No. 11 Use of Personal Electronic Devices on Hospital Premises Purpose Personal electronic devices such as cell phones, computers, and mp3 players frequently incorporate the use of cameras, video and voice recorders as features. Various organizations and facilities, such as schools, gyms, clubs and courts, are struggling to identify strategies to limit inappropriate use of such technology. Hospitals face similar challenges, especially as they relate to maintaining privacy and confidentiality of client/patients, families, visitors, staff and the organization as a whole. While the potential threat that these devices can pose to privacy is self-evident, a complete ban on use or access to electronic devices is not likely to be a successful solution as the use of these devices can be practical and therapeutic. This clinical practice dilemma offers guidance regarding client/patient, family or visitors’ use of electronic devices. Although there is no specific CAMH policy that specifically deals with the use of electronic devices by clients/patients, families, and visitors, concepts such as monitored and prohibited items, storage of inpatient belongings, and health privacy are covered in the following documents: • Search of a CAMH Client/Patient’s Room, Belongings, or Person • Clinical Practice Dilemma: Search of a CAMH Client/Patient’s Room, Belongings, or Person • Inventory and Safekeeping of Inpatient Belongings • Health Privacy • Visitors to CAMH Client/Patients The Law Clinicians are responsible for providing a therapeutic milieu that is as least restrictive as possible. To that end, clinicians may recommend that client/patients use electronic devices such as mp3 players, cell phones, and laptops to listen to music or watch videos for therapeutic benefits, to maintain contact with friends and family, or for informational or educational purposes. However, unmonitored access to electronic devices has privacy and risk implications. No single piece of legislation or court decision currently defines what is and is not an appropriate use of any or all electronic devices in a hospital setting. Consequently, drawing on key legislation and jurisprudence, CAMH management and staff need to identify relevant principles and considerations with which to guide responses to electronic device use by clients/patients, families, and visitors. As health information custodians under the Personal Health Information Protection Act (PHIPA), hospitals, clinicians and staff are responsible for keeping client/patient personal health information (PHI) private. PHIPA relies on the concepts of “express” and “implied” consent for obtaining patient consent to collect, use or disclose PHI (e.g. have their picture taken). However, there are many patients at CAMH who have been found or otherwise deemed incapable of consenting to the use, collection or disclosure of their PHI. These patients are incapable of giving either “express” or “implied” consent for the purposes of PHIPA. As a result, only their SDM have can provide such consent. Other client/patients and visitors are most likely unaware of a client/patient’s legal capacity, and may simply assume that they are obtaining a client/patient’s consent, even if that patient has an SDM in place for the purposes of PHI. Additionally,

This Clinical Practice Dilemma is not intended to give legal, ethical or clinical advice. Rather it is intended to set out general principles and approaches to clinical practice in order to allow clinicians an opportunity to understand the issues inherent in certain clinical situations. The Dilemma should not replace the need for individualized clinical assessment and treatment plans by health care professionals with knowledge of the specific circumstances.

other patients and visitors are most likely unaware of what constitutes PHI for the purposes of PHIPA, and may inadvertently record or take pictures of PHI. Hospitals are also required to protect the privacy of recorded