Protection of patient data in multi-institutional medical computer networks: regulatory effectiveness analysis.

Privacy protection is one of the major issues in the development of multi-institutional clinical information networks. Judicial decisions have confirmed patient's rights to protection of a "reasonable expectation of privacy". Incorporating this protection into a system requires analysis of appropriate models. The National Practitioner Data Bank (NPDB) contains confidential data concerning physician competence. The medical profession had substantial input into the privacy protection features of the NPDB, which are much more comprehensive than those used in many clinical information systems. The NPDB represents the privacy protection which physicians expect for their own data. Regulatory Effectiveness Analysis can be used to analyze the suitability of the NPDB as a model for patient privacy protection. Judicial opinions set public policy and legal structures for privacy, and the NPDB provides an inventory of useable technical tools. After eliminating minor discontinuities, the NPDB can be used as a model to create a useable standard for privacy for multi institutional data transfers.