The Legal Issues on the Information Privacy and Security With Electronic Medical Records in Healthcare Systems

探討醫療機構使用電子病歷對資訊隱私與安全之法律議題

黃維民(Wei-Min Huang)

《電腦稽核》 27期 (2013/01) Pp. 7-17

摘要

電子病歷帶來許多醫療機構管理的便利性，它包含許多重要的個人臨床與公共衛生資訊。因此，如何建立相容模式和方便存取對於醫療機構而言非常重要，然而這些都需要耗費大量的成本和資源。導入雲端電子病歷系統的主要考量因素之一就是財務問題，可以明顯減少成本和增加效率，也可以提高服務品質。然而，儲存於雲端系統的電子病歷卻也可能面臨著資訊隱私與安全的重要法律問題，這是近年來在醫療資訊管理領域中，最受各界關注和討論的焦點議題之一。根據相關實證研究指出，在美國、英國和德國等先進國家中，不論是民眾或是專業的醫療人員對於集中於國家管理的公共電子病歷系統普遍缺乏信心，尤其是所謂的雲端電子病歷系統。主要的原因就在於資訊隱私和安全的顧慮，擔心容易被侵害與盜用。實際情況亦顯示使用電子病歷更容易產生醫療上的糾紛與增加醫療訴訟的機會。因此使用雲端電子病歷系統雖然可以提高服務效率和增進醫療品質，但是也會使醫療機構暴露於更多的法律危機之中。本文將就電子病歷、雲端系統和資訊隱私與安全的相關法律議題，以美國法律系統為主要參考背景，做初步分析與探討，期能引起更多學術的討論並做為日後政策實施的參考。

關鍵字

電子病歷 ； 雲端系統 ； 資訊隱私與安全

並列摘要

The electronic medical record (EMR) contains a wealth of clinical information that can range from the individual level to the population level; however, a major challenge is obtaining the data in a consistent and standardized format. Cloud computing improves agility and reduces capital expenditure cost. Moreover, the increased portability and accessibility of electronic medical records may also increase the ease with which they can be accessed and stolen by unauthorized persons or unscrupulous users. The legal developments in healthcare have been driven by the public concern for personal privacy and confidentiality within the context of an increasingly connected world centered on the Internet. In the United States, Great Britain, and Germany, the concept of a national centralized server model of healthcare data has been poorly received. Issues of privacy and security in such a model have been of concern. Failure or damages caused during installation or utilization of an EMR system has been feared as a threat in lawsuits. Similarly, it's important to recognize that the implementation of electronic medical records carries with it significant legal risks. The adoption of information and communication technology (ICT) in healthcare is driven by the need to contain cost while maximizing quality and efficiency. However, ICT adoption for healthcare information management has brought far-reaching effects and implication on the patient privacy and confidentiality.

並列關鍵字

Electronic Medical Record (EMR) ； Cloud Computing ； Information Privacy and Security

參考文獻

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