Ian Cheong wrote:
> At 4:33 pm +1000 11/7/06, David Guest wrote:
>> [...]
>>
>> So we ensure privacy at the cost of worse health care. It's a pyrrhic
>> victory.
>>
>> David
>>
> 
> I agree.
> 
> The privacy risk is a non-issue if patients agree to accept the risk in
> the interests of quality care.

As long as it is *informed* consent. My view is that it needs to be
explained to patients thus: "We will be sending your medical details
contained in a discharge summary to your GP via unencrypted email, which
is like the electronic version of writing on the back of a postcard and
sending it without an envelope through Australia Post, except that what
we will be doing offers less privacy protection than a postcard because
computers owned by third parties (but we don't know who they are) can
automatically read and make copies of the information as the information
passes through them. You need to balance such privacy concerns against
the fact that by sending the information via unencrypted email, your GP
may receive the information more rapidly than otherwise, which may
improve your care, although we could also fax the information which
probably has a similar effect on your care and provides better
protection for your privacy but may be less convenient for your GP to
file away and is more hassle for us to send. And there is a much better
system called encrypted email that both protects your privacy and has
the advantages of speed and filing/storage convenience, but we failed to
manage to arrange to do that although others have succeeded. So, do you
consent?"

Also, remember that the law works on a case-by-case basis, not on a law
of averages. Thus, although in the aggregate the sending hospital or the
receiving GP may decide that having discharge summaries sooner via
unencrypted email outweighs the threat to privacy, there will still be
cases in which the timeliness of the discharge summary has no positive
effect on the quality of the patient's care but the loss of privacy or
threat of loss of privacy is has a large negative impact. The lawyers
can still have a field day with that case, even though there may be
dozens or hundreds of others in which the opposite is true.

Tim C

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