Computerisation and health care: some worries behind the promises

Most clinical facilities are looking towards achieving seamless integration of services based on a clinical “intranet” and deployment of full electronic records. These developments open a wealth of opportunities and promise benefits; however, they bring with them several important concerns and risks, at the root of which are security issues.1 Computerised and hard copy information differ in two fundamental ways. One difference relates to perception: hard copy is something we are all familiar with and feel that we understand. By contrast, information that is stored in electronic form is mysterious and therefore a source of anxiety. Understandably, therefore, professionals and the public alike are more concerned about the security of electronic records, especially not knowing where they are stored or who controls them. The various well publicised failures of computerised systems have contributed to this unease. #### Summary points Security remains a critical issue in respect of health information management systems: too few people understand the risks inherent in the technology, although anxiety is widespread Patients assume that care providers are in control of the technology they use and that the technology is fit for the purpose, but there is no process of certification for this The law can offer little useful help: it has always trailed reality, often by a considerable margin The goal must be to prevent security breaches, because once they have happened the damage is already done as far as …