Information and communication technologies are becoming increasingly important in health care, by helping to make accurate information more easily available to medical operators and improving the quality and lower the costs. The European Commission is supporting research projects for the development of telemedicine applications. One of these is MediMedia, intended to provide a common access to the various databases containing medical images and created by the existing projects within the 4th Framwork programme for Health Telematics. The use of Internet, through which clinical database are accessable, promotes, more than ever, the widespread dissemination of health-related information and strengthen the necessity to safeguard the patient right to privacy and data security. Protection of patient privacy is a long-standing issue in health care. Since the fourth century B.C., physicians have abided by the oath of Hippocrates, binding them to keep secret the information they learn from patients during the course of providing care. The growing use of information technology, within the health care sector, entails substantial changes in the management of the traditional patient-medical staff relationship. In the process of patient data flow, the interactions among the commonly known medical operators (physicians, nurses, technicians) are now widen to other participants of the health care management: administrative personnel, insurers, researchers and others. Besides the growing number of partecipants, the prospect of storing health information in electronic form raises concerns about:
- patient privacy
- economic interests
Both issues are based on the assumption that the access to health information, even if tried to be kept limited by the use of advanced technical mechanisms, is now widen to a great number of “users”.
This paper is intended to focus on those issues. The issue of privacy that information systems developers, handling with health information, have to face with are based on two considerations. The first is that individuals have a fundamental right to control the dissemination and use of information about themselves. Because privacy is a fundamental right, other organizations, that may wish to make claims on such information, should be obliged to respect the wishes of the individual and to obtain explicit authorization from the individual for each instance of information collection, processing, or further disclosure. In this context, the paper will enphasize the need for the consent of the person subject in various circumstances, with a particular reference to the one concerning research aims, governed by Directive 95/46/EC. The second concern is that information about an individual, revealed to some other party, not willingly designated by the individual, may be used to harm his or her interest. These interests may include economic interests.
The issue of economic implications is based on the consideration that the availability of a service by a telemedicine provider, as the rapid consultation of medical images provided by MediMedia, will raise a real “publishing business”. It is due to the considerable investments needed for the project exploitation in the market, and the perspective of a wide use, especially if the service is offered over Internet. In this context, in this paper will be carried out an analysis of the economic interests in perspective, with the ethical issues needed to limit the speculation on the publication of medical data.