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Security for the digital information age of medicine: issues, applications, and implementation.

Privacy and integrity of medical records is expected by patients. This privacy and integrity is often mandated by regulations. Traditionally, the security of medical records has been based on physical lock and key. As the storage of patient record information shifts from paper to digital, we find new security concerns. Digital cryptographic methods provide solutions to many of these new concerns. In this paper we discuss the new security concerns, new legislation mandating secure medical records, and solutions providing this security.

Computer Security↗

Personal health record systems and their security protection.

The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.

Computer Security↗

Control and use of information, seen from a nurse's perspective.

This paper deals with the impact of information technology used in nursing with special regard to confidentiality, integrity and availability. A brief overview is given of the current value and usage of information systems by nurses. This is followed by recommendations for the increase of awareness regarding proper use of IT systems in (A) the direct environment of patients, and (B) the secure communication between health professionals and institutions.

Communication↗

A proposed architecture and method of operation for improving the protection of privacy and confidentiality in disease registers.

BACKGROUND: Disease registers aim to collect information about all instances of a disease or condition in a defined population of individuals. Traditionally methods of operating disease registers have required that notifications of cases be identified by unique identifiers such as social security number or national identification number, or by ensembles of non-unique identifying data items, such as name, sex and date of birth. However, growing concern over the privacy and confidentiality aspects of disease registers may hinder their future operation. Technical solutions to these legitimate concerns are needed. DISCUSSION: An alternative method of operation is proposed which involves splitting the personal identifiers from the medical details at the source of notification, and separately encrypting each part using asymmetrical (public key) cryptographic methods. The identifying information is sent to a single Population Register, and the medical details to the relevant disease register. The Population Register uses probabilistic record linkage to assign a unique personal identification (UPI) number to each person notified to it, although not necessarily everyone in the entire population. This UPI is shared only with a single trusted third party whose sole function is to translate between this UPI and separate series of personal identification numbers which are specific to each disease register. SUMMARY: The system proposed would significantly improve the protection of privacy and confidentiality, while still allowing the efficient linkage of records between disease registers, under the control and supervision of the trusted third party and independent ethics committees. The proposed architecture could accommodate genetic databases and tissue banks as well as a wide range of other health and social data collections. It is important that proposals such as this are subject to widespread scrutiny by information security experts, researchers and interested members of the general public, alike.

Computer Security↗

Data security in medical information systems: technical aspects of a proposed legislation.

This paper analyses the results of a recent survey performed among medical establishment personnel in Greece, evaluates information security legislation existing in other countries and incorporates guidelines of international societies to propose principles governing a future legal framework. Furthermore, it presents a design methodology for designing secure information systems and provides an example of the use of this methodology in designing a database oriented secure medical information system with access rights incorporated.

Computer Security↗

Effective audit trails--a taxonomy for determination of information requirements.

Current methods of detecting confidentiality breaches in electronic medical record systems are inadequate, partially due to the lack of necessary information at the point of audit trail analysis. In order to determine the information requirements for effective audit trail analysis, we have formulated a taxonomy of confidentiality breaches. By considering scenarios in which an inappropriate access might occur, we have identified "indicators" of confidentiality breaches, which may be thought of as evidence suggesting the possibility that a confidentiality breach has occurred. The collection of facts needed to describe the indicators provides insight into the types of information needed to improve confidentiality breach detection. Much of the information needed is unlikely to be available in the patient record. Research is needed exploring means of collecting and utilizing information from sources other than the patient record for use in improving patient information security.

Computer Security↗

Internet/Web-based administration of benefits.

Most funds will face the challenge of deploying at least some Web-based functionality in the near future, if they have not already done so. Clear objectives and careful planning will help ensure success. Issues that must be considered include support requirements, security concerns, functional business objectives, and employer and member Web access.

Computer Security↗

What HIPAA means for your clinical practice.

The Health Insurance Portability and Accountability Act (HIPAA) defines simplification, privacy, and security standards that have prompted health care providers to embark on a process of formalizing long-standing values to protect patient information. Targeting vulnerable practices, raising awareness through education, and formalizing reasonable policies and procedures will go a long way toward assuring privacy and confidentiality for patients and clients. This article offers solid approaches on how to develop and implement privacy and security measures that will engender patient trust and confidence.

