The confidentiality of patient and physician information in pharmacy prescription records

Our concerns regarding the confidentiality of patient and physician information entrusted to pharmacists led us to examine the regulations governing the sale of prescription data. All provincial pharmacy regulatory authorities except that of Alberta completed our written survey in 2001 (the survey findings are presented in tables accompanying the online version of this article [www.cmaj.ca/content/vol170/issue5/index.shtml#COMMENTARY]). We also examined the published policies of provincial regulatory authorities and provincial pharmacy legislation up to July 2003. There was great variability between provinces in the survey responses from the regulatory authorities, the published policies of the regulatory authorities and the pharmacy legislation regarding prescription data sales. Also, survey responses from the regulatory authorities were not always consistent with their own published policies and their provincial pharmacy legislation. The protection of patient confidentiality was a universal tenet in the published policies of the regulatory authorities pharmacy legislation of all provinces; however, what constituted an identifier was generally left open to interpretation. In addition to name and contact information, which are obvious identifiers, the British Columbia regulatory authority's guidelines specifically prohibit the release of identifying numbers, the Nova Scotia regulatory authority's guidelines prohibit birth date, and the Newfoundland and Labrador regulatory authority's standards prohibit (since 2002) identifying numbers, birth date, and service, intervention and visit dates. The New Brunswick regulatory authority reported in the survey that there were no regulations regarding which data elements could be disclosed. The regulatory authorities of British Columbia, Saskatchewan, Ontario, Prince Edward Island, and Newfoundland and Labrador reported in the survey that birth date, sex and identity of third-party payer were permitted to be sold. Only the regulatory authorities of Saskatchewan, Manitoba and Nova Scotia reported in the survey that consent was necessary before physician-linked prescribing data were sold, and the regulatory authority in British Columbia indicated that the release of physician identifiers was not permitted. The pharmacy legislation of New Brunswick bans disclosures without physician consent, whereas the regulatory authority guidelines in Saskatchewan, Prince Edward Island and Nova Scotia specifically allow the disclosur