Fisher F, Madge B
Science and Information Division, British Medical Association, London, UK.
Int J Biomed Comput. 1996 Oct;43(1-2):115-9. doi: 10.1016/s0020-7101(96)01236-6.
The maintenance of patient confidentiality is of utmost importance in the doctor patient relationship. With the advent of networks such as the National Health Service Wide Area Network in the UK, the potential to transmit identifiable clinical data will become greater. Links between general practitioners (GPs) and hospitals will allow the rapid transmission of data which if intercepted could be potentially embarrassing to the patient concerned. In 1994 the British Medical Association launched a draft bill on privacy and confidentiality and in association with this bill it is pushing for encryption of all clinical data across electronic networks. The manager's role within an acute hospital, community units and general practice, is to ensure that all employees are aware of the principles of data protection, security of hospital computer systems and that no obvious breaches of security can occur at publicly accessible terminals. Managers must be kept up to date with the latest developments in computer security such as digital signatures and be prepared to instigate these developments where practically possible. Managers must also take responsibility for the monitoring of access to terminals and be prepared to deal severely with staff who breach the code of confidentiality. Each manager must be kept informed of employees status with regard to their 'need to know' clearance level and also to promote confidentiality of patient details throughout the hospital. All of the management team must be prepared to train new staff in the principles of data security as they join the organisation and recognise their accountability if the programme fails. Data security and patient confidentiality is a broad responsibility in any healthcare organisation, with the Chief Executive accountable. In family practice, the partners are responsible and accountable. The British Medical Association believes as a matter of policy, that allowing access to personal health data without the patients consent, except in a legally allowable situation, should be a statutory offence.
在医患关系中,维护患者的隐私至关重要。随着英国国民医疗服务体系广域网等网络的出现,传输可识别临床数据的可能性将变得更大。全科医生(GP)与医院之间的联系将使数据能够快速传输,而这些数据一旦被拦截,可能会让相关患者陷入尴尬境地。1994年,英国医学协会发起了一项关于隐私和保密的法案草案,并在此法案的推动下,要求对所有通过电子网络传输的临床数据进行加密。急症医院、社区单位和全科诊所的管理人员的职责是,确保所有员工都了解数据保护原则、医院计算机系统的安全性,并且确保在公众可访问的终端不会发生明显的安全漏洞。管理人员必须了解计算机安全方面的最新发展,如数字签名,并准备在实际可行的情况下推动这些发展。管理人员还必须负责监控对终端的访问,并准备对违反保密规定的员工进行严厉处理。每位管理人员都必须了解员工的“知悉必要性”权限级别,并在整个医院内促进患者信息的保密。所有管理团队成员都必须准备好在新员工加入组织时,对他们进行数据安全原则培训,并认识到如果该计划失败,他们应承担的责任。在任何医疗保健组织中,数据安全和患者隐私都是一项广泛的责任,首席执行官要对此负责。在家庭医疗中,合伙人要负责并承担责任。英国医学协会认为,作为一项政策,在未经患者同意的情况下允许他人访问个人健康数据,除非在法律允许的情况下,应构成刑事犯罪。