Emergency physicians’ letter urges closing Humber River’s ER until IT systems fixed following cyberattack, but hospital says it’s safe

A group of emergency physicians at Humber River Hospital has written a letter to the hospital's administrators calling for the emergency department to be temporarily closed until IT systems are fully restored, citing concerns over patient safety.The hospital’s information technology system has been shut down since Monday following an early-morning ransomware attack that triggered a Code Grey, or loss of essential services.The IT shutdown has led to delays in medical and diagnostic test results needed to assess patients, according to the physicians who authored the letter obtained by the Star.“This is leading to compromised and dangerous conditions for our patients,” the letter reads. The authors want “normal activities in the emergency department to cease until our IT systems are restored to normal function,” noting patients could travel to nearby GTA hospitals that “can operate at the proper level of care.”The letter, sent late Thursday to administrators at Humber River, was co-authored by a group of emergency physicians, none of whom signed their name to the letter due to concerns about speaking against their employer. Staff who spoke with the Star say the letter was approved by a group of 30 physicians who work in the hospital’s emergency department. That’s about half the staff of 65 physicians in the department. In an interview with the Star, Dr. Leon Rivlin, chief and medical director of the emergency department, said the hospital has “continued to deliver care to all of our patients in a very safe way” during the ongoing Code Grey. The emergency department is now safely relying on paper records while assessing patients, he said. It’s also working closely with the diagnostic and laboratory departments “to ensure that we are maintaining all of the efficiencies and the safety mechanisms that have been developed in order to make sure patients get the care that they need,” Rivlin said.Since Monday, Rivlin said he has been made aware of only one patient complaint regarding care received in the emergency department.“And we’re seeing between 200 and 300 patients a day,” he said.In their letter, the group of physicians provide examples of how they believe patient care has been compromised during the IT shutdown, including: delays in laboratory tests, including those for suspected heart attacks; the inability to view and share diagnostic test results, including those needed to assess a trauma patient; and lengthy waits for blood test results for dialysis patients. The letter goes on to say: “The situation is currently such that we would never consider sending our own loved ones here.”Rivlin said he was unable to comment specifically on each example without reviewing patients’ medical charts and histories. “I appreciate all of these cases that have been brought forward by our peers, and they need to be looked at closely,” he said. “My job is to determine what exactly took place in each case, that makes it a concern of a physician peer.”Following the June 14 cyberattack, the hospital immediately shut down its IT systems, including the one for patient records, to prevent the ransomware from encrypting files. In a statement released June 15, the hospital said the IT shutdown had not affected surgeries, though “a variety of clinics” were cancelled, and some ambulances would be redirected to other hospitals.Jane Casey, program director for Humber River’s emergency department, said the hospital “has seen a decrease in the volume of ambulances over this period” due to the local ambulance service choosing to send some patients to nearby hospitals. Rivlin said Humber River has not made a request to the Ministry of Health for its emergency department to be temporarily closed during the IT shutdown, and would not do so given its patient population. “Our community is a very high-needs community, which doesn’t have the financial means to effectively travel to receive their health care,” he said. “We would not close our door to our patients. That was never an option.” In a statement to the Star, Ontario Health said it has been “closely monitoring the situation and our Cybersecurity team has been supporting the Humber River Hospital (HRH) team as needed. Should HRH require regional support, Ontario Health would engage to help mobilize it.”A spokesperson for the hospital confirmed its IT team has been “working around the clock” and is being helped by IT staff from other GTA hospitals. “We’re very hopeful that we will be up and back electronically by Saturday,” Casey said.Megan Ogilvie is a Toronto-based health reporter for the Star. Follow her on Twitter: @megan_ogilvie

Emergency physicians’ letter urges closing Humber River’s ER until IT systems fixed following cyberattack, but hospital says it’s safe

A group of emergency physicians at Humber River Hospital has written a letter to the hospital's administrators calling for the emergency department to be temporarily closed until IT systems are fully restored, citing concerns over patient safety.

The hospital’s information technology system has been shut down since Monday following an early-morning ransomware attack that triggered a Code Grey, or loss of essential services.

The IT shutdown has led to delays in medical and diagnostic test results needed to assess patients, according to the physicians who authored the letter obtained by the Star.

“This is leading to compromised and dangerous conditions for our patients,” the letter reads.

