The Differences between
Canada’s PHIPA and HIPAA

canada phipa hipaa

In Canada’s Ontario Province, healthcare privacy is regulated by the Personal Health Information Protection Act, or PHIPA. PHIPA is similar to HIPAA in a number of aspects. 

However, PHIPA contains several requirements that HIPAA does not. Continue reading for more details about this personal health information act.

How is PHIPA Similar to HIPAA?

PHIPA, like HIPAA, is a series of rules governing the use, disclosure, and collection of health information. HIPAA regulates the use of protected health information, or PHI. PHIPA uses a different phrase to describe this information: personal health information

Under PHIPA, personal health information includes the following:

Any  “identifying information” about an individual, whether oral or recorded, if the information: 

  • Relates to the individual’s physical or mental condition, including family medical history; or
  • Relates to the provision of health care to the individual; or
  • Is a plan of service for the individual; or
  • Relates to payments, or eligibility for health care or for coverage for health care; or
  • Relates to the donation of any body part or bodily substance, or is derived from the testing or examination of any such body part or bodily substance; or
  • Is the individual’s health number; or 
  • Identifies a health care provider or substitute decision-maker for the individual

Covered Entities vs. Health Information Custodians

While HIPAA regulates the use and disclosure of PHI by covered entities, PHIPA regulates the use and disclosure of personal health information by health information custodians (HICs). Under PHIPA, an HIC is a health care practitioner or person who:

  • Operates an organization that provides health care to an individual; and
  • Has custody or control of that individuals personal health information. 

HIPAA Privacy Rule vs. PHIPA Part IV

Under the HIPAA Privacy Rule, a covered entity – a provider, health plan, or clearinghouse that  electronically transmits health information in connection with certain transactions – may generally not use or disclose PHI unless:

  • An exception to the Privacy Rule allows it to; or
  • The individual who is the subject of the information (or the individual’s personal representative) authorizes the use or disclosure in writing.

Part IV of PHIPA, “Collection, Use and Disclosure of Personal Health Information”, imposes a similar requirement on HICs. Part IV requires that HICs take “reasonable steps” to protect personal health information against the following:

  • Theft; 
  • Loss;
  • Unauthorized use and disclosure; and
  • Unauthorized copying, modification, or disposal.

As a custodian, you may become aware of a privacy breach in a number of ways, including:

  • During the normal course of business.
  • Through a complaint filed by an individual.
  • Notification from the Information and Privacy Commissioner of Ontario, when it receives a formal complaint. 

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Once a custodian becomes aware of the theft, breach, or unauthorized access, the custodian must notify affected individuals.

How does PHIPA Differ from HIPAA?

PHIPA differs from HIPAA in several aspects. PHIPA imposes a number of requirements that HIPAA does not. 

HIPAA Breach Notification Requirements vs. PHIPA Breach Notification Requirements

Under HIPAA, covered entities are required to report breaches of unsecured protected health information. A covered entity’s breach notification obligations differ based on whether the breach affects 500 or more individual, or fewer than 500 individuals. 

If a breach of unsecured protected health information affects 500 or more individuals, that b