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New security guidelines will foster EDI use.

Both HCFA and HHS have issued new policies that provide direction to providers and payers regarding maintaining confidentiality of the medical data they transmit. A HCFA draft policy allows Medicare contractors and others to use the internet to transmit Medicare information, marking a reversal of HCFA's previous stand on the issue. At the same time, HHS has issued a proposed rule governing security and electronic signature standards, which directs all organizations that deal with patient information to develop a policy that ensures security of patient data.

Centers for Medicare and Medicaid Services, U.S.↗

Curing privacy problems: HIPAA/Healthcare.

A New Jersey-based health system began its HIPAA compliance project in late 1999, several years away from the deadline. The article discusses what the organization has done and is doing, including launching an education initiative, assessing existing privacy and security policies, upgrading complete security services, and designing a HIPAA project management tool.

Access to Information↗

Public key infrastructures for health.

Introducing the technological step into this new 3rd millennium, advanced communication means like global networks including the Internet become more and more important for a fast and convenient information exchange across regional and even national borders. Concerning the sector of public and private healthcare and welfare, new health information system, or citizens' information systems in general, are coming up to meet the needs of the whole information society. Thus, developing and implementing those systems is one of the most important aims of the present and the near future. Access to, and communication of, relevant patient-related administrative and medical information items always means a secure and trustworthy way of dealing with data. Concerning the main aspects of specific legal, social, ethical, technical, organisational, and even political requirements for secure access and secure communication of health data in terms of data protection, data security, privacy, safety and quality using unprotected networks as, e.g., the Internet, there is a strong and even growing need for the fundamental technology of Trusted Third Parties to meet the whole range of the security categories as integrity, confidentiality, availability, accountability, and access control.

Computer Security↗

Implementing interoperable secure health information systems.

Ensuring the privacy and confidentiality of individuals has made security an indispensable component of health information systems. Delivery of healthcare services beyond the enterprise level to the regional, national or cross-border area places new challenges for security implementation. We review the current status and uptake of security measures in healthcare settings across European countries and examine in more detail some of the leading eHealth applications. Drawing on the findings of this analysis, we propose a generic model for streamlining the security implementation process on any level -local, regional, national or cross-border. Finally, we address the future prospects and requirements for advancing secure delivery of healthcare services across European borders.

Computer Security↗

Security requirements for electronic patients records: the Norwegian view.

Information security, including secrecy, privacy and data integrity, quality and availability, are fundamental issues when electronic patient records are introduced and used. In this paper we outline the results of a project that KITH carried out on an assignment from the Norwegian Ministry of Health. We describe the general and detailed requirements set up in the project for electronic patient records, and to the hospitals that take such into use. We believe that these requirements are the minimum necessary to give a positive answer to the question of whether electronic patient records can meet all the security-related requirements and intentions given by current regulations. In our work we have focused on secrecy, privacy and data integrity, but also on elaborating requirements that allow a user friendly and suitable implementation of electronic patient record systems.

Computer Communication Networks↗

An Internet implementation of an international clinical study.

This paper describes a clinical study that is being conducted in 15 countries world-wide via the internet. The study concerns the removal of Factor VIII inhibitors in haemophilic children. The suitability of the Internet for this type of study is explored together with the technology (Active Server Pages, Secure Sockets Layer) that is involved in the creation of such a system.

Child↗

Willow: a uniform search interface.

The objective of the Willow Project is to develop a uniform search interface that allows a diverse community of users to retrieve information from heterogeneous network-based information resources. Willow separates the user interface from the database management or information retrieval system. It provides a graphic user interface to a variety of information resources residing on diverse hosts, and using different search engines and idiomatic query languages through networked-based client-server and Transmission Control Protocol/Internet Protocol (TCP/IP) protocols. It is based on a "database driver'' model, which allows new database hosts to be added without altering Willow itself. Willow employs a multimedia extension mechanism to launch external viewers to handle data in almost any form. Drivers are currently available for a local BRS/SEARCH system and the Z39.50 protocol. Students, faculty, clinicians, and researchers at the University of Washington are currently offered 30 local and remote databases via Willow. They conduct more than 250,000 sessions a month in libraries, medical centers and clinics, laboratories, and offices, and from home. The Massachusetts Institute of Technology is implementing Willow as its uniform search interface to Z39.50 hosts.

Computer Communication Networks↗

A web-based interactive database system for a transcranial Doppler ultrasound laboratory.

BACKGROUND: Variations in transcranial Doppler (TCD) examination performance techniques and interpretive paradigms between individual laboratories are a common challenge in the practice of TCD. Demand for rapid access to patient ultrasound examination data and report for use in intensive care settings has necessitated a more flexible approach to data management. Both of these issues may benefit from a computerized approach. METHODS: We describe the application of a World Wide Web-based database system for use in an ultrasound laboratory. Results. Databasing information while generating a TCD report is efficient. Web accessibility allows rapid and flexible communication of time-sensitive report information and interpretation for more expeditious clinical decision making. CONCLUSIONS: Web-based applications can extend the reach and efficiency of traditionally structured medical laboratories.

Cerebrovascular Disorders↗

Digital radiographic image archival, retrieval, and management.

Data in the health care environment can encompass a wide range of contents, each representing one aspect of health care delivery. Examples of such a diverse and yet related content are diagnostic images, laboratory results, patient history, hospital administration, and insurance and payer coverage. The focus of this article is the handling of diagnostic imaging in general and radiographic imaging in particular, therefore fundamental concepts and issues are presented and discussed.

Computer Security↗

[The development of endoscope workstation].

This paper introduces an endoscope workstation, which solved the weak points of multimedia endoscope database used by most hospitals. The endoscope workstation was built on pedal-switch and NTFS file system. This paper also Introduces how to make program optimal and quick inputting. The workstation has promoted the efficiency of the doctor's operation.

Computer Security↗