Computer Security↗

Draft secure medical database standard.

Medical database security is a particularly important issue for all Healthcare establishments. Medical information systems are intended to support a wide range of pertinent health issues today, for example: assure the quality of care, support effective management of the health services institutions, monitor and contain the cost of care, implement technology into care without violating social values, ensure the equity and availability of care, preserve humanity despite the proliferation of technology etc.. In this context, medical database security aims primarily to support: high availability, accuracy and consistency of the stored data, the medical professional secrecy and confidentiality, and the protection of the privacy of the patient. These properties, though of technical nature, basically require that the system is actually helpful for medical care and not harmful to patients. These later properties require in turn not only that fundamental ethical principles are not violated by employing database systems, but instead, are effectively enforced by technical means. This document reviews the existing and emerging work on the security of medical database systems. It presents in detail the related problems and requirements related to medical database security. It addresses the problems of medical database security policies, secure design methodologies and implementation techniques. It also describes the current legal framework and regulatory requirements for medical database security. The issue of medical database security guidelines is also examined in detailed. The current national and international efforts in the area are studied. It also gives an overview of the research work in the area. The document also presents in detail the most complete to our knowledge set of security guidelines for the development and operation of medical database systems.

Computer Security↗

Safeguarding biomedical AI: a critical scoping review of privacy-enhancing technologies, hybrid approaches, and deployment models.

BACKGROUND: Biomedical artificial intelligence (AI) requires the integration of privacy-enhancing technologies (PETs) to safeguard sensitive clinical, imaging, and genomic data while preserving analytical utility. OBJECTIVES: This review critically and systematically maps applications of PETs across the biomedical AI lifecycle in accordance with PRISMA-ScR guidelines and evaluates their technical trade-offs, deployment feasibility, and residual risks. METHODS: We systematically searched PubMed, IEEE Xplore, ACM Digital Library, and Scopus for studies published between 2015 and 2025. Eligible studies addressed differential privacy, federated learning, secure multiparty computation, homomorphic encryption, or hybrid approaches in biomedical AI. Data were charted on PET type, modality, lifecycle stage, utility metrics, privacy parameters, and deployment considerations. A critical appraisal rubric assessed threat-model adequacy, methodological clarity, reproducibility, privacy-utility transparency, and deployment realism. Additionally, we hand-searched major venues (USENIX Security, NeurIPS, AAAI) and screened Google Scholar for grey literature, applying de-duplication across sources. RESULTS: We identified 87 studies spanning clinical decision support, genomics, and medical imaging. From 25,761 initial records, 3,754 underwent title/abstract screening and 1,968 underwent full-text assessment. PETs demonstrated distinct strengths and limitations: differential privacy provided provable guarantees but reduced performance on imbalanced data; federated learning improved data access but remained vulnerable to gradient leakage; and cryptographic methods ensured confidentiality at high computational cost. Synthetic data generation supported privacy-conscious data sharing and benchmarking but remained sensitive to disclosure risk, fidelity loss, and subgroup representation. Hybrid and emerging approaches, including trusted execution environments, zero-knowledge proofs, and privacy-preserving transformer architectures, mitigated composability gaps yet lacked full end-to-end assurance. Case studies at hospital and biobank scale illustrated practical feasibility and infrastructure demands. CONCLUSIONS: Situating PETs within technical and operational contexts clarifies their capabilities, limitations, and deployment challenges. Residual risks persist, including fairness concerns, inference-time leakage, and overreliance on PETs as compliance proxies. Sustained technical innovation and institutional governance remain essential for the trustworthy integration of PETs in biomedical AI.

biomedical AI↗

A front end authorization mechanism for hospital information systems.

Authorization is an important functionality that every hospital information system (HIS) should provide. An authorization mechanism permits information to be accessed only by properly authorized users. Authorization models and mechanisms have been widely investigated within the framework of HISs. However, their implementation into existing systems, that do not any longer meet increased authorization requirements, requires a major redesign effort. This paper describes a front end authorization mechanism that has been developed in an attempt to enhance the security features of an existing HIS without extensive modifications to the system structure.

Authorship↗