Patients' safety, privacy and effectiveness--a conflict of interests in health care information systems?

Information technology (IT) is finding its way into daily clinical work. IT is primarily seen as a tool for providing quality of service, cutting costs and promoting efficiency in every aspect of health care, but improvements for patients' safety are also a driving force. IT-solutions can be found both at an administrative and a clinical level, supporting everything from documentation, distribution and storing of patient data to workflows, monitoring and decision making. However, the increasing use of IT in health care raises questions. What is the impact on patients' rights and privacy? Does the law benefit IT-solutions in health care, or does it raise barriers for optimized use? Which interests does the law safeguard in the health care sector, and in the light of an increasing use of IT, do any of these identified interests collide? In conjunction with a governmental national project (InfoVU) during 2001-2004, the Swedish National Board of Health and Welfare (NBHW) had to address these issues and other legal aspects of IT use in health care. The agency's analysis was published in November 2005. The purpose of this article is to present some of the agency's conclusions on legal issues pertaining to the management and processing of patient data. It will show, from a Swedish legislative point of view, the need for a common information security strategy for health care information management as well as discussing other legislative issues in order to meet both the patients' and the health care provider's interests in an electronic environment.