Psychiatry – Dr. Lorraine Lazier

Confidentiality:

Protecting your personal health information under the Personal Health Information Act

The Personal Health Information Act (PHIA) governs the collection, use, disclosure, retention, disposal and destruction of personal health information.

PHIA was proclaimed on December 4, 2012 and came into force on June 1, 2013.

The Act recognizes both the right of individuals to protect their personal health information and the need of custodians to collect, use and disclose personal health information to provide, support and manage health care.

Please see the website for more information: www.novascotia.ca/DHW/PHIA

What is the Personal Health Information Act?

The Personal Health Information Act or PHIA is a new provincial law that aims to balance your right to have your personal health information protected with the need of those in the health sector to use your information to provide you with appropriate care and treatment.

How does PHIA protect my personal health information?

PHIA requires that “custodians” of personal health information (including hospitals, physicians, dentists, and nursing homes) have policies and practices to protect your personal health information. Under PHIA we must:

• follow PHIA’s requirements for appropriate collection, use, disclosure, retention and destruction of your personal health information
• have a privacy contact person who can answer your questions about our management of your personal health information
• have policies to protect the privacy and security of your personal health information whether it is held on paper or in electronic form, or if it is unrecorded
• have a complaints policy for you to use if you have concerns about our compliance with PHIA
• take appropriate action if the privacy of your personal health information has been breached which may include notifying you or the Privacy Review Officer
• handle your requests for access to and correction of your personal health information

Limits of confidentiality

Custodians are required by law to breech confidentiality under the following circumstances:

• if your comments or behaviours suggest there is an imminent risk of harming yourself or someone else
• if there is reason to suspect a child or vulnerable adult is in danger or being abused/neglected
• if ordered by a judge or court of law

Who can see and use my personal health information?

• individuals involved in your care and treatment, including students
• individuals who require the information to get payment for your health care
• anyone who can legally act for you with your consent
• specified organizations who have a legal right to see the information

What are my rights under PHIA?

• You have the right to have your personal health information collected, used, disclosed, retained and destroyed according to the provisions in
• You have the right to request access to your personal health information which is provided according to the PHIA access fee schedule
• You have the right to request a correction to your personal health information.
• You have the right to request information on who has accessed your personal health information held in electronic form.
• You have the right to request that some or all of your personal health information not be collected, used or disclosed to specific individuals or organizations involved in your care.
• You have the right to make a complaint to any custodian related to their management of your personal health information.
• You have the right to request a review by the Review Officer responsible for PHIA if you are not satisfied with the resolution of your complaint or your access or correction request.

Who do I contact for more information on my rights under PHIA?

This information is a summary of your rights and our obligations under PHIA. There are specific exceptions to these rights and obligations. Additional information is included in our brochure [name of custodian’s brochure].

You can also contact our PHIA Contact Person at [contact person’s phone number and e-mail address].

For general information on PHIA, you can reach the Department of Health and Wellness PHIA contact at 1-902-424-5419 or toll-free at 1-855-640-4765.You can also get general information on PHIA at www.novascotia.ca/DHW/PHIA or by e-mailing your questions to phia@gov.ns.ca.

Non-Insured Services Fees

There are many aspects of care which are not covered by MSI or health insurance companies. When this is the case, you will be informed of the cost, and be given the option to decline this service. These may include, but are not limited to:

• Printing, faxing, mailing documents
• Medical advice by letter, phone, fax, email
• Prescription renewal by phone
• Medical record transfer or chart summary
• Medical-legal services
• Requested forms/reports, such as (but not limited to)
  • Disability forms
  • Third party requested letters/questionnaires
• Scotopic Sensitivity Screening

Payment

Payment for non-insured services is due at the time of provision. Payment for late and cancellation fees are due within 2 weeks of the cancellation. Further appointments will not be offered until your account is settled. Exceptions for late and cancellation fees may be made in the case of emergencies (such as unexpected death of a family member, motor vehicle accident, health emergency), with proof of the event.

Referral Criteria

To bill for psychiatry services through Nova Scotia Medical Service Insurance (MSI), the patient must be referred by a physician. The assessment process is most efficient if all relevant information is forwarded for review and entry into your chart before your first appointment. This could include past assessments by other mental health clinicians (private and public), laboratory investigations, and clinical notes from the referring physician. A consultation appointment will not be scheduled until the requested information is received.

Dr. Lazier uses a collaborative, holistic approach and prefers to work with other professionals to optimize treatment outcomes. She therefore is seeking to provide consultation for children who are already working with a private therapist and/or have already had a psychological assessment. This allows for a more efficient and effective consultation for the purpose of diagnostic clarification and/or medication review.

Dr. Lazier is accepting referrals for children from 5-15yrs of age. She will review each referral to determine whether her expertise match the referral request. If the individual’s age or the reason for referral is deemed to be beyond the scope of her practice and clinical abilities, she will notify the referring physician that an alternate consultant should be sought.

Dr. Lazier works part-time hours. It is possible that the demand for her services may exceed her availability. In this case, the referring physician will be notified that an appointment cannot be offered in a reasonable time period, and an alternative consultant should be sought.

There are certain clinical scenarios which require more intensive services than can be safely provided in an outpatient setting. For this reason, individuals with the following diagnoses should be referred to the district health authority mental health system:

• Severe Disruptive, Impulse-Control and Conduct Disorders
• Eating Disorders
• Autism Spectrum Disorder (Level 2 and Level 3 Severity)
• Psychosis
• Primary Personality Disorder
• Primary Substance Use Disorder

Areas of Clinical Interest

Dr. Lazier is a child and adolescent psychiatrist. Her main areas of interest are:

• Attention Deficit Hyperactivity Disorder
• Anxiety Disorders
• Obsessive Compulsive Disorder
• Tourette Disorder

Dr. Lazier has a keen interest in understanding the effects early trauma and neglect have on the developing brain and she is actively pursuing further training in this area. In particular, she is interested in how the developmental stage of the child at the time of trauma may inform treatment decisions, both pharmaceutical and non-pharmaceutical. She has Level 2 training in HANDLE (Holistic Approach to Neurodevelopment and Learning Efficiency), and plans to acquire her Screener’s certificate by 2016.

Dr. Lazier is also interested in understanding how seemingly minor neurodevelopmental differences can impact a person’s functioning – socially, academically and emotionally. One such difference is Scotopic Sensitivity Syndrome (also known as Irlen Syndrome). Dr. Lazier completed Irlen Screening training in 2014.