Key Points:

One health worker has been sacked and up to 20 others disciplined after snooping through the private medical records of patients.

Staff also looked up the records of celebrities.

The Auckland District Health Board staff members - including doctors, nurses and other clinicians - have been using a "revolutionary" electronic records system to access information which includes patients' medical notes, x-rays and laboratory test results and community lab tests.

Management at Auckland District Health Board yesterday refused to say which celebrities were targeted or how often, but confirmed up to 20 staff had been disciplined for inappropriately delving into patient records and at least one had been sacked.

The board's chief medical officer Dr David Sage said none of the patients affected had been told of the breach.

Celebrities and TV personalities who have recently been patients include Lana Coc-Kroft, Mike King, Greer Robson and Jonah Lomu.

The ADHB staff members - including doctors, nurses and other clinicians - have been using a "revolutionary" electronic records system to access information which includes patients' medical notes, x-rays and laboratory test results and community lab tests.

"We've had occasions where we've had to approach staff when they have looked up inappropriately for celebrities," the board's chief medical officer, Dr David Sage, said yesterday.

The breaches were picked up by electronic audits, which were run regularly after celebrities had stayed in the hospital to see who had accessed their records. Such checks took just seconds.

Random audits were also run on individual staff to check their use of the system for the preceding six months. The results were "encouragingly good", Dr Sage said.

However he has warned staff against looking up any patients not under their care whether they are celebrities, neighbours, friends, relatives, or their own children.

They should not even look at their own records.

Dr Sage would not reveal the jobs of people who had been disciplined.

Health and Disability Commissioner Ron Paterson said last night it was essential that district health boards had systems in place to ensure staff did not wrongly access patient information.

It was a bonus of having a modern electronic systems that could catch out inappropriate access.

He said patients should be told.

"Clearly patients should be told if their records have been viewed inappropriately. I imagine they won't be very happy to find out if it's happened," he said.

Patients may wish to lodge a complaint with the privacy commissioner, he said.

Dr Sage said the patient would be involved if there was "a serious breach".

Lynda Williams, coordinator of the Auckland Women's Health Council, questioned how much the public knew of the extent of electronic medical records.

This included Testsafe, the year-old system giving doctors at Auckland's three health boards access to their patients' community lab results unless patients specifically request results be left out.

But she acknowledged the new systems could improve care and welcomed the ability they offered to trace misuse.

She said the old paper records permitted much unnecessary access to files by people other than the person who ordered them.

"So although the electronic medical records system has the potential to allow a lot more access, it also allows for access to be traced a lot better than the old system," she said.

"It is heartening to know that this is being monitored and that somebody has already lost their job over it, which I could never imagine happening in the old paper-based system. It would have been very difficult to prove anything under the old system."

Dr Sage said the electronic system, called Concerto, relied on trusting the clinicians who used it, which was justified by the immense improvement in the care of patients it had permitted. The board's 1000-plus doctors, more than 2500 nurses and other clinicians have instant, rapid computer access.

"Concerto is a fantastic tool that has completely revolutionised the medical record with timely, accurate clinical information 24/7 (well, nearly always)."

"When you go to the emergency department at 3am, the ED doctors think the system is fantastic. Ten years ago they didn't know a thing about you. There was no method of getting the paper record easily. It would take several hours to get the paper record from the warehouse, so they had to work by the seat of their pants."

- additional reporting Errol Kiong