The authors want “normal activities in the emergency department to cease until our IT systems are restored to normal function,” noting patients could travel to nearby GTA hospitals that “can operate at the proper level of care.”

The letter, sent late Thursday to administrators at Humber River, was co-authored by a group of emergency physicians, none of whom signed their name to the letter due to concerns about speaking against their employer. Staff who spoke with the Star say the letter was approved by a group of 30 physicians who work in the hospital’s emergency department. That’s about half the staff of 65 physicians in the department.

In an interview with the Star, Dr. Leon Rivlin, chief and medical director of the emergency department, said the hospital has “continued to deliver care to all of our patients in a very safe way” during the ongoing Code Grey.

The emergency department is now safely relying on paper records while assessing patients, he said. It’s also working closely with the diagnostic and laboratory departments “to ensure that we are maintaining all of the efficiencies and the safety mechanisms that have been developed in order to make sure patients get the care that they need,” Rivlin said.

Since Monday, Rivlin said he has been made aware of only one patient complaint regarding care received in the emergency department.

“And we’re seeing between 200 and 300 patients a day,” he said.

In their letter, the group of physicians provide examples of how they believe patient care has been compromised during the IT shutdown, including: delays in laboratory tests, including those for suspected heart attacks; the inability to view and share diagnostic test results, including those needed to assess a trauma patient; and lengthy waits for blood test results for dialysis patients.

The letter goes on to say: “The situation is currently such that we would never consider sending our own loved ones here.”

Rivlin said he was unable to comment specifically on each example without reviewing patients’ medical charts and histories.

“I appreciate all of these cases that have been brought forward by our peers, and they need to be looked at closely,” he said. “My job is to determine what exactly took place in each case, that makes it a concern of a physician peer.”

Following the June 14 cyberattack, the hospital immediately shut down its IT systems, including the one for patient records, to prevent the ransomware from encrypting files. In a statement released June 15, the hospital said the IT shutdown had not affected surgeries, though “a variety of clinics” were cancelled, and some ambulances would be redirected to other hospitals.

Jane Casey, program director for Humber River’s emergency department, said the hospital “has seen a decrease in the volume of ambulances over this period” due to the local ambulance service choosing to send some patients to nearby hospitals.

Rivlin said Humber River has not made a request to the Ministry of Health for its emergency department to be temporarily closed during the IT shutdown, and would not do so given its patient population.

“Our community is a very high-needs community, which doesn’t have the financial means to effectively travel to receive their health care,” he said. “We would not close our door to our patients. That was never an option.”

In a statement to the Star, Ontario Health said it has been “closely monitoring the situation and our Cybersecurity team has been supporting the Humber River Hospital (HRH) team as needed. Should HRH require regional support, Ontario Health would engage to help mobilize it.”

A spokesperson for the hospital confirmed its IT team has been “working around the clock” and is being helped by IT staff from other GTA hospitals. “We’re very hopeful that we will be up and back electronically by Saturday,” Casey said.

Megan Ogilvie is a Toronto-based health reporter for the Star. Follow her on Twitter: @megan_ogilvie

Source : Toronto Star More   

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Can I be fired if I don’t get vaccinated? Experts answer pressing questions about vaccines and the workplace

