The Legal and Ethical Changes in the NHS Landscape Accompanying the Policy Shift from Paper-Based Health Records to Electronic Health Records

Abstract

The introduction of IT into health and associated forms of care has changed the nature of risks associated with the use of information. Continuing development is increasing the rate of change. This paper will consider the relationship between policy, ethics and the law within this changing landscape using a risk management approach.The paper considers a 20 year time period from 1990 to 2010 and first maps out the landscape in terms of key shifts in policy. The article seeks to explore how the policy shifts have changed the legal and ethical implications of handling information, by addressing three specific questions:1. Do the policy changes following the 1997 General Election amount to a Kuhnian paradigm shift or simply an evolution?2. How have the legal and ethical implications of handling information been modified by changes in technology, policy and the law?3. How can the concept of opportunity risk help us understand the ethical implications of increased use of IT in health care?The article will conclude by identifying the legal and ethical challenges yet to come as the landscape continues to evolve.