What Ontario clinics need to know about digital health rules in 2026
, 4 min read
Running a clinic in Ontario now means meeting real legal standards for how you handle patient data. The privacy commissioner can fine you directly, and new federal rules are changing how health software has to work. This article covers five areas to check.
1. Privacy fines no longer need a court
The Information and Privacy Commissioner of Ontario (IPC) can now fine you without going to court first.
- What changed: Under the Personal Health Information Protection Act (PHIPA), the IPC can issue fines called administrative monetary penalties.
- How much: Up to $50,000 for an individual and $500,000 for an organization.
- What triggers them: Serious breaches, such as staff looking at records they have no reason to see.
- What to do: Make sure your system logs every time someone opens or changes a patient record. Each log entry should show who did it, when, and what they did. Nobody, including admins, should be able to edit those logs.
2. AI scribes need oversight
If you use an AI tool to write clinical notes, the IPC expects you to manage it carefully.
- Before you start: Complete a privacy impact assessment.
- Tell patients: Let patients know you use AI in their care.
- Check every note: A clinician must review and approve each AI-generated note before it goes in the chart.
- Check your vendor: Find out whether the vendor uses your patient data to train its models. If it does, ask how it removes identifying details.
3. Your software vendor can't hold your data hostage
The federal Connected Care for Canadians Act targets vendors that make it hard to move or share your data.
- What it bans: Charging unreasonable fees or using closed formats to stop you from exporting data or sharing it with other providers.
- What it expects: Health software that uses common standards, such as HL7 FHIR.
- What to do: At your next contract renewal, ask the vendor to show that you can export your data for referrals or a switch to another system.
4. Ontario is connecting records across the province
Ontario Health is building a shared provincial health record.
- What it means for you: Some primary care models must contribute data to the provincial record.
- Patient access: Patients use verified digital identities to see their own records.
- What to do: Check whether your patient portal and virtual care tools meet Ontario Health's requirements, especially if your funding depends on them.
5. Know where your data lives
Data location matters, but the rules are narrower than many people assume.
- What the law says: PHIPA doesn't require you to store data in Canada. You are responsible for protecting it wherever it's stored.
- The real risk: Data on US servers can fall under US laws that let authorities request access. Many clinics, health organizations, and patients prefer Canadian hosting for that reason.
- What to do: Find out where your EMR, backups, and messaging tools store data. If any of it is outside Canada, document why and how you protect it, and check whether your contracts or funding agreements require Canadian hosting.
Quick checklist
| Area | What to check |
|---|---|
| Audit logs | Every record access is logged with user, time, and patient, and logs can't be edited. |
| AI tools | You've done a privacy impact assessment and clinicians review every AI note. |
| Data location | You know where every system stores patient data and have a reason for each choice. |
| Data sharing | Your software can export data in a standard format such as HL7 FHIR. |
| Staff access | Each staff member can see only what their role needs. |