<<Does the new system distinguish between security and confidentiality?
It seems to me that if the designers understood what we mean by
confidentiality the system could be designed to be quite sensitive to
clinician patient and administrator requirements.>>
Security is a prerequisite for confidentiality. Perhaps models of
protecting confidentiality will evolve in much the same way that at our
practice meetings we continue to talk about better ways of protecting
patients dignity when booking appointments in our open waiting
room/reception desk. Maybe not the best analogy as the open room is
technically not secure and in designing a new system we could make it
closed.
<<There seems to be an implicit assumption that security equals
confidentiality, and it is this that I find most deeply concerning ...
Administrators and official bodies with appropriate security codes need
to be forced to consider patient confidentiality before any access to
identified data is granted. Unless they are so compelled, I am concerned
that there will be a 'free for all' approach to data-mining the
identified patient record for non clinical reasons.>>
Yes. Clinicians need to explain the concepts of confidentiality to
system designers. This is the point of us now getting more involved.
<<After all, what a good way such access is to improve the poor quality
of UK census data, to prevent NHS Fraud, to check up on immigrants, to
identify and locate particular racial groups, to enquire into the health
and lifestyle of one's political enemies, etc etc.. No wonder the
Government felt it worth spending 2.9 billion or whatever it was...>>
We share similar views Paul. Not withstanding this we are in a minority.
The majority of doctors apparently see CRS as a high priority for the
NHS and as something which will help them deliver better health care. So
where do we go from here? Given the momentum of the CRS locomotive, a
minority boycott would be ineffectual. A larger boycott is pretty
unlikely and even if it caused ICR to fall over this would be at a
terrible cost to the taxpayer. I would prefer to be actively involved in
ensuring that confidentiality measures are built into the system.
Laurie
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