There are, no doubt, many security issues that still need to
be addressed. (How, for example, does one ensure that patient
sensitive information is not copied onto personal PCs?) However, lack
of access from remote (non-dedicated) sites does somewhat limit value.
We often make a mistake in healthcare that runs as follows:
1 Here's a new medium (fax, mobile 'phones, email, whatever)
2 Oh look, it has some risks related to confidentiality (or security,
or affecting syringe drivers or whatever)
3 Therefore we must reject it.
Part 2 is often made even worse by "IT Depts" being responsible for
computer-mediated communication but not for traditional media such as
paper, 'phones and conversations in corridors.
A healthier approach is:
1 Here's something that needs to be communicated.
2 Lets agree how much security and confidentiality is needed.
3 Let's look at all the available media and list the risks, advantages
and disadvantages.
4 Then choose the one that has the best combination of security,
confidentiality, accountability, and cost.
Net technology doesn't carry greater risks than other media and is
usually the cheapest and most transferable solution.
Now onto the gross overgeneralisations:
1 The biggest threat to security and confidentiality is the 'phone.
* Does your laboratory give out reports over the 'phone to
"clinicians"?
* Do your wards give out clinical information about patients to
"clinicians" and "relatives"?
2 If the answer is "fax" you probably haven't understood the question.
Jonathan
