title: Accessibility versus confidentiality of information in the emergency department.
abstract: BACKGROUND
  In the emergency department (ED), clinicians can benefit greatly from having access to information at the point of care. It has been suggested that using computerised information systems could improve the accessibility of information. However, making information accessible, while maintaining confidentiality, is one of the main challenges of implementing information systems. This article presents the ED staff perspectives about the accessibility and confidentiality of information in the ED.
  
  
  METHODS
  The authors undertook a qualitative study in March-April 2007. Data were collected using in-depth semi-structured interviews with the ED staff of an ED located in Northern England. In total, 34 interviews were conducted and transcribed verbatim. Data were analysed using framework analysis.
  
  
  RESULTS
  The results showed that the ED staff had role-based access to the current information systems, and these systems met only a small part of their information needs. As a result, different sources were used to get access to the needed information. Although the ED staff believed that improving the accessibility of information could be helpful in emergency care services, there were concerns about the confidentiality of information. The confidentiality of information could be threatened--for example, by sharing passwords, misusing patient information or by unauthorised staff having access to patient information.
  
  
  CONCLUSIONS
  To design a system, the accessibility and confidentiality of information should be addressed in parallel. A balance between these two is needed, as the failure of each of these may negatively influence the use of the system.
authors.affiliation: Centre for Health Information Management Research and Health Informatics Research Group, Department of Information Studies, University of Sheffield, Sheffield, UK. h.ayatollahi@sheffield.ac.uk
authors.forename: H
authors.initials: H
authors.lastname: Ayatollahi
authors.forename: P A
authors.initials: PA
authors.lastname: Bath
authors.forename: S
authors.initials: S
authors.lastname: Goodacre
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003219:Confidentiality / Q000941:ethics*; D004636:Emergency Service, Hospital / Q000941:ethics* / Q000458:organization & administration; D004739:England; D004991:Ethics, Institutional; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016347:Medical Records Systems, Computerized / Q000941:ethics* / Q000458:organization & administration; D008875:Middle Aged