The Régie de l’assurance maladie du Québec (RAMQ) launched, in December 2017, a new online application: the Québec Health Booklet. Although it seems like an interesting idea on the surface, this new tool raises many questions.

For those who want it, the Québec Health Booklet will provide access to your lists of medications, and the results of clinical and medical analyses, as long as they’ve been input in your Québec Health Record. Other sections, such as physician’s notes, registration to find a family physician, and the Québec Medical Appointment Scheduler, will complete the application.

Unless prohibited by the courts, parents can activate and access their child’s (under the age of 14) health booklet. For incapacited individuals judged, power of attorney and legal guardianship mechanisms will need to be respected.

A pilot project will be launched in Québec City and Laval in January 2018. The official launch is planned for April 2018. Specific applications for organ donations, for example, could complete the project, which will gradually be implemented until 2021.

A recognized risk

Despite stringent security measures in place, on December 4 the CSQ and the Fédération de la Santé du Québec (FSQ-CSQ) met with RAMQ officials, who admitted that although the systems could be hacked, they would be ready to act fast. Definitely something to thing about…

What’s your price?

Besides better access to health information and improved planning of medical visits, the Québec Health Booklet would also promote a self-care approach in which the “patient-partner” plays a more active role. The government might even consider indicating the costs of each care episode. Why? To raise patient awareness? Or to gradually implement procedure-based financing?

“No one goes to the emergency room or doctor’s for fun. This type of practice would only result in feelings of guilt, even discrimination,” says Sonia Éthier1.

Vigilance is needed

A variety of questions have been addressed to the RAMQ, notably with regards to evaluating the access procedures that aim to control risks and the obligation to declare security incidents to the Commission d’accès à l’information.

Invited to collaborate with the RAMQ, the CSQ and FSQ-CSQ will consider these issues. One thing is for certain, the government’s management policies need to be closely monitored.

1 Sonia Éthier is vice-president of the CSQ.

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