Ontario has specific privacy legislation governing how healthcare organizations collect, use, disclose, and protect Personal Health Information (PHI). Clinics and healthcare practitioners operating in Ontario are responsible for ensuring their privacy practices and workflows align with these legal requirements.
As more healthcare practices move toward cloud-based systems, online communication, digital intake forms, automations, and electronic workflows, it becomes increasingly important to understand how privacy laws apply to the technology and systems being used within your clinic.
At ClinicMonk™, we understand how important privacy, security, and responsible handling of PHI are for healthcare practices. ClinicMonk™ is built on secure, HIPAA-enabled infrastructure and is designed to support clinics in meeting their privacy obligations under applicable laws such as HIPAA, PHIPA, and PIPEDA.
This guide is designed to help provide a general overview of Ontario privacy requirements and explain some of the steps clinics may take to support privacy-conscious workflows when using digital systems like ClinicMonk™.
In this guide, we’ll cover:
Which privacy laws apply in Ontario
What information is considered Personal Health Information (PHI)
Basic privacy principles under PHIPA
Actions clinics and practitioners can take to support compliance
Consent requirements in Ontario
Additional privacy considerations for healthcare practices
This information is not a legal interpretation of the law and is not binding on the Office of the Information and Privacy Commissioner of Ontario (IPO). This information is not intended to nor should it ever replace formal legal counsel.
Privacy Laws for Health Records in Ontario
Healthcare organizations and practitioners operating in Ontario are generally required to handle Personal Health Information in accordance with Ontario’s health privacy legislation:
Personal Health Information Protection Act (PHIPA)
PHIPA establishes rules surrounding the collection, use, disclosure, storage, and protection of Personal Health Information by healthcare providers and organizations in Ontario.
Ontario’s PHIPA legislation has been recognized as substantially similar to Canada’s federal private-sector privacy legislation PIPEDA.
As a result, PHIPA typically governs how Ontario healthcare organizations handle health records and Personal Health Information.
PHIPA applies to Health Information Custodians (HICs), which may include:
healthcare clinics
private practices
healthcare practitioners
organizations providing healthcare services
This applies whether services are delivered virtually, in person, publicly funded, or privately funded.
Because many modern healthcare practices use cloud-based software, digital communication tools, online forms, scheduling systems, and automated workflows, clinics should ensure the systems they use support privacy-conscious operations and appropriate safeguards for handling PHI.
Personal Health Information (PHI) in Ontario
Under PHIPA, Personal Health Information (PHI) generally refers to identifying information related to an individual’s physical or mental health, healthcare services, or healthcare history.
Examples of PHI may include:
names and contact information
appointment details
intake information
treatment or service history
health card numbers
billing or payment information related to healthcare
clinical notes
care plans
referral information
communication records related to healthcare services
PHI may also include any other information that could reasonably identify an individual in connection with healthcare services or healthcare-related activities.
Because healthcare practices increasingly communicate electronically through email, SMS, intake forms, scheduling systems, and digital workflows, clinics should carefully consider how PHI is collected, accessed, shared, and stored across all systems used within the practice.
ClinicMonk™ is designed to support healthcare practices with privacy-conscious workflows, communication systems, and organizational tools; however, clinics remain responsible for determining what information is appropriate to collect, communicate, and store within their workflows and ensuring their procedures align with applicable privacy laws and regulations.
PHIPA’s Basic Principles of Collection, Use and Disclosure
Under PHIPA, healthcare organizations in Ontario are expected to follow a number of core privacy principles when collecting, using, storing, and disclosing Personal Health Information (PHI).
These principles are designed to help ensure that PHI is handled responsibly and only used in ways that are appropriate for providing healthcare services and operating a healthcare practice.
Some of the key principles include:
Only collect, use, or disclose PHI with appropriate consent or where permitted or required by law.
Limit the amount of PHI collected, used, or disclosed to only what is reasonably necessary for the purpose.
