Electronic communications

15 July 2010
Volume 26 · Issue 7

Keep your data safe, says Nigel Knott.

In our professional lives we feel constant pressure to increase our efficiency and use of the internet.  It is no exaggeration therefore to foresee a migration of high spending private patients towards dental practices delivering the benefits of the very latest information and communications technology.  Electronic communications are a routine part of daily business and the regulatory environment in which we work becomes more complicated as a result. 

Unsurprisingly, statutory regulations apply to the use of electronic communications embracing dental practice websites and email. It is worth a visit to www.valident.co.uk where the statutory regulations applying to dentistry are listed in detail.

Risk management in dentistry is a constant concern and everything we do is designed to reduce or eliminate it. However, like the unseen dangers of radiation, the digital world conceals new challenges that dentists can ill afford to ignore.   

The advent of computerised design and milling systems (CADCAM) in dentistry have quickened the pace of the market penetration of digital services and encouraged us to learn about the basics of digitisation and new aspects of electronic communications. The cessation of traditional analogue TV programming has forced us to move to digital channel broadcasting. However, the pace of change is so rapid in our digital world that mistakes can prove costly and understanding the use of electronic applications adds stress to an already busy surgery routine.

We may not enjoy it but we cannot ignore the challenge and when we look at the advantages, perhaps we should approach the task with an element of enthusiasm and even excitement. 

The benefits can be massive. How many readers do not enjoy the consumer advantages of being able to buy tickets and gifts via the internet after all the shops have shut?   How about the advantages of transmitting digital radiographs with patient referrals and digital scans to your dental laboratory to receive an all ceramic crown at the surgery 48 hours later?  This is a reality where ecommerce is not just a convenience but also an essential part of business life.

The postal strike brought home the incredible benefits that email can deliver to minimise the disruption to our practices.  So now let us take a detailed look at the central hub of our new age electronic communications and whether or not our own particular version is fit for professional purposes. 

Only recently hotmail appeared in the mass media headlines having suffered the misfortune of several thousand email accounts being ‘hacked’ and personal data profiles stolen. A quick audit of the BDJ classifieds reveals that hotmail is a commonly used email service, but is it a suitable service to use in a dental practice for professional purposes?  The definitive answer is negative – together with many other email services.

But how do we know whether the particular service we have chosen is suitable and safe? Generally I believe that the ‘no free lunch test’ should be applied as a rule of thumb because the free services tend to rely on advertising for their income and often use personal data for commercial purposes.

I cannot tolerate the whole of the computer screen being instantly cluttered with the advertising and ‘stickies’ commonly employed by most free email services. The delivery of messages can be unpredictable and unreliable. Where dentistry is concerned, we all have a duty of care to ensure that our patient data is kept safe and secure within our practice precincts (bastion or fortress security to use the jargon) and also when it is transmitted electronically.

The purely physical task of data control within huge organisations is almost impossible - the more people who are involved in data handling the greater the likelihood of error or fraud.  NHS Net has a daily struggle to keep up with tracking data losses and the Government has finally given up the lost cause of securing a ‘big bang’ national database of all patient records. In general, the smaller companies who provide specialist secure email services for a monthly subscription are the place to look first for an electronic practice mail exchange service. They need to be well established and experienced in handling data transmission contracts in the healthcare sector where patient record traffic is a familiar part of their business. These smaller companies frequently pride themselves on exceptional standards of personal customer service and when you look at the value they provide and the peace of mind they offer they are not expensive.

If you encounter a problem you need a knowledgeable person to be available instantly to give advice.

Your dental practice image and culture is important as are the external visible signs.  Does sending an email to a patient from a practice email address at hotmail, AOL or Yahoo for example, transmit the right professional signal? Looking deeper down does info@bestdentalpractice.com suggest anything better apart from the inevitable threat of GDC sanction?

I am very conscious of the nervousness of many dentists and their staff when faced with IT problems that are frequently expensive and difficult to remedy. Where email is concerned not only is the reliability of the service itself important but it is the internal practice protocols that are equally so.

A dental practice data controller appointed in accordance with the Information Commissioner Office guidelines should be mandatory. An inexpensive second hand Macintosh laptop used exclusively for the purpose of your internet connection and email exchange will provide an excellent security filter. Under no circumstances must this laptop be connected to any practice digital network other than the internet.  No patient data must be transmitted on anything other than a secure electronic network without suitable encryption.

Remember that the weakest link in your email messaging use is poorly constructed password protection.  In a recent survey only six per cent  of users combined letters and numbers (good security) whilst the most common password was 123456! Online banking teaches us to keep passwords in a dynamic state and change them frequently. It is worth stating that having your bank account hacked can usually be remedied by compensation whilst the loss of patient data can have incalculable consequences.