This information is not intended to replace legal advice from a lawyer. If you have a legal problem or need legal advice you should speak to a lawyer.
The Personal Health Information Act and you
Nova Scotia's Personal Health Information Act (PHIA) sets out rules to protect the privacy of personal health information, and for the collection, use, disclosure, retention and destruction of personal health information.
PHIA also sets out rules about your right to:
- access your personal health information
- ask for corrections if your health information is not complete, accurate, or up to date
- make a complaint and request a review if you feel a custodian has not followed the rules under PHIA
- in certain situations, access the personal health information of a person who has died.
You also have a right to request a review of a decision made under PHIA. The Office of the Information and Privacy Commissioner for Nova Scotia (OIPC) is an independent oversight body responsible for responding to “requests for reviews” under PHIA.
The law aims to balance your privacy rights with the needs of health care providers to share information to support and manage health care.
What information does PHIA protect?
PHIA protects "personal health information", which is information that identifies you and is about:
- your physical or mental health
- your family’s health history
- your payments for, or eligibility for, health care
- health care you have received
- who provides health care to you
- organ donation, and related test or exam results
- your health registration information, including your health card number
- the identity of your substitute decision-maker, if you are not able to make your own health care decisions.
The rules under the PHIA apply to your personal health information regardless of how the information is recorded or stored. Also, PHIA continues to apply to your personal health information even after your death.
The rules under the PHIA apply to your personal health information regardless of how the information is recorded or stored (for example, paper or electronic records). Also, PHIA continues to apply to your personal health information for the earlier of 120 years after the record was created or 50 years after you die.
Who does PHIA apply to?
PHIA applies to certain designated "custodians". Custodians are people or organizations who have custody or control of personal health information because they provide health care, or support the provision of health care.
- any member of a regulated health care profession, like your doctor, dentist, nurse, phsyiotherapist, chirporactor, optometrist, dietician, psychologist or pharmacist
- the Nova Scotia Department of Health and Wellness
- the Nova Scotia Health Authority
- the Izaak Walton Killam Health Centre (IWK)
- the Review Board under the Involuntary Psychiatric Treatment Act
- designated Mi’Kmaw First Nations bands
- licensed pharmacies
- a licensed continuing care facility
- Canadian Blood Services
- a Nova Scotia Hearing and Speech Centre
- any government approved home care, or home oxygen agency
- a community hospice operator.
PHIA does not apply to others who may have your health information for reasons unrelated to providing health care to you, such as your employer or an insurance company.
Protecting your privacy
PHIA requires custodians to:
- have safeguards and practices in place to protect your personal health information
- protect against theft, loss and unauthorized handling of personal health information
- have a designated contact person to handle compliance with PHIA, including responding to requests for access to or correction of personal health information, and to process complaints
- notify you if your privacy has been breached and there is potential for harm or embarrassment to you.
Making a Complaint
You can make a complaint to the custodian if you believe they have not followed the privacy rules of PHIA. You can raise your concerns about how the custodian collects, uses or discloses your information, about any consent concerns you have, the practices the custodian has in place to protect privacy, and how your information is used for research. You can also make a complaint if you feel you were not notified properly of a privacy breach.
If you are not satisfied with the custodian’s response to the complaint, you can ask the Information and Privacy Commissioner to review it. You will find more information about requesting a review below.
Accessing your personal health information
PHIA gives you a right of access to your own personal health information that a custodian has. You can get a copy of the records or you can arrange to view the records. The access request should be in writing, although the custodian can waive that requirement.
You do not have to tell the custodian why you want to see the record. If your request is not specific enough the custodian must offer you help to revise your request.
How much will it cost to access my personal health information?
Custodians may charge you a general fee of up to $30.00 for the initial processing of a request to access your personal health information. The custodian may charge additional fees for things like photocopying. The fees are set out in the regulations of PHIA which can be found here. Custodians must give you an estimate of the fees to be charged before doing the work.
All or part of the fee may be waived if you can’t afford to pay it, or if there is another good reason why it would be unfair for you to have to pay it.
If you do not agree with a fee estimate, first talk with the custodian to see if they will reduce or waive the fee. If you still can’t resolve it, you can contact Nova Scotia’s Office of the Information and Privacy Commissioner (OIPC) to request a review. You will find more information about requesting a review below.
How long will it take to access my personal health information?
A custodian has up to 30 days to either grant or refuse your request for access to your records. They may extend the timeline, but must tell you in writing if they do. If the custodian takes longer than 30 days without informing you of an extension, this may be considered a refusal to provide the records which you may ask to have reviewed by the Office of the Information and Privacy Commissioner for Nova Scotia.
Can a custodian refuse me access to my personal health information?
Custodians may refuse to grant access to your personal health information if it is reasonable for the custodian to believe that disclosing the records would:
- risk serious harm to your treatment, recovery, physical or mental health
- risk serious harm to the mental or physical health of someone else
- identify a person who provided information they reasonably expected to be kept confidential
- give you information about someone else’s personal health information.
Custodians may also refuse your request if the information is subject to a legal privilege, another statute or court order prohibits disclosure, the information was for a quality review program, or the information was for a proceeding that is still happening. Additionally, the custodian does not need to grant access to your personal health information if they believe the request is “frivolous or vexatious." Generally, a request may be considered frivolous or vexatious if it is primarily made for a reason other than accessing the records, for example, to harass the custodian.
