Electronically connecting the health care industry by an integrated system of electronic communication networks would allow any entity within the health care system to exchange information and process transactions with any other entity in the industry. As a result of the linkage of computers, patient information will no longer be maintained, accessed, or even necessarily originate with a single institution, but will instead travel among a myriad of facilities. Smart cards have also been proposed as a means to computerize and maintain health care information. A major focus of security and confidentiality measures for these systems is preventing privacy invasion by trusted insiders. For online computer systems, security is generallyprovided by use of user identification names and passwords, and by menus to control access to computer system functions.
Some systems also use audit trails to record significant events on a system.
However, technology alone cannot completely secure a system. Organizational education, policies, and disciplinary actions supplement technical protection for confidentiality. Smart cards can serve as an access control device, providing the security functions that are normally carried out by the user. Computerization can reduce some concerns about privacy in patient data and worsen others, but it also raises new problems. Computerization increases the quantity and availability of data and enhances the ability to link the data, raising concerns about new demands for information beyond those for which it was originally collected.