Data security and patient confidentiality: the manager's role

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.