Long term preservation of electronic health records. Recommendations in a large teaching hospital in Belgium.

Health records should be readily accessed by authorised persons for diagnosis, treatment and legal security purposes during patient's lifetime and thereafter for research and training purposes. Technology makes difficult the preservation of digital material, because of rapid changes in information media, hardware and software evolution, and because of the multiplicity of its location as well as the complexity of its environment. A committee in a large teaching hospital in Belgium, recommends two complementary approaches: (1) After a patient departure, all his health information should be managed by a unique organisation that would update regularly accesses to all data bases concerned by this patient. Health archives should be formatted using XML (Extensible Mark up Language) software family, and set on supports such as DVD-ROM, to be upgraded or updated when needed. This archive media is fast but not safe. (2) Computer output microfilm (COM) and scanners for non electronic data to be preserved appears to be also needed, as it is storage safe for at least 250 years and readable directly by eye. This archive media is safe but not fast.

"The Electronic Wardenî management of the data security access in a heterogeneous university hospital environment in Belgium.

A very flexible software system called "Electronic Warden" has been developed. It is based on a "client/server" architecture. It controls and manages the access right of the complex and heterogeneous data computer system at St Luc Hospital in Brussels. The electronic warden is independent of the other software applications of the hospital and is connected to them through API'S. The physical access is managed with the use of smart card and allows the electronic signature. The management of the users and their accesses to the data is run in a centralised or a decentralised way which allows a lot of flexibility.