Canadians are once again navigating a strange new normal.Vaccines offer protection, but what are the rights of those who choose to not get jabbed? When Erin Pepler, a Burlington, Ont. resident, recently booked massage therapist and osteopath appointments, vaccination status was on her mind. “I didn’t really want to flat out ask if they’ve been vaccinated because it felt invasive, but my RMT freely shared this information during an appointment and it definitely made me feel much better about continuing treatment,” she said. “There are high-risk individuals in my household. If a health-care worker told me they were unvaccinated by choice, I’d definitely question their judgment and consider finding a different practitioner.” Anticipating that many clients would have similar concerns, Farzana Mayer, owner of iKhaya Day Spa in B.C., put a plan in place.“In the event that any of our current employees had chosen to not get the vaccine, they would have been placed in a position that does not require direct contact with colleagues or guests. An example of this would be the front-end co-ordinator position behind a Plexiglas,” she said. Ottawa says it is planning to lessen quarantine requirements for travellers who have had both jabs of any two-dose vaccine, but governments have not yet issued specific guidelines around the use of “vaccine passports” in private sectors of the economy. Paul McLean, a specialist in employment law at Mathews Dinsdale, says his firm has been receiving many questions from employers about how they can talk with staff and customers about vaccination.“The limited government advice so far is couched with the caveat that it can all change tomorrow, so it’s quite up in the air,” he said. To seek some clarity, the Star reached out to employment lawyers, labour boards and the Office of the Privacy Commissioner of Canada. The below are general guidelines only, and should not be treated as legal advice. Is it legal for employers to ask staff to disclose their vaccination status?Kirsten Hume Scrimshaw, founding partner of Ally Workplace Law, said employers have to balance privacy concerns and their obligation under health and safety laws to provide a safe space for employees and the public.“Business owners must assess the risks, such as the level of interaction employees have with customers. If they are asking staff about vaccination status as part of legitimate efforts to assess workplace health and safety, privacy laws have a reasonableness component that would protect employers’ rights to inquire,” she said. “Vaccination is highly encouraged by public health officers. If an employer has to go to court to justify their policies, it’s best to use those same guidelines to show they have an evidence-based approach in bringing in policies.”McLean said there might be circumstances where an employee could argue that it isn’t necessary for them to disclose their vaccination status. “It is fair for an employer to ask in most cases, but I’d say it may vary ... Someone who works at a senior care home is very different from someone who works remotely at home.”Can employers fire unvaccinated staff? Scrimshaw hasn’t heard about business owners putting an ultimatum to employees to get vaccinated or else lose their jobs, but adds that a lot of employment lawyers are waiting to hear any recommendations from the Office of the Privacy Commissioner and looking for guidance from provincial health officers.A spokesperson for the Ontario Ministry of Labour said workers with concerns about vaccination policies in the workplace may raise the issues with their trade union or company health and safety committees. “The Employment Standards Act, 2000 (ESA) does not address mandatory vaccinations. However, if an employer ends the employment of an employee because they refused to be vaccinated, the employee may be entitled to termination pay and severance pay under the ESA,” the spokesperson said. When it comes to whether unvaccinated employees can sue for wrongful termination, McLean said this could happen, but individuals “would have to think about whether to pursue a claim if an employer can demonstrate a vaccine was necessary and proper for the workplace to function.” What are the rights of employees who wish to remain unvaccinated?A worker’s rights might depend on the reason they are unvaccinated, says McLean. “If you have an employee who thinks (vaccination is) a Bill Gates microchip conspiracy, an employer could say that’s not a legitimate reason to refuse a vaccine and your presence in the workplace is putting coworkers and members of the public at risk,” McLean said.But if any staff member has a medical reason why they should not get vaccinated, employers have an obligation to make workplace accommodations. “They would have to assess and possibly modify work duties, such as allowing someone to work from home, or in some workplaces maybe they would continue to wear PPE,” McLean said.When it comes to privacy rights, empl

Can I be fired if I don’t get vaccinated? Experts answer pressing questions about vaccines and the workplace

Canadians are once again navigating a strange new normal.

Vaccines offer protection, but what are the rights of those who choose to not get jabbed?

When Erin Pepler, a Burlington, Ont. resident, recently booked massage therapist and osteopath appointments, vaccination status was on her mind.

“I didn’t really want to flat out ask if they’ve been vaccinated because it felt invasive, but my RMT freely shared this information during an appointment and it definitely made me feel much better about continuing treatment,” she said.

“There are high-risk individuals in my household. If a health-care worker told me they were unvaccinated by choice, I’d definitely question their judgment and consider finding a different practitioner.”

Anticipating that many clients would have similar concerns, Farzana Mayer, owner of iKhaya Day Spa in B.C., put a plan in place.

“In the event that any of our current employees had chosen to not get the vaccine, they would have been placed in a position that does not require direct contact with colleagues or guests. An example of this would be the front-end co-ordinator position behind a Plexiglas,” she said.

Ottawa says it is planning to lessen quarantine requirements for travellers who have had both jabs of any two-dose vaccine, but governments have not yet issued specific guidelines around the use of “vaccine passports” in private sectors of the economy.

Paul McLean, a specialist in employment law at Mathews Dinsdale, says his firm has been receiving many questions from employers about how they can talk with staff and customers about vaccination.

