The computerized patient file: Finding balance between patient privacy and available computerized data

In a given hospital system, the computerized patient file allows pooling of all patient information; this may include both medical and personal information. A health professional will have access to this information according to his status or function. The facility to which this information may be accessed could compromise confidentiality. A health professional not concerned by all of the information available might inappropriately exchange information concerning the patient. Every health professional has a duty to respect professional secrecy. However, this entails more than the respect of a rule. Professional secrecy implies other values such as discretion and the capacity to discern which details may be shared and which details should be kept confidential. Otherwise, there could be a risk of loosing the patient's confidence. In 2009, the computerized patient file system, also known as the shared file, was put into service at the hospital of Tours. The purpose of this system was to optimize the well-being of the patient by finding adequate balance between the sharing of required information and patients' privacy. This meant two things. First of all, it was necessary to control entries into the system as well as authorizations and traceability of these entries. Secondly, it was necessary to find way to inform patients on how the system worked and how privacy was to be kept. The number of health professionals consulting a paper file is limited. A computerized file opens up new possibilities. There is a risk of unjustified entries. While the hospital institution laid down rules, specific entries and use of the information found became the responsibility of each health professional. Awareness is therefore essential. Privacy, appropriate access, and the consequences of sharing private information need to be fully understood. (C) 2013 Published by Elsevier Masson SAS.