[Med-privacy] more from Britain

[Peter Marshall]

Original URL: http://www.theregister.co.uk/2006/11/27/care_record_conf/
CfH report confirms confidentiality risk
By Lucy Sherriff
Published Monday 27th November 2006

Plans to upload medical records onto a central database - the so-called 
spine - will put patient confidentiality at risk, Connecting for Health 
(CfH) has been told by its own consultants.

In its own risk analysis of the project, the agency responsible for 
centralising the country's medical records has acknowledged that GPs' 
concerns about patient confidentiality have merit, and that it would be 
safer to store records locally.

According to Helen Wilkinson-Maker of The Big Opt Out, a campaign group 
opposed to the spine, the risk analysis was intended to consider two 
scenarios: a spine with and without "sealed envelopes", sections of the 
medical record marked by the patient as not to be shared.

However, during the consultation with health professionals, civil 
servants, and patient representatives, a third scenario was put forward 
for analysis: that of locally held, digital medical records. This was 
found to present much lower risk of confidentiality breaches, according 
to the report.

Wilkinson-Maker said: "One major result of the interviews was to start 
NHS CfH thinking of alternative solutions that would provide the 
desired confidentiality in a practical and effective manner without 
adversely impacting on patient safety."

The Risk Analysis was presented to conference for General Practitioners 
in Stratford upon Avon on Friday by Dr Paul Thornton, a GP critic of 
the Connecting for Health proposals.

Dr Thornton said: "These confidentiality risks to health have been 
found to outweigh the benefits from automatic sharing of health 
information on a national database. The more that information is 
accessible by all health workers, the less likely it becomes that 
crucial information will be divulged to any one of us."

The consultants identified a conflict between patient safety and 
confidentiality: records with some details kept hidden were found to 
put patient safety at a greater risk than those with all the medical 
information in the clear. This is because the potential for error in 
diagnosis or treatment is much higher if all the facts are not known, 
the report says.

Meanwhile, patient confidentiality is at its most secure when some 
information is not just sealed in a single envelope, but in a variety 
of envelopes, with data being stored locally, and therefore only being 
accessible locally.

The consultants concluded that the alternative sealed envelope solution 
(i.e. local storage of data) presented the lowest summed risk to 
patient safety and confidentiality.

The report was commissioned by CfH and produced by consultants DET 
NORSKE VERITAS. You should soon be able to read it here 
(http://www.nhsconfidentiality.org).