Privacy and Computerized Health Information in Community Health Centers and District Health Agencies
Privacy and Computerized Health Information in Community Health Centers and District Health Agencies
复制标题
社区卫生中心和地区卫生机构的隐私和计算机化健康信息
DOI：
10.1097/00005650-198202000-00007
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发表时间：
1982
期刊：
影响因子：
3
通讯作者：
R. Tonn
中科院分区：
文献类型：
--
作者：
B. Trute;R. Tonn
计算机在医疗保健服务中发挥着重要作用。电子数据系统已广泛应用于卫生环境中，以促进治疗程序，作为项目管理辅助工具，并提供成本控制和计费功能。计算机技术不断扩展的应用背后是隐私问题，因为它适用于个人健康信息的收集、存储和检索。为了理解这一问题的复杂性，我们必须注意将健康数据用于特定于患者的治疗任务，以区别于它们在汇总管理、统计和研究任务中的使用。这方面的关键因素是识别可以链接到特定人员的信息。本文重点讨论计算机使用中出现的基本隐私问题以及它们与健康信息使用政策的关系。必须解决收集和存储健康详细信息的不同方法，包括哪些信息应被视为机密、谁应有权访问数据库以及应允许哪些系统间链接。对患者权利的突出关注出现了，例如需要知情同意和个人访问其个人医疗档案。从本质上讲，最重要的问题是谁控制健康信息的哪些方面、控制程度以及在什么情况下控制。考虑采用加拿大模式，其中小型地区卫生中心共享计算机硬件，同时保持对其个人管理信息文件的独立控制。在这个共享系统中保护患者信息的关键是计算机库中不存在任何可以识别患者个人身份的个人信息。维护此类共享计算机系统的卫生管理员应确保卫生从业者并尽可能由服务接受者对特定治疗信息进行最大程度的了解和控制。
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.