Request to Access Personal Health Information

Hôpital Montfort collects personal information about your health, whether that information is provided by you or a person acting in your interests. For example, we collect your name, date of birth, address, medical history, the history of your visits to Hôpital Montfort and the care you received during your visits. We occasionally collect your personal health information from other sources, provided that we have obtained your consent or if the Act permits us.

Public Notice under the Personal Health Information Protection Act (PHIPA)

Use and Disclosure of Your Personal Health Information

We use and disclose your personal health information for the following purposes:

• To treat and care for you. This may include sharing your information with your family doctor, a laboratory, another healthcare provider, or other hospitals involved in regional and/or provincial electronic health record initiatives.
• To obtain payment for your treatments and care (Ontario Health Insurance Plan, Workplace Safety and Insurance Board, private insurance, or other payers).
• To plan, administer, and manage our operations.
• To carry out risk management and quality improvement activities.
• To support research and education.
• To comply with applicable laws and regulations.
• To fulfill other purposes permitted or required by law.

Your name and address may be provided to the Montfort Hospital Foundation so that it can inform you about its activities and contact you for fundraising campaigns. You have the right to request that your name and address not be used for this purpose. Please be assured that the Foundation will never disclose your information to other organizations.

Your Rights

• You may request access to your personal health information and request corrections to it.
• You may contact us to withdraw your consent for certain uses and disclosures listed above (subject to legal exceptions).

Our Commitment

• We take the necessary steps to protect your personal health information from theft, loss, unauthorized access, copying, modification, use, and disclosure.
• We conduct audits and investigations to ensure that your personal health information and privacy are protected.
• We collect only the information necessary to carry out our work.

Contact Us

For any questions regarding your personal health information, please contact the Access to Information and Privacy Office at (613) 748-4903 or infoprivee@montfort.on.ca

If you believe your rights have not been respected, you have the right to file a complaint with the Information and Privacy Commissioner of Ontario:

Information and Privacy Commissioner of Ontario
2 Bloor Street East, Suite 1400
Toronto, ON M4W 1A8
Phone: (416) 326-3333 or 1-800-387-0073
Fax: (416) 325-7539

Note

1. Personal Health Information (PHI) is defined as identifiable information about an individual, whether oral or recorded in any form, if it relates to:
   a) the individual’s physical or mental health, including family health history;
   b) the provision of health care to the individual, including identifying a person as a health care provider;
   c) a service plan under the Long-Term Care Act, 1994 for the individual;
   d) payments for health care provided to the individual or their eligibility for such care;
   e) the donation by the individual of part of their body or bodily substance, or resulting from the analysis or examination of such a part or substance;
   f) the individual’s health card number;
   g) identifying a substitute decision-maker for the individual.
   (PHIPA, Section 4(1), 2004)
2. Personal Health Information Record: commonly refers to a medical or clinical record.

Aline-Chrétien Health Hub: Health Information Network

The Aline-Chrétien Health Hub is a partnership between Hôpital Montfort, Bruyère, CHEO, the Eastern Ottawa Resource Centre, Ottawa Community Geriatric Psychiatry Services, the Ottawa Youth Services Bureau, ParaMed, Ottawa Public Health, and Champlain Home and Community Support Services. This collaboration aims to provide easier access to coordinated healthcare services. As part of this initiative, Montfort collects personal health information from clients of the Health Hub.

For more information, please visit the Health Information Network page on the Aline-Chrétien Health Hub website.

Forms

To submit a request for access or correction, please use the form that best suits your needs.

• Request to Access Personal Health Information (formerly clinical records): access to clinical records, release of information, proof of birth, stay and death - fees apply.
• Request to Correct Personal Health Information

Requests for access to personal health information and corrections: please send us your original request by mail or visit us in person. Please note that two pieces of ID will be required.

Processing time

Requests are processed according to reception date. Requests for continuity of care are prioritized.

If you are making a written request in order to obtain access to your personal health information (clinical record) or to ask for a correction, we have in principle 30 days to answer. We always do our best to answer your needs before the 30-day period and to ensure a quality customer service.

Contact

Visit us during business hours (8 a.m.– 4 p.m.). We are located in the D Wing, basement level, 00D135. 
Phone: 613-748-4903

To reach the Access to Information and Privacy Protection Office: 

Tel. :(613) 748-4903 
Fax: (613) 748-4949 
E-mail: infoprivee@montfort.on.ca

NOTE: PDF documents are available in a different format upon request at communications@montfort.on.ca