“The limited government advice so far is couched with the caveat that it can all change tomorrow, so it’s quite up in the air,” he said.

To seek some clarity, the Star reached out to employment lawyers, labour boards and the Office of the Privacy Commissioner of Canada. The below are general guidelines only, and should not be treated as legal advice.

Is it legal for employers to ask staff to disclose their vaccination status?

Kirsten Hume Scrimshaw, founding partner of Ally Workplace Law, said employers have to balance privacy concerns and their obligation under health and safety laws to provide a safe space for employees and the public.

“Business owners must assess the risks, such as the level of interaction employees have with customers. If they are asking staff about vaccination status as part of legitimate efforts to assess workplace health and safety, privacy laws have a reasonableness component that would protect employers’ rights to inquire,” she said.

“Vaccination is highly encouraged by public health officers. If an employer has to go to court to justify their policies, it’s best to use those same guidelines to show they have an evidence-based approach in bringing in policies.”

McLean said there might be circumstances where an employee could argue that it isn’t necessary for them to disclose their vaccination status.

“It is fair for an employer to ask in most cases, but I’d say it may vary ... Someone who works at a senior care home is very different from someone who works remotely at home.”

Can employers fire unvaccinated staff?

Scrimshaw hasn’t heard about business owners putting an ultimatum to employees to get vaccinated or else lose their jobs, but adds that a lot of employment lawyers are waiting to hear any recommendations from the Office of the Privacy Commissioner and looking for guidance from provincial health officers.

A spokesperson for the Ontario Ministry of Labour said workers with concerns about vaccination policies in the workplace may raise the issues with their trade union or company health and safety committees.

“The Employment Standards Act, 2000 (ESA) does not address mandatory vaccinations. However, if an employer ends the employment of an employee because they refused to be vaccinated, the employee may be entitled to termination pay and severance pay under the ESA,” the spokesperson said.

When it comes to whether unvaccinated employees can sue for wrongful termination, McLean said this could happen, but individuals “would have to think about whether to pursue a claim if an employer can demonstrate a vaccine was necessary and proper for the workplace to function.”

What are the rights of employees who wish to remain unvaccinated?

A worker’s rights might depend on the reason they are unvaccinated, says McLean.

“If you have an employee who thinks (vaccination is) a Bill Gates microchip conspiracy, an employer could say that’s not a legitimate reason to refuse a vaccine and your presence in the workplace is putting coworkers and members of the public at risk,” McLean said.

But if any staff member has a medical reason why they should not get vaccinated, employers have an obligation to make workplace accommodations.

“They would have to assess and possibly modify work duties, such as allowing someone to work from home, or in some workplaces maybe they would continue to wear PPE,” McLean said.

When it comes to privacy rights, employers should not share employees’ medical information publicly, but this is an emerging grey area, says Scrimshaw, pointing to how some businesses are advertising the vaccination rate of their staff.

It’s unclear whether advertising the general vaccination rate of staff as a group contravenes privacy rights. The Star reached out to multiple provincial ministries across Canada, and none provided clear rules.

A spokesperson for the Privacy Commissioner of Canada, a non-partisan ombudsman and officer of the Parliament of Canada, said the Commissioner did not have any other guidelines to provide at this time. It had issued an earlier statement on the importance of considering privacy rights in vaccine passport development.

Can business owners refuse service to unvaccinated customers?

There are no federal guidelines at this time on private sector practices around the use of proof-of-vaccination documentation, or informally asking customers about vaccination status.

Businesses in the U.S. and Europe have hosted events with different policies for attendees who are vaccinated, and those who are not. In Canada, whether businesses choose to ask customers about vaccination would depend on the nature and even location of the business, said McLean.

“A small eco-resort in a remote community might choose to only accept vaccinated guests because they lack access to medical facilities of COVID-19 testing in their area,” he said.

“A large retail or grocery store, however, would have more options to serve customers. If someone is unvaccinated, they could be offered online shopping or staff members could bring goods outside.”

As for whether customers could complain about unfair treatment, McLean anticipates this would most likely take place on social media rather than play out in courts of law.

Joanna Chiu is a Vancouver-based reporter covering both Canada-China relations and current affairs on the West Coast for the Star. Follow her on Twitter: @joannachiu

Source : Toronto Star More   

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