Canadian Lawyer InHouse

21 W hat do you do when you receive a request for thousands of pages of information spanning fi ve years of patient survey documents and you have limited re- sources in-house? Wendy Lawrence, who was legal coun- sel at Mount Sinai Hospital at the time the request came through, turned to Cognition LLP to assist with the request the hospital re- ceived under the Freedom of Information and Protection of Privacy Act. "We wanted to be transparent and release the records, but [we] wanted to do so in a manner that respected patient privacy," says Lawrence, who is now counsel at another Toronto hospital. Lawrence says because it was a "high-volume, out-of-the-ordinary request," she decided to out- source the project, primarily because of the size of the request and the fact the records had to be re- viewed, redacted for patient privacy, and prepared for disclosure within the legislated timelines. The hospital sector was brought under FIPPA in 2012. Compliance with FIPPA has been chal- lenging for hospitals, as the legislation can be high- volume and labour-intensive. FIPPA also requires legal expertise, as each line and page of a record must be reviewed by the hospital for applicable legal exemptions that protect important interests such as patient privacy, solicitor-client privilege, or propri- etary rights prior to release to a requester. Mount Sinai partnered with Cognition to imple- ment a legal project management approach to the re- quest. It proposed an approach to the work involving a fi rst-level review by a team of junior lawyers, and then a legal audit of the work completed by more se- nior lawyers, accompanied by a fi nal review by a proj- ect management lawyer, who also provided oversight over the work and acted as the primary contact with Mount Sinai. Lawrence worked with Jackie Dinsmore, Jason Moyse, and Morgan Borins of Cognition. Cognition proposed a legal project management team approach, usually reserved for corporate due diligence projects. Lawrence says outsourc- ing the project made sense instead of having one internal employee and a handful of secondary personnel pulled in to prepare the records for disclosure. Cognition provided computer software, scanners, and redaction tools to respond to the request and saved the hos- pital the costs of obtaining these tools on a one-off basis for this particular request. The fi rm's approach of assigning a legal project team with multiple levels of review, audit, and legal oversight provided Mount Sinai with the assurance that its needs could be meet. The legal project team ensured the work was done in a SANDRA STRANGMORE Outsourcing saves hospital money and time STANDING: Jackie Dinsmore SITTING: Wendy Lawrence CATEGORY: Working with External Counsel DEPARTMENT SIZE: Small COMPANY: Mount Sinai Hospital thorough manner that assured the hospital it was meeting its legislative obligations. Lawrence says outsourcing the work was cost effective, as it was given more attention than an internal staff member could provide under the legis- lated timelines. There were also savings — outsourcing ended up being less than 10 per cent of the cost of a full-time equivalent lawyer. There was no lost time due to re-assigning sec- ondary staff to assist, and no need to obtain equipment to assist with the preparation and redaction of records. "It was really cost effective. Instead of using the tradi- tional model of having a senior partner and an associate spend several hours doing one review of the records, we had various levels of lawyers — junior and senior — and in a project team that proved to be [a] more cost-effec- tive and more in-depth review," says Lawrence. Lawrence says there were also improved deliver- ables, as the hospital did not have to ask for a time extension or delay response. Mount Sinai was also able to receive a more rigorous review of the records (e.g. team of lawyers with multiple levels of review) that ensured patient privacy.

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