If you are refused access to all or part of your records, the custodian must tell you why in writing.
If you are refused access to your personal health information and disagree with that decision you have a right to complain to the Information and Privacy Commissioner for Nova Scotia (OIPC), and ask them to review the custodian's decision. You must file a request for review within 60 days, from the time you get notice of the refusal. In some cases the 60 day time limit may be extended, so it is a good idea to contact the OIPC about your situation even if you have missed the 60 day time limit.
If the OIPC recommends that you should be allowed access to your health record, and the custodian still refuses to allow access, you may appeal to the Supreme Court of Nova Scotia. It is a good idea to consult a lawyer if you wish to appeal to the Supreme Court.
What if I want to make a correction to my records?
If, after reviewing your records, you believe your records are not complete, accurate or up to date, you may request a correction. The request should be in writing, and you must provide evidence to show the custodian why your record is not complete, accurate or up to date. The custodian may also agree to correct the record if you simply ask them to.
A custodian does not have to correct your record if:
- it is a record not originally created by the custodian, and the custodian does not have sufficient knowledge, expertise and authority to correct the record
- the record is a good faith professional opinion or observation that the custodian made about you
- you have not provided sufficient information to show that a correction is required – it is not enough to simply ask for a correction without proof
- the custodian believes the request is frivolous or vexatious or is part of a pattern of conduct that amounts to abuse of the right of correction.
The custodian has 30 days to respond to your request either by correcting the record, or refusing to correct your record.
If the custodian refuses to correct your record they must explain why in writing.
If you disagree with the refusal you can request that the Office of the Information and Privacy Commissioner (OIPC) review the custodian's decision. You must file your request for a review within 60 days, from the time you get notice of the refusal. There is more information about review requests below.
Can I access the personal health information of a person who has died?
Yes. PHIA allows a custodian to disclose personal health information about a person who has died if:
- you are the personal representative of the person who died, and you need the records so you can administer the estate;
- you are either a family member or a person with a close personal relationship with the person who died, and the information relates to the circumstances of the death or health care received by the person who died. Information may not be released if disclosure would be against the prior express wishes of the person who died.
Can I get a record of who has looked at my personal health information?
Yes. You can request a ‘record of user activity’ which is a list of the people who have looked at your health information in an electronic health information system. There is no fee to get this record. Once you make a request, the custodian has up to 30 days to respond.
If you are concerned that there has been a breach of your privacy, the custodian will have a designated person you can contact who can respond to your concerns.
Requesting Review of a decision (appealing a decision)
If you disagree with the response you have received from a custodian you may ask the Information and Privacy Commissioner for Nova Scotia (OIPC) to review the decision. The OIPC has information about the review process in their "How to Appeal a Decision (Request a Review)" fact sheet.
You must request a review within 60 days of receiving the decision of the custodian The OIPC may extend the 60 day deadline in some situations, so it is best to contact the OIPC to discuss your situation even if you have missed the review deadline.
You may request a review under PHIA if:
- you disagree with a fee estimate provided by a custodian
- a custodian does not respond to a request for access to your records within 30 days
- a custodian has refused to provide access to all or part of your personal health information
- a custodian has refused to correct an error in your personal health information
- you are not satisfied with the custodian's response to your privacy complaint.
Review requests must be in writing. You can request a review by using a form provided by the OIPC, or by writing a letter. Be sure to include:
- the custodian's name, and the decision date
- a copy of the custodian’s decision
- if available include a copy of your original access request
- your address and telephone number.
There is no fee for requesting a review from the OIPC.
When the OIPC receives a review, it will first try to settle the matter informally between the parties. If that does not work, then a formal review process will start and the parties will make written statements and Information and Privacy Commissioner will make a report deciding if the custodian was correct, partially correct, or incorrect. The report will make recommendations for the custodian to follow. Generally with privacy matters, the report is not made public. You can see examples of OIPC reports here. The custodian then decides whether to reject or accept and implement all or part of the Commissioner’s recommendations. If you are not satisfied with the custodian’s response to the Commissioner’s recommendations, you can appeal to the Nova Scotia Supreme Court.
Appealing to the Supreme Court of Nova Scotia is more complicated. You may need to pay court fees and other costs and other factors may need to be considered. It is a good idea to consult a lawyer if you wish to appeal to the Supreme Court.
For more information
Office of the Information and Privacy Commissioner of Nova Scotia:
Visit the Office of the Information and Privacy Commissioner of Nova Scotia (OIPC) website for more information, or contact the OIPC at:
Phone: (902) 424-4684
No Charge-Dial: 1-866-243-1564
Email: [email protected]
The OIPC also has a helpful "Mini-Guide to Health Information in Nova Scotia".
Nova Scotia Department of Health and Wellness:
Go to novascotia.ca/dhw/phia/ for information about PHIA from Nova Scotia's Department of Health & Wellness, or contact their Privacy & Access Office at:
No Charge-Dial: 1-855-640-4765
Privacy and Access Office
1894 Barrington Street
PO Box 488
Halifax, NS B3J 2R8
Email: [email protected]
Last reviewed February 2021