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Dealing with information accessibility and security.

Changing marketplace demands and healthcare reforms are bringing about the most sweeping transformation the industry has ever seen. Increased reliance on computerized information by a wide variety of users in both caregiving and administrative roles has accelerated, necessitating a new level of security. The following article explores these issues and describes how advances in information technology can be applied to provide such an environment.

Computer Security↗

Functions of an electronic health record.

The functionality of a personal electronic health record (EHR) may vary from a simple web-based interface for interactive data entry and data review up to a much more powerful system, additionally supporting electronic data/document communication between clinical information systems of primary care practitioners or hospitals, and even reminder-based support for the empowered citizen to actively take care of his/her health, based on relevant disease management programs. It is a means of supporting patient empowerment. Since storage and communication of data in an EHR involves sensitive personal health data, it is necessary to implement specific security and access management requirements for each of these functions.

Computer Security↗

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, new security concerns arise. Digital cryptographic methods provide solutions to many of these new concerns. In this article we give an overview of new security concerns, new legislation mandating secure medical records and solutions providing security.

Computer Security↗

[Confidentiality within the scope of secondary data research--approaches to a solution of the problem of data concentration].

In order to implement general data protection requirements and internationally recognised ethical requirements, research with personal health and social data demands a specific framework for the secure handling of confidential data. In the process of transferring data from the health service providers to the place where they are analysed, an important role is played by a so-called trust centre, responsible for pseudonymisation of personal and institutional identifiers. An undesirable concentration of data in the trust centre can be avoided by early separation of data in the data transfer institution: the trust centre receives only the identifier to be pseudonymised, while the health provision data are sent direct to the analysing institution, where they can be matched with the pseudonyms from the trust centre, with the help of a unique case number. The possibility of reidentification, which exists mainly in large (pseudonymised) data sets, can be reduced by use of an appropriate pseudonymisation process (e.g. insuree-based pseudonymisation by health service providers for sampling of insurees). The measures described here are suitable for protecting confidentiality and for further improving data security in the handling of confidential personal and institutional data.

Computer Security↗

HIPAA--clinical and ethical considerations for nurses.

Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) to protect patients' basic rights to privacy and their control over the disclosure of their personal health information. Advances in and the more widespread use of communication technology were increasing the public's concerns over the ease with which their health information could be transmitted, how protected that information was during such transmissions, and their lack of approval for the use of that information by known and unknown third parties. This article, the first of two papers focusing on HIPAA, discusses HIPAA from the clinical perspective and focuses primarily on the HIPAA Privacy Rule. Under what circumstances can a covered entity disclose protected health information? What are the ethical issues inherent in HIPAA? What does HIPAA require of covered entities? What are the implications of HIPAA for professional nurses? The goal of HIPAA is to ensure the protection of confidential health information through having appropriate security systems to guard against unintentional disclosure of that information.

Access to Information↗

Incremental adoption of information security in health-care organizations: implications for document management.

The incremental adoption of electronic media in U.S. health care has created increased risk of security and privacy violations in provider organizations. Protective regulatory efforts have been proposed to address ineffective security of patient information, with severe noncompliance penalties. Using data from a nationwide survey of health information managers, this study examines how industry-wide knowledge management trends may influence the degree of security program adoption in health-care organizations. Results suggest that significant nonadoption of mandated security measures continues to occur across the health-care industry. Paper-based systems still prevail, and computerized settings tend to have less security measures. Implications for document management and knowledge policy are discussed.

Computer Security↗

Web-based digital radiology teaching file: facilitating case input at time of interpretation.

OBJECTIVE: Our goal was to develop a software system that allows easy and rapid input of digital radiology images and text reports, at the time of interpretation, into an easily searchable electronic teaching file database using the Internet and the World-Wide Web protocols, servers, and browsers. CONCLUSION: Using the Internet, the World-Wide Web, and our software system, we can rapidly input digital radiology images and associated text reports into an easily searchable database accessed by privileged users. This inexpensive and simple method for building a digital teaching file database allows cross-platform access for users who have a Web browser.

Computer Communication Networks↗

Health data security: a new priority.

As more health care information is computerized, concerns about the security of on-line data are growing. Some well-publicized health data security breaches illustrate the potentially devastating impact of confidentiality violations. This package of stories offers and in-depth look at the state of health data security. It includes a "roundtable discussion" by five prominent chief security officers, as well as articles on data encryption, biometrics, legislation and other topics.

Computer Security↗

Security aspects for medical device vigilance information exchange.

The implementation of appropriate security mechanisms for an effective and efficient medical device vigilance information exchange is very important, as the system handles sensitive information. These mechanisms have to be designed in such a way that they maintain confidentiality, integrity and availability of the data of medical devices. In this paper the security aspects of the information exchange on medical device vigilance is examined in detail.

Computer Security↗

Health data privacy.

How can the tradition of patient-provider confidentiality be preserved and still meet the changing information needs of insurers, employers, public health agencies, policy analysts, and researchers? As countries grapple with the issue of a patient's right to medical record privacy, actions that the U.S. takes in this area will set precedents and have implications for nearly every health care electronic transaction. The Health Insurance Portability and Accountability Act requires the Secretary of Health and Human Services (HHS) to recommend standards for electronic financial and administrative transactions. The HHS focused on the confidentially of patient's health care information, guided by five principles in developing recommendations: (1) Boundaries; (2) Security; (3) Consumer Control; (4) Accountability; and (5) Public Responsibility.

Computer Security↗