The Protocols of Privileged Information Handling in an E-Health Context: Australia

The Protocols of Privileged Information Handling in an E-Health Context: Australia

Juanita Fernando
DOI: 10.4018/978-1-4666-2770-3.ch036
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Health authorities need to review the privacy and security of real-life work contexts before pioneering new, privileged information handling protocols as a foundation of a new national e-health scheme.
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Reflecting global trends, Australia is increasingly adopting unified, national electronic health (e-health) frameworks to improve standards of patient care while containing service costs. The term “e-health” refers to the electronic management and exchange of patient health information using information and communication technology (ICT). The ICT includes databases, mobile phones, faxes, computerized devices and the Internet. Threats to health information stored on computer networks are complex and jeopardize the privacy of millions of patient-care records rather than, as reported prior to e-health, perhaps hundreds of paper records per incident (Zajac 2010). Evidence suggests privileged e-health information handling protocols are a broad and complex subject area, yet few studies analyze their impact in relation to complicated social and material, or socio-material, interactions in patient care settings (Orlikowski, 2007; Westbrook et al., 2007). This chapter attempts to rectify the shortcoming, adding to knowledge about the protocols of privileged-information handling and informing national e-health framework strategies (Table 1).

Table 1.
An overview of findings drawn from informatics studies about the application of HIT to HIS P&S from (Fernando & Dawson, 2009) p.819 (© IEEE 2009 Used with permission)
AffectsSecurity influenceStudy findings
Data fragmentationControlEnhances data integrity & data availability
ThreatExacerbates data integrity & data availability shortcomings
TranscriptionControlEnds transcription, writing legible
ThreatEntrenches transcription as clinicians collude to transcribe updates to an electronic health record (EHR)
UsabilityControlReduces number & range of threats to private information
ThreatIncreases number and range of existing threats as well as some new ones
ProductivityControlCan enhance efficiency (user skill, ends duplication of work)
ThreatHinders efficiency (productivity trade-offs)
AuditControlAuditable, tailored access to health records
ThreatNon-auditable, clinician collusion over the highest level of access to health records
CostControlIT devices reduce pressure on inadequate budgets due to increased efficiency
ThreatIT devices magnify pressure on inadequate budgets due to ongoing maintenance and technology investment costs
Information securityControlRobust e-health P&S implementations will control information threat & ensure that health records can be shared (data availability/integrity)
ThreatGreatly increased magnitude of information threat on an e-health system (data confidentiality/availability/integrity)

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