Security issues arising in establishing a regional health information infrastructure

A regional health information infrastructure is being developed in an internally self-governing country which is a dependent territory of the British Crown, is not part of the United Kingdom but is a member of the British Commonwealth. This country of about 70000 inhabitants (and significant numbers of visitors) within the British Isles shares many functions with the United Kingdom-from the perspective of this paper the key shared functions relate to the infrastructure of the departments of social security, social services, central registry, all health care services and national insurance systems. Although it remains independent in various other respects, for the most part it endeavours to achieve an harmonious legislative relationship with the UK, and with the EU. One primary goal of the information infrastructure development project is to provide links between community, primary and secondary healthcare services and thereby to ensure integrity of information as it refers to each individual receiving care services. A second goal has been to integrate this environment with various other government functions including the issuing and checking of NHS ID numbers and of national insurance ID numbers, the payment of social welfare benefits, and perhaps with other functions where access to a common list of names and addresses is a significant factor. This paper outlines some of the issues that have arisen in endeavouring to meet the often conflicting wishes and needs of different groups as regards a health information infrastructure within a general public sector information service.