DATA MANAGEMENT
T Paper thin security?
he situation which NHS trusts are
facing at the moment
is a difficult one - increase productivity but with fewer resources.
Trusts are under pressure to move as much data as possible into digital formats which, as well as freeing up a large amount of storage space, is also supposed to make that data more secure. However, this is not always the case.
“In a world in which 64 gigabytes of data can be stored in a memory stick it is clearly now possible for vast quantities of data to be removed from a secure data centre without it being obvious that it has gone,” says John Hemming MP who, apart from his political career, has been involved in IT for many years.
“Furthermore, any system with IP connectivity raises questions about how data is transferred from place to place without any scrutiny at all.”
There certainly have been many examples of data loss in the NHS and whether they have occurred through a lost disc or missent email, lost healthcare data has the potential to cause harm to thousands of people.
Fuelled by pressure from a variety of sources, the government has now
strengthened the powers of the Information Commissioner’s Office to come down more heavily on organisations which break data protection rules.
60 nhe
However, it is the design of the core systems used by the NHS itself which is the main problem, according to John.
“The problem with the
government’s approach in terms of designing systems for storing medical information is that these are done for the convenience of the government rather than in the best interests of the patient concerned.
“Payment systems such as the Quality and Outcomes Framework for GPs mean that GPs get paid on the number of patients that satisfy certain criteria. This is easily produced from a centralised database with tables of patient names and data fields. However, such data systems have inherent design problems that make them dangerous to patients’ health.
“The reason for this is that it is a question as to who has what access to patients’ medical records and under what circumstances. A patient’s medical records should be kept for the interests of the patient. This means a very strong level of confidentiality.”
Much data was actually far safer when it was stored in the more traditional way.
“When data is stored on paper files at GPs’ offices then there is a challenge to obtaining medical information. However, if they are accessible centrally then there are major issues of control. It may be entirely possible to have a system which flags access requests and has a simple level of access control. However, there will always be ways in which people can get access to a lower system level of the data.
“It would be possible to have a system designed using private key cryptography that did not make it easy to make multiple copies of the data although the Windows clipboard will always make some copying possible.”
It is not only the potential for loss which is worrying John but that if records are stored centrally, this will make it easier for individuals or organisations to use them for their own ends.
“We now have systems where employers see nothing wrong
Sep/Oct 10
Given the amount of pressure on trusts to work in more eco-friendly and efficient ways, it is easy to see why many are doing their best to become either paper light or move all of their documents online completely. Although this may have many benefits, it also carries some risks. National Health Executive spoke to John Hemming MP to find out more
with asking for a copy of their employees’ records to be sent to an assessment unit as a matter of course. Patients’ medical records are also regularly used against them in the family courts. The growing centralisation of records and the making available of those records will undermine healthcare.”
For John, the matter is not about staying in the past or being afraid of technology. It is simply about respecting the awesome power of the technology which the NHS is using.
“Obviously, there are potential benefits to having electronic access to health material. However, the system has to have the confidence of patients. If patients believe that it is against their interests to have records in the government’s database they will either refuse to have the information stored or even refuse to be treated because they are worried about the implications of having a record about treatment that will be used against them.
“I don’t think these basic questions of the philosophy and the objectives of a medical information system have been properly considered and unless that is done then no quantity of complex systems of cryptography will actually produce a system that suits the needs of the patients who have to be at the centre of the system.”
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