps toward enhanced resilience and reduce risk in healthcare environments.

Presenters

Mirel Sehic – Honeywell

Dipesh Patel – London Health Sciences Centre

 

Foundations for Citizen Consent in Canada’s Digital Health Ecosystem 

Purpose/Objectives

Canadian national surveys have found there is a growing patient demand for online access to their health records and digital health services on a centralized platform. In developing a centralized platform, it is critical to understand the patient expectations of privacy, especially in the unregulated commercial digital health environment. Canadian legislative frameworks generally require meaningful consent for the collection, use and disclosure of Personal Information and Personal Health Information (PHI). Legislation also permits Canadians to express their wishes to limit use and disclosure their records for some purpose; however, questions often arise with respect to the recording and management of consent in digital health records in a digital health ecosystem. The purpose of this project is to develop key functionality of a consent management service for the ecosystem, thereby enabling various digital health services to connect and share with each other in a way that meets the needs and expectations of Canadians.

Methodology/Approach

This two-part study consists of a national survey of Canadian citizens and three stakeholder workshops across Canada. A national survey was conducted to understand the citizen preferences on data control and consent models. The survey was informed by a literature review and grounded in a privacy/trust framework (the eHealth Trust Model). Vignettes and scenarios based on the Meaningful Consent checklist by Information Privacy Commissioner of Canada were used to assess patient preferences on meaningful consent. Stakeholder workshops will be conducted in the fall and will be focused on identifying consent requirements and functionality to support the practical implementation of meaningful consent for digital health services.

Finding/Results

Overall, 1017 Canadians nationally represented by province and chronic illness completed the survey. The preliminary analysis found that almost 9 in 10 participants rate their level or privacy in healthcare as good or excellent and believe that their healthcare records are kept private by healthcare providers. A quarter of participants used some sort of digital health service. Approximately 70% of participants felt the electronic sharing of their PHI within the healthcare system is safe and secure based on their structural assurances (perceptions of legislation, advances in security, and privacy safeguards).

Almost all participants (94%) believed it is very important to have the dynamic control over who can access their health records. Over half (54%) believed that having a broad consent model (all or none) met their needs, whereas 29% would like more granular control of who can access what parts of their health records. Participants had more information needs when consenting to family and friends accessing their records compared to a commercial digital health service provider.

Conclusion/Implications/Recommendations

Based on the preliminary findings, a majority of Canadians want online access to their health records and digital services in a centralized platform. Qualitative analysis of the survey data will be conducted to understand the rationale underpinning their preferences. The findings of this survey will inform the development of key system functionalities for a consent management solution. The solution will be co—designed with patients and provisional stakeholders in consent management across Canada.

Summary

This presentation outlines the key requirements of a consent management service for the digital health ecosystem that will meet the expectations of Canadians.

Presenters

Sarah Wickham – Canada Health Infoway

Abigail Carter-Langford – Canada Health Infoway

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