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"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.

Belgium↗

A web service-based Grid portal for Edgebreaker compression.

BACKGROUND: In health applications, and elsewhere, 3D data sets are increasingly accessed through the Internet. To reduce the transfer time while maintaining an unaltered 3D model, adequate compression and decompression techniques are needed. Recently, Grid technologies have been integrated with Web Services technologies to provide a framework for interoperable application-to-application interaction. OBJECTIVES: The paper describes an implementation of the Edgebreaker compression technique exploiting web services technology and presents a novel approach for using such services in a Grid Portal. The Grid portal, developed at the CACT/ISUFI of the University of Lecce, allows the processing and delivery of biomedical images (CT--computerized tomography--and MRI--magnetic resonance images) in a distributed environment, using the power and security of computational Grids. METHODS: The Edgebreaker Compression Web Service has been deployed on a Grid portal and allows compressing and decompressing 3D data sets using the Globus toolkit GSI (Globus Security Infrastructure) protocol. Moreover, the classical algorithm has been modified extending the compression to files containing more than one object. RESULTS AND CONCLUSIONS: An implementation of the Edgebreaker compression technique and related experimental results are presented. A novel approach for using the compression web service in a Grid portal allowing storing and preprocessing of huge 3D data sets, and subsequent efficient transmission of results for remote visualization is also described.

Algorithms↗

Legal aspects of digital image management and communication.

This paper outlines the legal issues that arise in digital image management and communication systems (IMACS). At the heart of this study is the digital image which is manipulated, processed, communicated, stored, compressed and archived, and which is difficult to ascertain from a legal point of view because of its intangible nature. On the one hand, personal data protection and the patient's right to privacy need to be protected through a data protection and security policy. This is particularly important in view of the capacity of IMACS to integrate with other systems such as HIS and RIS, since the information generated by the totality of these systems offers a very complete picture of any patient. On the other hand, the evanescent nature of the digital image creates legal uncertainties as to questions of evidence, of procedural and legal admissibility and acceptability and of liability.

Belgium↗

Enhancing medical database security.

A methodology for the enhancement of database security in a hospital environment is presented in this paper which is based on both the discretionary and the mandatory database security policies. In this way the advantages of both approaches are combined to enhance medical database security. An appropriate classification of the different types of users according to their different needs and roles and a User Role Definition Hierarchy has been used. The experience obtained from the experimental implementation of the proposed methodology in a major general hospital is briefly discussed. The implementation has shown that the combined discretionary and mandatory security enforcement effectively limits the unauthorized access to the medical database, without severely restricting the capabilities of the system.

Computer Security↗

Cryptographic protection of health information: cost and benefit.

Medical, legal, and economic reasons inevitably force health care establishments to apply more and more open distributed IT systems rather than the less flexible and more expensive mainframes. Managing, for example, electronic patient records by various users at different locations by means of large scale client server systems requires new security provisions for storing, archiving and communicating those data. Using an analogy, data processing is being changed from railroads to highways. Formerly, only one engine-driver was responsible for the security of a whole train whereas now the car-drivers themselves are responsible each for his own car. Unless the cars are equipped with suitable security mechanisms like breaks and safety belts this change endangers individuals within and outside the cars. Cryptography provides many of the relevant security mechanisms for open distributed health care IT systems. Indeed, suitable cost effective cryptographic products are available but are rarely found in health care IT systems. The reason is more political than economic, diverging national security interests in the EU have prevented strong security in public telecommunication infrastructures arguing that, e.g. criminals would profit, too. The resulting uncertainty of investments delays the development, standardisation and installation of cryptographic solutions.

Computer Security↗

Peer-to-peer computing in health-promoting voluntary organizations: a system design analysis.

A large part of the health promotion in today's society is performed as peer-to-peer empowerment in voluntary organisations such as sports clubs, charities, and trade unions. In order to prevent work-related illness and long-term sickness absence, the aim of this study is to explore computer network services for empowerment of employees by peer-to-peer communication. The 'technique trade-off method was used for the analysis of the system design. A Critical Incident Technique questionnaire was distributed to a representative sample of trade union shop stewards (n = 386), and focus-group seminars were arranged where a preliminary set of requirements was discussed. Seven basic requirements were identified and matched to a set of 12 design issues for computer network services, allocating a subset of design issues to each requirement. The conclusion is that the systems design displays an inexpensive and potentially feasible method for peer-to-peer computing in voluntary health-promoting organisations.

Computer Communication Networks↗

Taiwan's perspective on electronic medical records' security and privacy protection: lessons learned from HIPAA.

The protection of patients' health information is a very important concern in the information age. The purpose of this study is to ascertain what constitutes an effective legal framework in protecting both the security and privacy of health information, especially electronic medical records. All sorts of bills regarding electronic medical data protection have been proposed around the world including Health Insurance Portability and Accountability Act (HIPAA) of the U.S. The trend of a centralized bill that focuses on managing computerized health information is the part that needs our further attention. Under the sponsor of Taiwan's Department of Health (DOH), our expert panel drafted the "Medical Information Security and Privacy Protection Guidelines", which identifies nine principles and entails 12 articles, in the hope that medical organizations will have an effective reference in how to manage their medical information in a confidential and secured fashion especially in electronic transactions.

Computer Security↗

Breaching the security of the Kaiser Permanente Internet patient portal: the organizational foundations of information security.

This case study describes and analyzes a breach of the confidentiality and integrity of personally identified health information (e.g. appointment details, answers to patients' questions, medical advice) for over 800 Kaiser Permanente (KP) members through KP Online, a web-enabled health care portal. The authors obtained and analyzed multiple types of qualitative data about this incident including interviews with KP staff, incident reports, root cause analyses, and media reports. Reasons at multiple levels account for the breach, including the architecture of the information system, the motivations of individual staff members, and differences among the subcultures of individual groups within as well as technical and social relations across the Kaiser IT program. None of these reasons could be classified, strictly speaking, as "security violations." This case study, thus, suggests that, to protect sensitive patient information, health care organizations should build safe organizational contexts for complex health information systems in addition to complying with good information security practice and regulations such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

Computer Security↗