Ontario building massive health database to aid COVID-19 response

The Ontario government's effort to fight COVID-19 includes a plan to bring artificial intelligence innovators together with health researchers to study a vast new pool of public health information.

That information will include anonymized data from OHIP billings, prescription drug claims, hospital discharges, ER visits and claims for home care and long-term care, which will be gathered in a "secure platform," according to a Ministry of Health statement released Sunday.

The statement was issued after the Star posed questions about a confidential government document it obtained, outlining plans for the new data platform known as Pandemic Threat Response (PANTHR).

According to the document, the platform could eventually grow to incorporate data from other sources outside the public health system, such as location data from Ontarians' mobile phones, vehicles and smart devices. However, the document notes that no Canadian province is currently using such data to combat the spread of COVID-19 and says it is an "ongoing policy discussion" for the province, which is weighing the potential benefits and privacy concerns.

A Health Ministry spokesperson told the Star that "no decisions have been made about the collection or use of mobile data to track contacts or any other personal information of citizens."

The purpose of the new PANTHR platform is to allow artificial intelligence and machine learning experts to analyze a large pool of data in order to:

• Improve the detection of COVID-19 cases and predict where future outbreaks might occur

• Identify risk factors for infection among vulnerable populations

• Assess the effectiveness of prevention and treatment measures

• Predict demands on the health-care system and better deploy resources

The project could "potentially save countless lives" by leveraging artificial intelligence and machine learning, according to the document obtained by the Star.

"Better access to integrated data will improve modelling and research to determine how COVID-19 is evolving, ensuring front-line staff are as prepared as possible in these unprecedented times," Health Minister Christine Elliott said in the news release on Sunday.

Groups involved in the project include the non-profit Compute Ontario, which will manage the platform; provincial superagency Ontario Health; the health research institute ICES; the Toronto-based Vector Institute for Artificial Intelligence; and Queen's University. The Centre for Advanced Computing at Queen's will host the platform, the Health Ministry said.

The confidential document notes the new platform represents "a fundamental change in collection, use and disclosure of public health information in Ontario."

To lay the groundwork for the project, the government made initial changes to both the Personal Health Information Protection Act and the Freedom of Information and Protection of Privacy Act several weeks ago.

Those changes included expanding the definition of who is able to responsibly access provincial health information, and introducing strict measures on how "extra-ministerial entities" can handle data. More severe penalties for data "breaches" and contraventions of the province's health privacy laws were also introduced, with the maximum fine for an offence raised to $200,000 for individuals and $1 million for corporations.

Brian Beamish, the province's information and privacy commissioner, praised these changes, writing in a blog post that "the government (made) significant changes to our access and privacy laws that, for the most part, strengthen data protection in our province."

The confidential document recommends that the final agreement with partnering groups contain provisions for "cybersecurity mechanisms" that meet or exceed industry standards and best practices, as well as the creation of a cybersecurity advisory body, an ability for the province to audit the project, and a pledge that the data of Ontarians will remain secure "at all times."

Health Ministry spokesperson Hayley Chazan told the Star on Sunday that the government "will be consulting with privacy stakeholders, including the province's information and privacy commissioner", to ensure this initiative is designed with the best interests of Ontarians in mind, including privacy protections for Ontarians."

The province will appoint a special adviser and also form a round table to guide the project.

According to government estimates in the document obtained by the Star, the platform will cost $47 million over five years, with $15 million required in the first year. Chazan confirmed the $15-million figure to the Star, but said the government has yet to determine future funding. Chazan said the money will come from "either internal ministry reallocation, or federal or interprovincial COVID-19 financial resources."

When asked what Health Canada's role in the project would be, a spokesperson told the Star that it is "working with provincial and territorial partners, as well as key national data agencies, to support greater patient access to health data while ensuring the protection of personal health information."

With regard to the use of artificial intelligence and big data, the proposal seen by the Star suggests an "ethical use framework" be developed specially for the project.

The confidential document cites a "medium risk" related to "the security of information and data stored in the program," and notes the increasing frequency of cyberattacks.

The document discloses that there were more than 500 "health information privacy breaches" in 2018 across Ontario, and says that harnessing artificial intelligence could help lower that number.

The proposal for the new data platform notes there is "interest and potential" to integrate data held by private companies in order to strengthen the province's response to COVID-19.

"For example," the proposal reads, "geolocation data from personal mobile devices, vehicles, and transit and credit card transactions have the potential to be paired with public health data." It also cites the potential to incorporate data from household and wearable smart devices.

The Ministry of Health told the Star on Sunday that "credit card data will not be collected."

This proposal comes in the wake of an article published by tech-focused news outlet The Logic, detailing comments made by Mayor John Tory that the city of Toronto was "obtaining cellphone data from wireless carriers to help it identify where people have assembled in groups." Tory's spokesperson and city staff said later that they were not collecting such data, and that Tory was instead talking about an offer made to him by various companies.

So far, no provinces have implemented the intrusive measures seen in countries such as China, where cellphones are tracked and citizens scolded for disobeying public health guidelines. But one page from the government's proposal includes a chart showing Ontario's handling of the pandemic compared with stricter approaches taken by countries in Europe and Asia.

As of Sunday, the province's 34 regional public health units were reporting a total of 320 deaths among 8,021 confirmed or probable cases of COVID-19.

Ted Fraser is a breaking news reporter, working out of the Star's radio room in Toronto. Follow him on Twitter: @ted_fraser