Optometry clinics are increasingly relying on Electronic Medical Records (EMRs) to manage all aspects of patient data—from scheduling appointments and processing payments to storing sensitive health information. While this digital transformation brings convenience and efficiency, it also introduces real risks if data is not properly protected from cyber threats.
Cybersecurity may sound technical, but at its core, it’s about keeping patient health information private and secure. Just as physical files are locked in a cabinet, digital records must be protected from hackers, accidental leaks, or unauthorized access by employees.
Protecting patients’ information is not only a legal requirement but an ethical responsibility. In Canada, optometrists must comply with privacy laws that govern the handling of Personal Health Information (PHI).
Understanding Your Legal Responsibilities
The federal privacy law, the Personal Information Protection and Electronic Documents Act (PIPEDA), applies to most private-sector businesses, including optometry clinics that collect and store PHI. Clinics are required to:
• Obtain consent when collecting, using, or disclosing patient information
• Use and store patient data only for legitimate healthcare purposes
• Take reasonable steps to protect data from theft, loss, or unauthorized access
• Respond quickly to breaches and inform affected individuals
In addition to PIPEDA, certain provinces—such as Alberta, British Columbia, and Quebec—have adopted their own privacy laws that align with federal standards. Other provinces, including Ontario, New Brunswick, Nova Scotia, and Newfoundland and Labrador, also have similar legislation. For example, in Ontario, clinics must comply with the Personal Health Information Protection Act (PHIPA). Failure to follow these laws can lead to fines, legal consequences, and reputational harm.
Choose an EMR That Meets Canadian Privacy Standards
Not all optometry Electronic Medical Record (EMR) systems are created with Canadian privacy laws in mind. It is essential to ensure that the software in use meets PIPEDA-compliant standards.
Ask the following questions:
- Where is the data stored? PIPEDA recommends that PHI be stored within Canada.
- Is the data encrypted? Data should be unreadable if stolen.
- Can staff access be limited by role?
- Does the system maintain an audit trail (logs of who accessed or edited records)?
Control Staff Access with Role-Based Permissions
EMRs should be configured so that each staff member only sees what they need to perform their job. This is called Role-Based Access Control (RBAC).
For example:
• Front desk staff can book appointments but shouldn’t access clinical test results.
• Technicians may view imaging files but not billing information.
Limiting access protects patient data and makes it easier to review audit logs for unusual activity.
Regularly Monitor EMR Access Logs
Your EMR software should track logins, file access, and changes made to records. Audit logs help detect suspicious activity such as:
• Repeated failed login attempts
• Logins during off-hours
• Employees accessing records without a legitimate reason
Review these logs at least monthly to catch problems early.
Back Up Your Data—And Test It
Even with strong security, disasters can happen: hardware failures, ransomware attacks, or human error. Backups are essential.
Backups should be:
• Performed daily
• Stored securely in Canada (cloud or off-site)
• Tested regularly to ensure quick restoration
An untested backup is nearly as risky as no backup at all.
Train Your Team to Avoid Cyber Risks
Most cybersecurity incidents stem from human error. Mistakes like clicking malicious links, sharing weak passwords, or emailing PHI to the wrong recipient can lead to serious breaches.
All staff should receive annual cyber safety training covering:
- How to identify phishing and suspicious emails
- Safe handling of emails and messages containing PHI
- Strong passwords, Multi-Factor Authentication (MFA), and avoiding reused credentials
- Importance of logging out of EMRs when not in use
- How to report suspicious activity or data breaches
Cybersecurity: A Shared Responsibility
Cybersecurity doesn’t have to be complicated—it’s about protecting your patients and your clinic. By following basic best practices, you can ensure compliance with privacy laws and maintain trust with your patients.
Here’s a quick checklist:
☑ Use PIPEDA-compliant EMR software
☑ Limit access based on job roles
☑ Track who is accessing the EMR
☑ Back up and test data regularly
☑ Train users annually on cybersecurity basics
Maryam Moharib, BOptom, BHSc, CSPO, CAPM
Maryam holds degrees in Health Sciences from the University of Ottawa and in Optometry from Anglia Ruskin University in Cambridge, England. She has dedicated many years to working alongside ophthalmologists in refractive surgical clinics, where she gained significant experience in clinical training and in EMR implementation for various software platforms.
Maryam has also worked as a certified product owner with an EMR software company where she played a key role in effectively bridging the gap between clinical needs and technology. Additionally, her certification in project management from the Project Management Institute has equipped her with the skills to lead implementation and transformative clinic projects successfully.
