Children’s Hospital of Eastern Ontario (BORN) - 2017 Three-Year Review of the Prescribed Persons and Prescribed Entities

Sep 14, 2026

2017 Three-Year Review document for the Better Outcomes Registry and Network (BORN) outlining mandatory requirements and how prescribed persons and prescribed entities implement and adhere to privacy and security practices. The review includes a statement on non-compliance and detailed compliance listings against an IPC manual, covering privacy documentation (policies, procedures, logs, agreements, consent and research/data sharing frameworks) and security documentation, with referenced appendix material.

LanguageEnglish

CategoryForms

FormatPDF

Pages145

Reading Time51 min

AccessFree to download

Introduction

Mandatory Requirements and Implementation of, and Adherence to Practices and Procedures

Statement on Non-compliance

Appendix B: Compliance to IPC Requirements

BORN Compliance to IPC Manual Part 1 - Privacy Documentation

BORN Compliance to IPC Manual Part 2 - Security Documentation

Children’s Hospital of Eastern Ontario in Respect of the Better Outcomes Registry and Network (BORN): 2017 Three-Year Review of the Prescribed Persons and Prescribed Entities Table of Contents I. Introduction .......................................................................................................................................... 6 II. Mandatory Requirements and Implementation of, and Adherence to Practices and Procedures......7 III. Statement on Non-compliance ............................................................................................................. 8 IV. Appendix “B”: Compliance to IPC Requirements............................................................................ 10 BORN Compliance to IPC Manual Part 1 – Privacy Documentation ....................................................... 10 1.1 Privacy Policy in Respect in Respect of CHEO’s Status as a Prescribed Person ............................ 10 1.2 Policy and Procedures for Ongoing Review of Privacy and Security Policies, Procedures and Practices .............................................................................................................................................. 14 1.3 Policy on the Transparency of Privacy Policies, Procedures and Practices .................................. 15 1.4 Policy and Procedure for the Collection of Personal Health Information AND Statements of Purpose for Data Holdings Containing Personal Health Information ................................................. 16 1.5 List of Data Holdings Containing Personal Health Information .................................................... 18 1.6 Policy and Procedures for Statements of Purpose for Data Holdings Containing Personal Health Information ......................................................................................................................................... 18 1.7 Statements of Purpose for Data Holdings Containing Personal Health Information ................... 18 1.8 Policy and Procedures for Limiting Agent Access to and Use of Personal Health Information.... 19 1.9 Log of Agents Granted Approval to Access and Use Personal Health Information ...................... 22 1.10 Policy and Procedures for the Use of Personal Health Information for Research ..................... 22 1.11 Log of Approved Uses of Personal Health Information for Research ......................................... 25 1.12 Policy and Procedures for Disclosure of Personal Health Information for Purposes Other Than Research.............................................................................................................................................. 25 1.13 Policy and Procedures for Disclosure of Personal Health Information for Research Purposes and the Execution of Research Agreements....................................................................................... 29 1.14 Template Research Agreement .................................................................................................. 33 1.15 Log of Research Agreements ...................................................................................................... 36 1.16 Policy and Procedures for the Execution of Data Sharing Agreements...................................... 36 1.17 Template Data Sharing Agreement ............................................................................................ 37 1.18 Log of Data Sharing Agreements ................................................................................................ 40 1.19 Policy and Procedures for Executing Agreements with Third Party Service Providers in Respect of Personal Health Information .......................................................................................................... 41 1.20 Template Agreement for All Third Party Service Providers ........................................................42 1.21 Log of A

FAQs

What is covered in the 2017 Three-Year Review for BORN?

The review covers mandatory requirements and adherence to prescribed privacy and security practices, includes a non-compliance statement, and provides compliance documentation aligned to the IPC manual.

What does “IPC Manual Part 1 - Privacy Documentation” include?

It details privacy policies and procedures plus operational items such as data holding purposes, agent access controls, logs for approvals and uses, disclosure rules, research and data sharing agreement templates, linkage procedures, de-identification, privacy impact assessments, audits, breaches, complaints, and inquiries.

Does the document also address security beyond privacy documentation?

Yes. It includes a section for “BORN Compliance to IPC Manual Part 2 - Security Documentation,” covering information security policy and ongoing review practices and procedures.

Sep 14, 2026

Uploaded by Arica Lee