Personal medical information : security, engineering, and ethics : personal information workshop, Cambridge, UK, June 21-22, 1996 : proceedings

In the last few years, the protection of computerised medical records, and of other personal health information, has become the subject of both technical research and political dispute in a number of countries. In Britain, the issue arose initially as an argument between the British Me­ dical Association and the Department of Health over whether encryption should be used in a new medical network. In Germany, the focus was the issue to all patients of a smartcard to hold insurance details and facilitate payment; while in the USA, the debate has been whether federal law should preempt state re­ gulation of computerised medical records, and if so, what technical and legal protection should be afforded the patient. Whatever the origin and evolution of this debate in specific countries, it has become clear that policy and technical matters are closely intertwined. What does 'computer security' mean in the medical context? What are we trying to do? What are the threats that we are trying to forestall? What costs might reasonably be incurred? To what extent is the existing technology - largely developed to meet military and banking requirements - of use? And perhaps hardest of all, what is the right balance between technical and legal controls? As the debate spread, it became clear that there was little serious contact between the people who could state the requirements - clinical professionals, medical ethicists and patients - and the people who could explore how to meet Front Matter....Pages I-X Information and the NHS (For me or for them?)....Pages 1-18 Chances, Risks and Side Effects of Chip Cards in Medicine: A Technology Assessment Study from Germany....Pages 19-26 Exceptionalism Redux: How Different Is Health Care Informatics?....Pages 27-37 Clinical Record Systems in Oncology. Experiences and Developments on Cancer Registers in Eastern Germany....Pages 39-56 Organisation of General Practice: Implications for IM&T in the NHS....Pages 57-65 Practical Protection of Confidentiality in Acute Health Care....Pages 67-78 Clinical Systems Security Implementing the BMA Policy and Guidelines....Pages 79-94 User-Oriented Control of Personal Information Security in Communication Systems....Pages 95-108 Information Management as Risk Management....Pages 109-115 Responsibility Modelling: A New Approach to the Re-Alignment and Re-Engineering of Health-Care Organisations....Pages 117-127 Keeping Confidence in Confidentiality: Linking Ethics, Efficacy, and Opportunity in Health Care Computing — A Case Study....Pages 129-150 Electronic Patient Records: Usability vs Security, with Special Reference to Mental Health Records....Pages 151-163 Security and Confidentiality Issues Relating to the Electronic Data Interchange of Clinical Data....Pages 165-173 Privacy Oriented Clearing for the German Health-Care System....Pages 175-194 Personal Health Data on Optical Memory Cards in Isehara City....Pages 195-198 The Perspective of Medical Ethics....Pages 199-205 Legal Requirements for Computer Security: An American Perspective....Pages 207-207 U.S. Health Information Privacy Policy: Theory and Practice....Pages 209-224 Managing Health Data Privacy and Security: A Case Study from New Zealand....Pages 225-232 An Update on the BMA Security Policy....Pages 233-250 Back Matter....Pages 251-253

This book originates from an international workshop on personal information held at the Isaac Newton Institute for Mathematical Sciences in Cambridge, UK, in June 1996. The workshop was organized under the joint sponsorship of the British Medical Association and the Isaac Newton Institute in the context of a six-month research program in computer security, cryptology, and coding theory.
The revised workshop papers appearing in this volume reflect a lively interdisciplinary exchange of views and ideas between doctors, lawyers, privacy activists, and the computer security community. The volume gives a representative snapshot not merely of the state of the art of the medical computer security art in various countries, but of the complex interplay between human, political, and technical aspects.

The book contains black-and-white illustrations.

Before discussing the Information and Technology strategy of the NHS, we must consider the objectives of that strategy and whether they are legitimate.