Rob Hosking wrote: > Dear All > I would be interested in other people's ideas to respond to this e-mail > from Pail Oppy at Austin Health.( The Austin is one of the major > hospitals in Melbourne for those who don't know). > I have asked to be removed from their e-mail list suggesting that I will > only receive encrypted e-mail regarding my patients. It concerns me that > such a large public institution is going down the track of using plain > e-mail for this communication with GPs. They also appear to have sought > advice from the Privacy Commissioner which is at odds to the advice the > GPCG received during the Security Project.Like most things, I suspect > that people will interpret things the way they want until it is > challenged legally. > I have referred him to the GPCG Security Guidelines and I am going to > inform him that future GP practice accreditation standards are likely to > be enforcing that communication be encrypted or secure in some other form. > Does anyone have any other thoughts that we can use to implore them to > not proceed in this way? Are there any other major public hospitals > around Australia taking this stance? > In 1906 George Bernard Shaw wrote a short play, the Doctor's Dilemma (http://mchip00.nyu.edu/lit-med/lit-med-db/webdocs/webdescrips/shaw1595-des-.html). It was about the ethics of implementing new technology and informed consent.
A century ago is the distant past. Since then we have had works of literature such as 1984 and A Brave New World. As a result we have legislated a right to privacy. To flaunt this without patient consent would seem to me to be a courageous move (in the Sir Humphrey Appleby sense). Like others on the list, as a recipient of this sort of data, I might turn a blind eye but ethically I would have to discourage it. However, I feel Mr Oppy's pain. Apart from maintaining the privacy of the data, he also has a duty to improve patient outcome by facilitating the movement of medical data. There are lots of options to do this - excellent proprietary products, free ones, simple ones, government approved ones and ones that are old and stodgy but which are and have been widely used for over a decade. Unfortunately nobody can tell him which is the right one. The doctors that he is sending data to face the same dilemma. He is in a position of power, however, and to some extent it does not matter what he chooses. If, perhaps in association with the two local Divisions, he chooses X then everybody can say "'The Austin' has chosen X, so X it is. That's what we will all use". Through the network effect it will be even better if the neighbouring hospitals, Divisions and States also use X. So that's the answer. He needs to use X. Our Area Health Service has just been through this whole process and they have chosen Y. Y is what we are going to use. I hope X can talk to Y. David
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