BMJ  2004;328:1437-1438 (12 June), doi:10.1136/bmj.328.7453.1437-b

Letter

Sharing electronic health records

Confidentiality is big issue

The first 150 words of the full text of this article appear below.

EDITOR—The central Hampshire electronic health record project raises important issues, with implications for the national spine network.^{1 2} The authors assert, after 20 web based responses from a population of 225 000, that most people support linked records. No informed consent was obtained to records being available across health and social care, driving a coach and horses through the General Medical Council's guidance on confidentiality and consent.³ This makes no exception for computerised dissemination undermining confidentiality between professional and client.

The authors' second paper, on data quality, considers coding and data unavailability, but not accuracy. Speculative diagnoses such as Munchausen syndrome by proxy, for example, may be withheld from patients because of potential harm. Thus informed consent to dissemination is unobtainable, and "garbage in, garbage out" inevitable.

Booth wrote that if safeguards to confidentiality and accuracy of patient information prove insufficient, then the caring professions will not use the . . . [Full text of this article]

Unit of Applied Epidemiology, University of the West of England, Frenchay Campus, Bristol BS16 1QY Derek.Pheby@uwe.ac.uk

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