Privacy, information technology, and health care

Digital communications and information resources affect almost every aspect of lives - business, finance, education, government, and entertainment. Clinical medicine is highly information intensive, but it is one of the few areas of our society where computer access to information has had only limited success in selected areas such as billing and scheduling, laboratory result reporting, and diagnostic instrument systems. The move to widely accepted electronic patient records is accelerating, however, and is inevitable because of many pressures. In this article, a systems view of privacy and information security in health care is taken into account. The nature of the most urgent threats to patient information privacy in perspective, the new threats that almost certainly will arise because of technologies of digital information, kinds of countermeasures that can be effective, places where technology is and is not of use, the risk/cost trade-off decisions that must be made for real-world systems, the overarching policy issues that must be addressed, and impediments to the resolution of these issues.