Quebec Health Record moves forward with help from DMR 

DMR and its partner, Notarius, have just finished delivering the Public Key Infrastructure (PKI) portion of the Health Information Access Layer (HIAL) to Quebec's Health Insurance Board (RAMQ). More particularly, the PKI portion involves delivering the access point that lets users access the Quebec Health Record (QHR). This highly secure access point requires a certificate of authentication found on a USB key. Consequently, delivery of the PKI portion involved a key ceremony in the presence of auditors because the master key for the PKI infrastructure had to be issued in a tightly controlled process, thus ensuring a failsafe level of security, all under the watchful eyes of Samson Bélair/Deloitte & Touche. The master key is the one used to issue other keys (certificates) to participants, thus preventing fraud, so it is imperative it be closely protected.

Remember that the goal of the QHR HIAL-PKI project is to implement the integration tools needed to ensure that the components are secure and work together, in accordance with Quebec's legal framework and Canada-wide standards imposed by Canada Health Infoway. To do that, DMR implemented an "infostructure" that can provide access to a patient's clinical information, circulate that information and manage security and confidentiality.

The information the QHR can access includes:

• user identification,
• allergies,
• intolerances, 
• emergency data,
• immunization data,
• professional contacts, 
• results of medical imaging diagnostics and lab results,
• prescribed drugs.

Pilot project under way
Delivery of the PKI allowed Quebec's Minister of Health and Social Services (MSSS) to officially initiate the QHR pilot project. On May 7, 2008, 3,553 letters were sent to patients in the Saint-Vallier Family Medicine Group in Quebec City informing them the clinic would be part of that pilot project. Some pharmacies will also be involved in this first phase of the pilot project, which will serve as a walkthrough. Some 20 professionals will also be affected. The pilot project will gradually be expanded to the entire region in the fall, and the rest of the province in 2009-2010. The overall project will generate $562,000 in investments.