Collect PHI directly from the individual whenever possible.
Protect PHI against unauthorized access, loss, theft, or disclosure.
Obtain appropriate consent for marketing or non-care-related communication where required.
Maintain reasonable safeguards to protect electronic and physical records containing PHI.
Ensure staff members understand their responsibilities regarding privacy and confidentiality.
Actions Clinics and Practitioners Can Take to Support Compliance
Supporting privacy-conscious operations under PHIPA involves both the systems a clinic uses and the internal procedures the clinic puts in place.
Below are some important steps healthcare practices may consider implementing to help support compliance and protect Personal Health Information:
1. Keep records accurate and up to date
Practices should make reasonable efforts to maintain accurate and complete records and update information when necessary.
This may include:
client contact information
intake information
billing details
appointment records
and healthcare documentation
Clinics should also have procedures in place for responding to requests to correct information where appropriate.
2. Protect records from unauthorized access
Healthcare practices should implement safeguards to help protect PHI from:
unauthorized access
theft
loss
misuse
inappropriate disclosure
This may include:
secure passwords
Multi-Factor Authentication (MFA)
role-based permissions
encrypted systems
secure Wi-Fi networks
and staff training on privacy procedures
ClinicMonk™ supports features such as user permissions, secure account access, and audit logging to help practices better manage access to information. Learn more about how ClinicMonk™ can help keep PHI secure here.
3. Retain records appropriately
Clinics should follow applicable record retention requirements and maintain records for the appropriate time periods required by their profession, regulatory body, or applicable laws.
Practices should also ensure records remain secure throughout the retention and disposal process.
4. Create privacy breach procedures
Practices should have internal procedures for responding to privacy or security incidents involving PHI.
This may include:
documenting incidents
assessing risks
notifying affected individuals where required
reviewing internal procedures to help reduce future risks
5. Designate a privacy contact person
Healthcare practices should designate an individual responsible for overseeing privacy-related matters within the organization.
This person may help with:
staff training
responding to privacy concerns
reviewing clinic procedures
handling requests for access to records
supporting ongoing privacy practices
6. Make privacy practices available to clients
Clinics should provide clear information regarding how Personal Health Information is collected, used, stored, and disclosed within the practice.
This may include:
privacy policies
communication consent forms
intake documentation
processes for requesting access to records or corrections
7. Carefully manage staff and third-party access
Practices should ensure that only authorized individuals have access to PHI and regularly review staff permissions and third-party systems connected to clinic workflows.
8. Obtain appropriate consent
Obtain express or implied consent, where appropriate, for the collection, use and disclosure of PHI. (Scroll down to the Consent section of this document for more information on consent required in Ontario).
9. Provide access to records when appropriate
Individuals generally have the right to request access to their Personal Health Information.
Practices should have procedures in place for responding to requests for access or corrections within applicable timelines.
10. Stay informed and review procedures regularly
Privacy requirements, technology, and communication tools continue to evolve.
Healthcare practices should periodically review:
privacy procedures
staff training
software configurations
automations
integrations
and communication workflows
to help ensure their systems and processes continue to align with current privacy expectations and regulatory requirements.
Consent Requirements in Ontario
Under PHIPA, healthcare practices in Ontario are generally required to obtain either express consent or implied consent for the collection, use, and disclosure of Personal Health Information (PHI), depending on the situation and purpose of the communication or disclosure.
Understanding when consent may be implied and when express consent is required is an important part of maintaining privacy-conscious workflows within a healthcare practice.
Implied Consent
Implied consent may apply when PHI is being collected, used, or disclosed for the purpose of providing or assisting with healthcare services.
Examples may include:
coordinating care between healthcare providers
scheduling appointments
processing payments related to healthcare services
communicating information necessary for ongoing care.
In these situations, consent may reasonably be inferred based on the individual seeking care or participating in healthcare services.
Express Consent
Express consent is generally required when PHI is being used or disclosed for purposes outside of providing healthcare services.
