Confidentiality Policies in Dr's Off Site Office

[Marc Carter <mcarter@cloud9.net>]

  More and more hospitals are linking referring and attending physician
  offices to their Hospital Information System or Integrated Health Network
  (IHN) through PC based networks.  The benefits are obvious, physicians can
  see the latest clinical data without having to call the Hospital.  In a very
  real sense the walls of the Hospital are breaking down and with that the
  "normal level" of control a Hospital would have on a patients medical record.
  
  How can a Hospital or IHN control unathorized physician office staff access
  to its medical records?
  
  What is to stop a secretary/clerk from cruising the Master Patient Index and
  finding her Uncle Joe, viewing his latest lab results, discovering that he
  has a positive VDRL or whatever and blabbing it to the family over
  Thanksgiving turkey.  Uncle Joe would have a very interesting legal case
  regarding a breech of records confidentiality and would create a liability
  issuer not only for the physician and Hospital but also the whole IHN.
  
  Does anyone have any successful experience in dealing with this question?
  
  Thanks,
  Marc Carter <mcarter@cloud9.net>
  Carter Consulting Group, Inc.