title: Pitfalls in computer housekeeping by doctors and nurses in KwaZulu-Natal: no malicious intent.
abstract: BACKGROUND
  Information and communication technologies are becoming an integral part of medical practice, research and administration and their use will grow as telemedicine and electronic medical record use become part of routine practice. Security in maintaining patient data is important and there is a statuary obligation to do so, but few health professionals have been trained on how to achieve this. There is no information on the use of computers and email by doctors and nurses in South Africa in the workplace and at home, and whether their current computer practices meets legal and ethical requirements. The aims of this study were to determine the use of computers by healthcare practitioners in the workplace and home; the use and approach to data storage, encryption and security of patient data and patient email; and the use of informed consent to transmit data by email.
  
  
  METHODS
  A self-administered questionnaire was administered to 400 health care providers from the state and private health care sectors. The questionnaire covered computer use in the workplace and at home, sharing of computers, data encryption and storage, email use, encryption of emails and storage, and the use of informed consent for email communication.
  
  
  RESULTS
  193 doctors and 207 nurses in the private and public sectors completed the questionnaire. Forty (10%) of participants do not use a computer. A third of health professionals were the only users of computers at work or at home. One hundred and ninety-eight respondents (55%) did not know if the data on the computers were encrypted, 132 (36.7%) knew that the data were not encrypted and 30 (8.3%) individuals knew that the data on the computers they were using were encrypted. Few doctors, 58 (16%), received emails from patients, with doctors more likely to receive emails from patients than nurses (p = 0.0025). Thirty-one percent of individuals did not respond to the emails. Emails were saved by 40 (69%) recipients but only 5 (12.5%) doctors encrypted the messages, 19 (47.5%) individuals knowingly did not encrypt and 16 (40.0%) did not know if they encrypted the data. While 20% of health professionals have emailed patient data, but only 41.7% gained consent to do so.
  
  
  CONCLUSIONS
  Most health professionals as sampled in South Africa are not compliant with the National Health Act or the Electronic Communications Transactions Act of South Africa or guidelines from regulatory bodies when managing patient data on computers. Many appear ignorant or lack the ability to comply with simple data security procedures.
authors.forename: Caron
authors.initials: C
authors.lastname: Jack
authors.forename: Yashik
authors.initials: Y
authors.lastname: Singh
authors.forename: Maurice
authors.initials: M
authors.lastname: Mars
mesh_terms: D016494:Computer Security; D034742:Electronic Mail / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D009726:Nurses / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D057566:Self Report; D013019:South Africa; D011795:Surveys and Questionnaires