This may include:
marketing communications
promotional emails
non-care-related disclosures
sharing information with third parties where consent cannot reasonably be implied.
Express consent may be obtained verbally, electronically, or in writing depending on the situation and the clinic’s procedures.
Electronic Communication & Consent
Because many healthcare practices now communicate electronically through:
SMS
email
intake forms
automated reminders
online scheduling systems
clinics should carefully consider how consent is obtained and documented for electronic communication.
Many practices choose to:
include communication consent language in intake forms,
provide clients with options regarding preferred communication methods,
avoid including unnecessary sensitive information in electronic messages.
ClinicMonk™ supports communication workflows and automations for healthcare practices, and includes features designed to help clinics seek and document consent for electronic communication:
Opt-in SMS consent on forms. By default, ClinicMonk™ forms include a text-messaging consent checkbox that is left unchecked, so the individual must actively check it to opt in. The default consent language reads: "By checking this box, I agree to receive non-marketing SMS messages from [Clinic Name] related to appointment confirmations, reminders, rescheduling, and service notifications. Message frequency may vary. Msg & data rates may apply. Reply STOP to opt out or HELP for assistance. Consent is not a condition of purchase." Because the box is unchecked by default and requires an affirmative action, consent is captured as a clear, express opt-in rather than assumed or pre-selected.
Privacy Policy link on forms. ClinicMonk™ forms include a link to the clinic's Privacy Policy. While ClinicMonk™ does not add a separate email-consent checkbox by default, clinics can use their linked Privacy Policy to explain how contact information and electronic communications are used, and to hold any additional consent-related disclosures appropriate to their practice.
Customizable to each clinic's needs. Clinics can adjust the wording of the consent checkbox, or add a second consent checkbox, to reflect the specific communications they send and the consent their workflows require.
Clinics remain responsible for determining which communications are appropriate within their workflows, configuring consent options to match those communications, and ensuring their overall consent procedures align with applicable laws.
Exceptions to Consent Requirements
PHIPA also contains specific situations where consent may not be required, including certain circumstances related to:
when you are using the information for the purpose for which it was already collected
if you are required by law to disclose it
for risk/error management or to improve the quality of care
to educate agents who provide health care
for purposes involving disposing of or modifying the information to conceal the identity of the individual
when your purpose is to obtain consent for a legal proceeding, to obtain payment for healthcare, for research (subject to certain conditions), or if permitted and/or required by law.
Clinics and practitioners should consult qualified legal or privacy professionals if they are unsure whether consent is required in a specific situation.
Additional Privacy Considerations for Healthcare Practices
In addition to PHIPA, healthcare practices may also need to consider other privacy obligations depending on:
their profession
regulatory college requirements
communication methods
business structure
the provinces and jurisdictions in which they operate.
Healthcare organizations using cloud-based systems, communication tools, automations, and third-party integrations should regularly review:
how PHI is being collected
where information is stored
who has access
how information flows through their systems and workflows
This is especially important when using:
SMS communication
email communication
online intake forms
AI tools
third-party integrations
automated workflows involving client information.
Healthcare practices should also review guidance from:
their regulatory college
professional association
legal advisors
privacy professionals
to ensure their internal procedures align with current expectations and best practices.
Important Disclaimer
This guide is provided for educational and informational purposes only and should not be considered legal, compliance, or regulatory advice.
ClinicMonk™ is designed to support healthcare practices with privacy-conscious workflows and operational systems, but no software platform alone can guarantee PHIPA compliance.
Each healthcare organization is responsible for evaluating its own compliance obligations and implementing appropriate policies, procedures, and safeguards.
We encourage all practices to consult qualified legal or compliance professionals regarding their specific PHIPA requirements.
Questions?
If you have questions about ClinicMonk™ and how it supports healthcare practices, our team would be happy to help.
Visit ClinicMonk™ or email [email protected] to learn more.