Policies and Procedures Table (PIA Annotated Template - Section E)
Document Purpose and Overview
A Privacy Impact Assessment (PIA) describes how proposed administrative practices or information systems may affect the privacy of the individuals who are the subjects of the information.
A Policies and Procedures Table must be included to highlight the relevant documentation you have developed that address your obligations under the Health Information Act (HIA).
The proper form to use is the PIA Annotated Template. This template is intended to assist community-based custodians in completing PIAs. It can be accessed on this page on the Alberta Health website.
Instructions for Use
- Below is an example of how to create a Policies and Procedures Table
- Include both general privacy policies as well as those specific to your clinic and PIA
Example
Policies and Procedures Table
| Topic Requiring Policy/Procedure | Policy Template |
| Privacy Accountability | Privacy Charter |
| Health Information and Privacy Practices | Privacy Roles and Responsibilities Policy |
| Privacy Impact Assessments | |
| Access to Health Information | Access to Health Information Policy |
| Correction Requests | Correction or Amendment of Health Information Policy |
| Training, Awareness and Sanctions | Information Handling Policy |
| Physical Security of Data and Equipment | |
| Business Continuity | |
| Information Flow and Legal Authorities | PIA - Flow Diagram and Legal Authorities Table |
| Collection of Health Information | Collection, Use, Disclosure and Disposal of Health Information Policy |
| Use of Health Information | |
| Disclosure of Health Information | |
| Records Retention and Disposition | |
| Third Parties | Information Security for Contactors Policy |
| Risk Assessment | Privacy and Security Risk Assessment |
| Mandatory Breach Reporting | Privacy Breach Management Procedure |
| Network and Communications Security | Wireless Networking and Remote Access Policy |
| Acceptable Use of Email Policy | |
| Facsimile Transmission Policy | |
| Password Policy |
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