Privacy and Computerized Health Information in Community Health Centers and District Health Agencies

Computers play an important role in health care delivery. Electronic data systems have been extensively applied in health settings to facilitate treatment procedures, to serve as program management aids, and to serve cost-control and billing functions. Underlying this expanding application of computer technology is the issue of privacy as it applies to the collection, storage and retrieval of personal health information. To appreciate the complexity of this issue, one must attend to the use of health data for patient-specific treatment tasks as differentiated from their use in aggregated management, statistical and research tasks. The key factor in this regard is the identification of information that can be linked to a specific person. This article focuses on the basic privacy issues that emerge from the use of computers and how they relate to policy in regard to the use of health information. Differential approaches in the collection and storage of health details must be resolved, including which information should be considered as confidential, who should have access to data banks and what intersystem linkages should be permitted. Salient concerns in regard to patient rights emerge, such as the need for informed consent and the access of individuals to their personal medical files. Essentially, the overriding question is who controls what aspects of health information, to what extent and under what circumstances. Consideration is given to a Canadian model in which small district health centers share computer hardware, while maintaining independent control over their individual management information files. The key to the protection of patient information in this shared system is the absence within the computer banks of any personal information that would allow individual patient identification. Health administrators who maintain such shared computer systems are urged to ensure that maximum awareness and control of specific treatment information should be held by the health practitioner and, as much as is possible, by the service recipient

Computer security · Confidentiality · Control (management) · Data collection · Health care · HRHIS · Identification (biology) · Internet privacy · Key (lock) · Masking (illustration) · Personally identifiable information · Political science · Protected health information · Sociology · Computer Science · Electronic Health Records Systems · Ethics in Clinical Research · Health Policy

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