Bylaws, Legislation & Standards of Practice

FAQs

• What is informed consent?

  Informed Consent is based on the right of each person to determine what will be done to their own body. Informed consent guarantees each person the right to refuse treatment, to consent to treatment, and to withdraw consent to treatment. Informed consent also ensures that the person understands the risks and benefits of each treatment option presented as well as the costs involved.

  Consent may be either implied or expressed. Implied consent is usually ascertained by the actions of the patient, as with the patient who opens their mouth for an examination. Express consent may be oral or written.

  Informed consent is not an event or specific form but rather an ongoing dialogue with patients that begins at the first visit to the office and continues as treatment progresses.

• What is the Health Information Act (HIA)?

  The Health Information Act (HIA) (Alberta) is privacy legislation that sets out specific rules about the collection, use, disclosure and protection of the health information that dentists, have in their custody and control. Dentists in Alberta are required to comply with Health Information Act and in order to do so, it is necessary to go beyond just protecting patient’s confidentiality, dentists also need to develop and participate in an ongoing privacy program that addresses accountability, information flow, right of access, and security.

• Are there resources available to assist Alberta dentists to comply with the HIA?

  The CDSA has developed Health Information Act (HIA) resources that are designed to assist Alberta dentists to implement a privacy and confidentiality program that is compliant with the HIA and the ADA&C Standard of Practice: Privacy and Management of Patient Health Information. The CDSA has developed several resources to assist Albert dentists.

  For information on the available resources click here.

• What's the purpose of patient records?

  A dental record must record an accurate picture of the patient’s general health, oral/dental status and any patient concerns and requests. It must include the clinical findings, diagnosis, proposed treatment plan and treatment performed, as well as all supporting documentation including the informed consent process. Outcomes of treatment must be documented and any deviations from expected outcomes recorded on the patient chart at time of service. Patients should be advised of compromised results as soon as the dentist is aware of the situation. All relevant information presented to the patient should be documented. Patient records have many purposes, including:

  a) facilitate the provision of effective clinical care;
  b) ensure the continuity and comprehensiveness of oral/dental health services; and
  c) satisfy a dentist’s professional and legal obligations.

• What are records?

  In dentistry, a record is any item of information, regardless of form or medium that is created or received by a dentist, dental office or professional corporation that is created and maintained to provide care to patients and to conduct business. Records are maintained as a valuable resource in the safe and efficient delivery of dental services, to provide evidence of the dentist’s clinical and financial interactions with patients, to ensure practice continuity in the event of a disaster, and to satisfy legal and regulatory requirements. The purpose of a record and the obligation to maintain it does not change with the manner in which it was created.

  Read our article on why record keeping is important.

• What if a lawyer requests a patient record?

  Read Dr. Darryl Smith’s article: Request from a Lawyer for a Patient Record.

• What is continuity of care?

  All Alberta dentists have an ethical responsibility to provide for continuity of care of their patients. Read our article on continuity of care.

• Can I provide a guarantee or warranty on dental treatment or services?

  It is unethical to guarantee dental treatment or services. The ADA&C Code of Ethics addresses guarantees in Article A8.

  Alberta dentists must not guarantee or warranty procedures or treatment provided to patients. Alberta dentists must be aware that there are companies in Canada who are marketing dental warranty programs to dentists. These types of programs are not appropriate for Alberta dentists as they are not compliant with the Code of Ethics. Guidance is found in paragraphs three and four of Article A8 of the Code of Ethics.

• Does the Code of Ethics provide information on patient referrals?

  As in many aspects of dentistry affecting patient welfare, communication is critical to avoiding complications and solving patient care issues, particularly when more than one provider is involved. The ADA&C Code of Ethics embodies the principle of referral to a
  provider in Article A4 Competence, Consultation and Referral. Read more here.

• Should laptops, mobile phones, and portable storage devices that contain identifiable Health Information be encrypted?

  The Health Information Act and regulations require custodians (dentists) to secure health information and to report losses of or unauthorized access to identifiable health information to the Office of the Information and Privacy Commissioner, the Minister of Health and the individuals involved.

  All mobile devices including laptops, tablets, mobile phones, and portable storage devices that contain identifiable health information should be strongly encrypted and password protected. Mobile devices are frequently stolen or lost and devices that are not strongly encrypted and password protected puts you and your patients at risk.

  In the unfortunate case where laptops, tablets, mobile phones, or portable storage with identifiable health information is lost the custodian (dentist) is required to assess the loss using the method and examples provided by Alberta Health in the Health Information Act Guidelines and Practices Manual Chapter 14 Duty to Notify. If the custodian (dentist) can demonstrate that  that the information was encrypted and password protected, thereby rendering it inaccessible to an unauthorized person notification to the Office of the Information and Privacy Commissioner, the Minister of Health and the individuals involved may not be necessary.

  Chapter 14 Duty to Notify provides examples of how to analyze losses or unauthorized access of identifiable health information to determine if notification of the breach must be reported to the Office of the Information and Privacy Commissioner, the Minister of Health and the individuals involved. See Chapter 14 page 33 for an example case involving loss of a USB storage device. This device was encrypted and password protected and notification was determined unnecessary.

  Losses can happen be sure your patients health information is protected encrypt and password protect all mobile devices.

• Why should I use social media with caution?

  There are a growing number of blogs, member chat rooms, networking sites and Internet forums (i.e. social media) aimed at dental professionals. Dentists can use these electronic communication avenues to share workplace experiences, discuss patient cases, foster professional connections, promote timely communication and seek support from peers and colleagues.

  While many dentists use social media without difficulty, caution is advised, even when communicating among peer, colleague, dentistry related and other professional venues. Dentists may be unknowingly exposing themselves to risk by the way they are using social media applications, providing personal material, or disclosing identifiable patient information. A dentist could disclose too much information and violate patient privacy and confidentiality. As well, a dentist could cause harm to their professional reputation and the entire profession.

  Ethical Responsibilities
  Social media can provide dentists with a space in which they can discuss their experiences within clinical practice. As material published on the Internet often exists in the public domain it is important that dentists exercise caution when discussing any details relating to specific cases.

  Dentists have a legal and ethical duty to protect patient confidentiality. Disclosing identifiable information about patients without consent would constitute a breach of standards and could give rise to complaints from patients.

  While most improper disclosures are unintentional, dentists should not share identifiable information about patients where it may be overheard or read, including all social media sites. Although individual pieces of information may not alone breach patient confidentiality, the sum of published information could be sufficient to identify a patient or their relatives. Dentists who wish to publish details about specific cases or clinical experiences online, which identify or run the risk of identifying a patient, should ensure they follow the guidelines relating to patient consent and disclosure set out by the Health Information Act and the Code of Ethics.