Medical information in hospital management

Abstract

Today the medical and administrative discharge databases constitute challenges in hospital management. Administrative staff is concerned in their exploitation. It raises several issues in term of confidentiality and access rights. Our paper aims at reviewing organizations which are set up in French hospitals. A questionnaire for medical information department (DIM) was elaborated. It comprised 23 questions divided in 5 topics: hospital description, management assistant positioning, access enquirers, aggregated data queries, individual data queries. Results are related to 171 questionnaires. Hospitals are, in majority, public and small structures, distributed on the all territory. Management assistants are attached to directions in 55% of cases. Enquirers are management controllers in 66% of cases. Queries are related to aggregated data in 85% of hospitals and to individual data in 62% of hospitals. In most cases, access is validated by the DIM on a case-by-case basis. Nevertheless no procedure for the queries validation is set up in 29% of cases. Only 10 hospitals have put in place a control access comity. Non anonymized data are accessed in 45 hospitals. Medical and administrative discharge databases are accessed by administrative staff Access and using policies are not always defined. The missions of the different partners should be better defined in the respect of confidentiality of medical data. DIM practitioners are legally implied in medico-economic studies.