I’m Kate Dewhirst.

I’m a lawyer who writes about legal issues affecting healthcare in Canada

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Are paper health records dangerous?

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While we live in a highly digitized world, we still rely A LOT on paper in healthcare. As we move towards even more integrated care, the reliance on and existence of paper health records will be a challenge to overcome.

From a privacy perspective, paper health records can be tricky to protect from loss, theft, unauthorized use and disclosure. The piece of paper offers challenges its electronic copy does not face.


Paper health records are vulnerable to loss in a way electronic records are not.  Floods and fires can decimate paper records without backup. If a paper record is misfiled, it may be lost forever, buried in another chart in a drawer with hundreds or thousands of other charts without the benefit of the Ctrl F  functionality leaving you with the only option of manual searching.

Shredding vs. Recycling

There are a number of privacy breach cases rooted in mistaken recycling of paper health records that were meant to be shredded. Confidential shredding bins are essential equipment for healthcare teams.  Still privacy breaches abound through human error. Leaving the key in the confidential shredding bin to make it easier to fit more paper leaves the bin vulnerable to interference.  Leaving overflow bags of shredding next to the confidential shredding bin can mean they are mistaken for recycling. Using “blue bins” as interim holding bins for what should be shredded can prove dangerous when cleaners mistake the blue shredding bin for a blue recycling bin.


There is a JAMA study showing Canadian hospitals consistently found low to high sensitivity paper records with identifiable health information thrown into their garbage cans.

Inadvertent Viewing

Avert your eyes! Ever notice that bored patients or their family members will read ANYTHING available when they have to wait to be seen. They even read upside down!  When people are bored they will look for things to do.  Paper records of other patients make for fascinating reading.  Keeping a clean desk without paper records viewable to passersby can be challenging to maintain.

What’s a Privacy Officer to do?

Most healthcare teams deal with paper health records to some extent.  Privacy Officers should not forget that paper likely exists in your team and make sure to include tips on how to protect paper records in your privacy training and reminders.

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Team Privacy Training Events

September 17, September 24, October 16, October 24 and November 21

For Primary Care clinics, Children’s Aid and FHTs

Kate trains health professionals from many more primary care organizations how being privacy-respectful can improve therapeutic relationships. more details...

Speaking event

October 23, 2019

Osgoode Professional Development – Mental health Certificate

Kate joins the faculty for this training event. More details...

Primary care webinars: Contracts & Communications

September 5 and October 3, 2019, 12 noon

Part of Kate’s monthly webinar series.

Our September webinar is about understanding contracts you may be asked to sign, and in Octber our title is Managing incapacity in the workplace.

Full details of the 2019 webinar series and registration here.

Privacy Officer training

January 20 & 27 and February 3,10 & 18, 2020

Kate is the program chair for the Osgoode Certificate in Privacy in Healthcare.

This program explores the range of privacy interests that must be protected in the day-to-day treatment of patients, the development of information systems and the creation of institutional policies.More details ...

Advanced Privacy Officer training

December 10, 2019

For experienced Privacy Officers within healthcare organisations.

This one day training course focuses on how to handle difficult privacy situations using real-life (but anonymized) case studies and role-play. Full details and registration here...

Free healthcare privacy webinar - ask me anything!

August 7 and September 4, 2019, 10-11am EST

Free webinars - advance registration needed

Whether you're an experience privacy officer or new in the field, pick Kate’s brain for free for an hour, in this live webinar. No charge, but you’ll need to register in advance.

Kate Dewhirst Health Law

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