"Hybrid files" not completely open to auditors--Alberta appeal court.

When Innovative Health Group Inc. of Calgary was asked to open its "hybrid files" to auditors of the Calgary Health Region, it went to court. These files in question belong to those patients who received publicly funded services and also received other services, privately paid. Innovative argued that the CHR was entitled to view the record of the publicly funded services only, and to open the complete patient record would breach privacy rights under Alberta's Health Information Act. The Court of Appeal agreed with Innovative.

A lower court ruled that the CHR auditors could examine the full record. Court of the Queen's Bench Justice A.G. Park stated, "The CHR must be able to look at the entire file and not just the area of the file where it funded the treatment. If any affiliate has engaged in double billing, the CHR must be able to determine such double billing practices."

The judge added, "To prevent the CHR from learning whether another funding source paid for the identical treatment funded by the CHR would thwart the CHR's ability to conduct a meaningful audit."

The appeal court disagreed. The court ruled that the CHR is entitled to access only those parts of the hybrid files that relate to publicly funded treatment provided by Innovative under contract to the CHR. Moreover, the order was too broad in that it authorized the CHR's access more than the health information it sought.

The Appeal judges also recognize problems in this decision. "This decision may give rise to practical problems about how to separate the accessible information from the inaccessible. Directions about resolving such difficulties should be pursued in the Court of Queen's Bench."