Dr. Pauline Lysak
Psychiatrist, Victoria BC
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Your Privacy, Emailing and Texting

Privacy is a serious concern in healthcare. This can be at odds with how we choose to share information in our personal lives. Many people feel the convenience of being able to email/text their doctor's office outweighs the risks of potential disclosure of health information.

The “standard” for security in healthcare is snail mail or fax (neither of which are perfectly secure either). Email and text are considered riskier.

If you understand the risks (see below) and agree, we're happy to communicate with you via email or text. We will use reasonable safeguards, discretion and our best judgment to protect your privacy.

Examples of electronic communications

The following are some examples of information we would normally consider appropriate to send via text/email:

  • lab results (other than positive results for infectious diseases or similar)
  • instructions regarding changes in medication use
  • appointment changes and reminders
  • information on medications, programs, and practitioners
  • answers to your questions we receive via email/text

Changing How We Communicate

On your intake form prior to your first appointment, we asked for your permission to communicate with you in various ways. You can change this at any time. Speak with us to see what consent you've given or if you may wish to change it.

We are always available to discuss your privacy and the use of technology.

Consent for Telehealth Appointments

By participating in your telehealth appointment, you accept the inherent privacy and security risks (e.g., unintentional disclosure of your health information) when using videoconferencing. By proceeding with your appointment, you agree that you understand the risks involved.

Remember, no technological system is 100% secure. To minimize this risk, you can participate from a private setting, and should not use an employer's or someone else's computer/device. If you have any questions or concerns, please raise them with us before your telehealth appointment.

The PHSA has some additional resources on the risks of using digital communication that you should read.

Our communications technology infrastructure

Video telehealth appointments are via Zoom for Healthcare, which the Ministry of Health endorses as meeting privacy and security requirements for patient care.

Fax messages are sent and received via an online service (SRFax) built for use in healthcare environments. Servers are in BC, data is encrypted on their server, and all communication with us is encrypted.

Email service is provided via secure servers located in Canada (WHC.ca). Our communication with email servers is encrypted. Email messages themselves are not encrypted.

Telephone, voice mail and text messaging services are provided via a cloud-based service (RingCentral.ca). All communication is encrypted. Servers have safeguards in place but are located in the USA.

The following is adapted from the Consent to Use Electronic Communications from the Canadian Medical Protective Association.

Risks of using electronic communication

We (Dr. Lysak and her staff and associates) will use reasonable means to protect the security and confidentiality of information sent and received using electronic communications, including email and text messaging. However, because of the risks outlined below, we cannot guarantee the security and confidentiality of electronic communications:

  • Use of email/text to discuss sensitive information can increase the risk of such information being disclosed to third parties.
  • Despite reasonable efforts to protect the privacy and security of email/text, it is not possible to completely secure the information.
  • Employers and online services may have a legal right to inspect and keep electronic communications that pass through their system.
  • Electronic communications can introduce malware into a computer system, and potentially damage or disrupt the computer, networks, and security settings.
  • Electronic communications can be forwarded, intercepted, circulated, stored,or even changed without our or your knowledge or permission.
  • Even after the sender and recipient have deleted copies of electronic communications, back-up copies may exist on a computer system.
  • Electronic communications may be disclosed in accordance with a duty to report or a court order.
  • Emails and texts can more easily be misdirected, resulting in increased risk of being received by unintended and unknown recipients.
  • Emails and texts can be easier to falsify than handwritten or signed hard copies. It is not feasible to verify the true identity of the sender, or to ensure that only the recipient can read the message once sent.
Conditions of using electronic communications
  • While we will attempt to review and respond in a timely fashion to your email/text, we cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. Email/text will not be used for medical emergencies or other time-sensitive matters.
  • If your email/text requires or invites a response from us and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether we received the email/text and when we will respond.
  • Email/text is not an appropriate substitute for in-person or over-the-telephone communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed. You are responsible for following up on our electronic communication and for scheduling appointments when warranted.
  • Electronic communications concerning diagnosis or treatment may be printed or transcribed in full and made part of your medical record. Other individuals authorized to access your medical record, may have access to those communications.
  • We may forward emails/texts to those involved in the delivery and administration of your care. We might use email/text to communicate with those involved in your care. We will not forward electronic communications to third parties, including family members, without your prior written consent, except as authorized or required by law.
  • You agree to inform us of any information you do not want sent via email/text. You can change this at any time by notifying us in writing.
  • Some electronic communications might not be used for therapeutic purposes or to communicate clinical information. Where applicable, the use of email/text will be limited to education, information, and administrative purposes.
  • We are not responsible for information loss due to technical failures associated with your software or internet service provider.
Instructions for communication using email/text

To communicate via email/text,you must:

  • Be aware of the risks of, or reasonably limit or avoid using an employer’s or other third party’s computer.
  • Inform us of any changes in your email address or mobile phone number.
  • Review all emails/texts to ensure they are clear and that all relevant information is provided before sending them to us.
  • Ensure we are aware when you receive an electronic communication from us, such as via replying to the message.
  • Take precautions to preserve the confidentiality of electronic communications, such as using screen savers and safeguarding computer passwords.
  • Withdraw consent only by notifying us in writing.
  • If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not rely on email/text. Rather, you should call our office or take other measures as appropriate, such as going to the nearest Emergency Department or urgent-care clinic.