A government report into the killing of Malcolm Beggs by his schizophrenic flatmate has fingered computer systems and a lack of consistency in privacy and security procedures relating to the storage of mental health information.
The report, prepared by the Mental Health Commission for the Minister of Health on the causes of the killing of Beggs by his flatmate Lachlan Jones in 1994, suggests there is considerable debate amongst mental health services staff about the appropriateness of computerising mental health service information and concerns about ensuring the appropriate level of security.
With the mental health sector’s move towards computerisation of records, and the concept of one record per person carrying all details of their condition and treatment, “issues of access and security are under active consideration in [mental health] services”, the report says.
It notes that there is a range of access levels among health providers. “Services are addressing this issue in different ways, with some allowing much wider access to the computerised mental health records than others.”
At the same time, say sources in the mental health sector, increased computer use, if consistent, could offer considerable potential for a solution to problems identified in the report. These include patients physically arriving with an agency up to a month before their paper records arrive, and GPs having unsatisfactory access to records of medication the patient is already taking, with the resulting risk of prescribing new medication which interacts adversely with the old drugs.
There are two major threads to current work on establishing a standard for information handling, says the health ministry’s chief advisor on health sector information and technology, Mike Rillstone. At a national level, the Health Intranet governance board has recently drafted a code of practice, working with Standards NZ. This document should be made public “within the next few months”, he says. “The second stream of work is at a local level. The government cannot make all 12,000 health organisations in New Zealand adopt this technology, so local support for the concepts is important to encourage uptake. The DHBs [district health boards] are key players in implementing this at a local level.”
Rillstone notes that IT considerations are only part of the protocols being established on information sharing and transmission.