Technical means for securing health information.

Securing health information is an application domain which can learn more from other environments like airlines and banking than from military formalism or academic freedom. The techniques of the 80s using clear separation between public and private areas have to be upgraded. Propositions are made. Costs are evaluated.

The technical conditions for an open architecture.

The development of Open Systems Architecture and the extensive networked interconnection of Health and Hospital Information Systems (HIS) offer great opportunities for improved care, but simultaneously these facilities pose a great danger to the overall security of the information held. The Geneva University Hospital which has built up it centralized informatics system over the last twenty years must now bring about the conditions for a migration towards open system, for although during the last ten years there have been declarations of intent, this architecture is still a long way from final implementation. Like others, the DIOGENE system (the Geneva HIS) has had to face difficult choices especially due to its own successful situation at the end of the eighties. This paper gives a brief explanation of the technical conditions needed in order to fully migrate towards an open system. The first choices towards obtaining optimum communication standards, operating systems and database management systems were the easiest. The real difficulties occurred when deciding on the choice for management tools in this open environment.

The doctor's view on education and training aspects of secure communication.

Using two examples of installed applications that are widely spread in a large teaching hospital, the awareness of secure communication is highlighted. Teaching to the rotating medical staff is organised on a regular basis. The physicians learn the responsibility they accept when entering the hospital information system (HIS). In a distributed environment, the confidentiality aspects change with the technology when the users perform with on-line helps and graphical interfaces.