The primary purpose of the EHR system is to make patient data accessible to other health care providers such as other doctors, therapists, pharmacists, physiotherapists and dieticians. The government of BC says that a health provider`s access rights will be based on his or her role, but it seems clear that they all could have access to the Core Data Set. Unfortunately, as of March 2009 the details of how this “roles based access” will actually work has not been defined. 

The other main purpose of creating the EHR system is to enable more efficient healthcare system planning. For this purpose, aggregated (e.g. compiled and anonymous) information from individual health records will be used to analyze how the whole health system is being used, to better understand health outcomes for people and minimize costs to the system. In addition, the EHR will facilitate the gathering and distribution of health information to researchers for research purposes. 

Critics argue that the province has not really even begun to address the privacy rights and protections that should be engaged when personal health information is used for these secondary purposes. Questions such as how and when personal health information is made anonymous, when it can be used in an identifiable form and how access to it is managed are not fully developed yet. Nevertheless, the systems are well on their way to being built.

The province is promising that patients will have the ability to put ‘disclosure directives’ on their files so that their information is not readily accessible. But it is not at all clear at this point how this will work. Will an individual will be able to put the disclosure directive on their file at the level of the particular treatment, prescription or physician name, or will the disclosure directive have to be on the whole file, thus effectively requiring the patient make an “all or nothing” choice. We don’t know.

Furthermore, the e-Health Act sets out the broad requirements for disclosure directives, but it is not at all obvious that the average citizen will be able to figure out how to put a disclosure directive on his file, which makes a disclosure directive of limited usefulness.