The realities of implementing health information legislation: the Manitoba experience, 1997-2004.

tection and the expansion of provincial health information systems provided the optimal context for developing health information access and privacy legislation. Manitoba’s Personal Health Information Act (PHIA) was thus enacted on December 11, 1997. PHIA was the first law of its kind in Canada and was developed with a view to interpreting internationally accepted fair information principles for application within the local health care system. PHIA requires health information trustees (public bodies and health care providers) to grant individuals access, upon request, to personal health information about themselves. It also requires trustees to protect the personal health information they maintain from inappropriate collection, use, disclosure, retention and destruction. Manitoba’s experience with PHIA over the past six years has included some interesting (and a few unforeseen) implementation challenges and has raised several demanding policy questions. This experience has also offered some useful lessons regarding the administration of health information access and privacy legislation. Some of these challenges, policy questions, and lessons are explored below.