The evolution of Health Information Systems, security in practice and open issues

Security issues during development and implementation of hospital information systems are briefly reviewed. Attention is paid to current issues as to: availability, integrity, authentication and access rights. In particular are discussed: some remaining risks as to integrity, the tension between in-house acceptance of HIS access rules and standardisation needed when implementing a transmural Electronic Health Record (EHR), access rights needed for medical audit, law suits and evaluation with their far-reaching consequences. The need for harmonisation of access rights is underlined and a further study of the requirements for systems from the perspective of medical audit, evaluation and juridical procedures is advocated.