The protocols of privileged information handling in an E-health context: Australia

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In this chapter, the author analyzes adherence to privileged health information handling protocols in the clinical context to inform work plans pioneering an ostensibly private and secure Australian national e-health scheme. The analysis leverages findings from new and emerging literature and data from a study involving twenty-three medical, nursing, and allied health clinicians working at public hospitals in Victoria, combined with data collected for a new case study from nine information technology (IT) support staff working at the same hospitals. In both case studies, data collection was based on the Questerview technique to examine the privacy of clinical e-health work for patient care. The research approach provided a rich source of qualitative data for analysis. The evidence suggests a socio-material mismatch between privileged information handling protocols and clinical work in the natural hospital environment. The protocols foster a range of information privacy threats that may affect patient care outcomes. The risks incorporate data confidentiality, integrity, and availability. That is, health data is accessible only to those with the required level of authorization, it is accurate and complete, and all authorized end users can obtain information when and where required. Reflecting international findings, some Australian clinicians avoid or work around the protections provided by health privacy legal frameworks. Although fixes for several privacy threats are available, they do not appear to be in common use. Rather than analyze and rectify privacy threats embedded into the socio-material interface of patient care settings before pioneering e-health schemes, authorities propose to amend the Privacy Act and weaken identification rules to advance the national unified record. At the same time, unresolved work tension exists between clinicians and IT support staff. The mismatch triggered a series of responses that this chapter argues do not benefit either the clinician or the patient, and may hamper the introduction of a unified Australian e-health scheme more generally. 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.

Original languageEnglish
Title of host publicationUser-Driven Healthcare
Subtitle of host publicationConcepts, Methodologies, Tools, and Applications
EditorsMehdi Khosrow-Pour, Steve Clarke, Murray E. Jennex, Annie Becker, Ari-Veikko Anttiroiko
Place of PublicationHershey PA USA
PublisherIGI Global
Number of pages23
ISBN (Electronic)9781466627710
ISBN (Print)1466627700, 9781466627703
Publication statusPublished - 31 Jan 2013

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