Using the internet to access confidential patient records: a case study

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Abstract
Effective programmes for management of chronic disease are invariably supported by information technology. These have typically been developed within secondary care, with limited access available to primary care. The British government's white paper The New NHS clearly states that a dedicated NHS network service (NHSnet), linking information systems in primary and secondary care, will be working by 2002.1 Although this could improve the flow of information between primary and secondary care, thereby improving patient care,1 there are, quite rightly, grave concerns about the security and confidentiality of patients' data both in terms of who has legitimate access and who has illegitimate access to the data. 2 3 Furthermore, it cannot be assumed that all general practitioners will be willing to spend the time and money necessary to connect to NHSnet and to conform to its code of connection,4 especially as more than one in eight general practitioners are already connected to and familiar with the internet5 and, increasingly, internet service providers are free of charge (apart from telephone charges). Users of NHSnet, however, will be charged for connection and use, the costs of which are not yet known. These are major concerns for general practitioners and may be a reason for the poor uptake of NHSnet by general practice.5 In addition, although NHSnet could increase hospitals' and general practices' access to patients' data, this information will still not be available within the patients' homes. This is exactly where general practitioners, seeing sick patients whom they may not know, need immediate access to this information. Internet technology could also allow patients access to their own data, thereby empowering them to allow appropriate healthcare professionals access to their data. We suggest that the internet will be as good, if not better, an integrating network as NHSnet, providing …

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