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Laparoscopy is a wonderful tool for performing gynecologic surgery. Whether or not laparoscopic surgery is advisable to diagnose or treat a particular gynecologic problem requires a careful consultation with an experienced gynecologist, who can help the patient weight the pros and cons of laparoscopy versus other options. For the management of this kind of surgical intervention we realise a computer based patient record.
The scope of this paper is to present the current needs and trends in the field of healthcare systems security. The approach applied within the described review was based on three major steps. The first step was to define the point and ways of penetration and integration of security services in current healthcare related applications addressing technical, organisational and legal/regulatory issues. The second step was to specify and evaluate common security technologies applied in healthcare information systems pointing out gaps and efficient solutions, whereas the third was to draw conclusions for the present conditions and identify the future trends of healthcare information security. A number of EU RTD Projects were selected, categorised, analysed and comparatively evaluated in terms of security. The technical focus was on key security technologies, like Public Key Infrastructures (PKIs) based on Trusted Third Parties (TTPs) in conjunction with other state-of-the-art security components (programming tools, data representation formats, security standards and protocols, security policies and risk assessment techniques). The experience gained within this review will provide valuable input for future security applications in the healthcare sector, solving existing problems and addressing real user needs.
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No longer just an information technology issue, network security requires a multifaceted, multidisciplinary approach to ensuring critical equipment functionality, data security, and patient safety. This article provides insight into the threat of malware and ways to deal with it.
Expanding use of information technology in health care, both within and between the institutions, leads to additional security demands. The role is discussed that can be played by smart cards for healthcare professionals.
Nursing information systems are computer systems that enable nurses to collect, manipulate, store, retrieve, display, and communicate data to administer nursing services and resources, manage nursing practice to improve patient care, and advance nursing knowledge. Selection and implementation of a nursing information system require a clear vision of the need for the system, careful planning, and astute forward thinking. Technology assessment provides a framework for generating pragmatic questions that can be used in systematically evaluating nursing information systems. This article provides a brief overview of nursing information systems, explains the technology assessment framework, and gives examples of questions useful in evaluating a nursing information system.
This paper outlines the legal issues that arise in the context of digital diagnostic image management and communication. At the heart of the 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. At issue is, on the one hand, data protection and security and, on the other hand, legal problems as to the images' evidential force, procedural and legal admissibility and most important uncertainties about the liabilities of those involved in handling the digital image.
Electronic prescribing offers the prospect of safer medication management, but fulfillment of that promise depends on ready access to personal health information from many sources, thus raising new concerns about information privacy and security. Federal privacy regulations under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) limit the sharing of health information by providers, and particularly may discourage information sharing over distributed computer networks. This analysis finds that although HIPAA has only a limited effect on current e-prescribing practices, future electronic prescribing systems will likely fall short of their potential benefits, absent policy refinements designed to encourage clinically appropriate, networked sharing of patient health information.
An integrated secure design methodology for the enhancement of database security in a hospital environment is presented in this paper. The proposed design methodology 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. The experimental implementation of the methodology in a major Greek hospital is also presented. The implementation has shown that the combined discretionary and mandatory security enforcement effectively limits unauthorized access to the medical database, without severely restricting the capabilities of the system.
Data security becomes more and more important in telemammography which uses a public high-speed wide area network connecting the examination site with the mammography expert center. Generally, security is characterized in terms of privacy, authenticity and integrity of digital data. Privacy is a network access issue and is not considered in this paper. We present a method, authenticity and integrity of digital mammography, here which can meet the requirements of authenticity and integrity for mammography image (IM) transmission. The authenticity and integrity for mammography (AIDM) consists of the following four modules. 1) Image preprocessing: To segment breast pixels from background and extract patient information from digital imaging and communication in medicine (DICOM) image header. 2) Image hashing: To compute an image hash value of the mammogram using the MD5 hash algorithm. 3) Data encryption: To produce a digital envelope containing the encrypted image hash value (digital signature) and corresponding patient information. 4) Data embedding: To embed the digital envelope into the image. This is done by replacing the least significant bit of a random pixel of the mammogram by one bit of the digital envelope bit stream and repeating for all bits in the bit stream. Experiments with digital IMs demonstrate the following. 1) In the expert center, only the user who knows the private key can open the digital envelope and read the patient information data and the digital signature of the mammogram transmitted from the examination site. 2) Data integrity can be verified by matching the image hash value decrypted from the digital signature with that computed from the transmitted image. 3) No visual quality degradation is detected in the embedded image compared with the original. Our preliminary results demonstrate that AIDM is an effective method for image authenticity and integrity in telemammography application.
It is hoped that the implementation of teleradiology will improve the quality and economic effectiveness of health care in the future. The German federal government has submitted a bill for a legal statute, thereby creating the necessary framework to guarantee the essential "document security". The responsibility of those involved with orderly data transmission as well as the limited responsibility for physicians' findings are both governed by general liability. General principles apply also with regard to professional discretion. Authorized utilization of external networks depends upon the quality of data security. Networks with unlimited-public access may not be used without explicit consent from those concerned.
Although other alternatives may exist, identification cards have been chosen as an acceptable and adequate tool to be used to identify patients and health professionals. It is planned to use these for digital signature and for access to electronic health records: for searching various databases as well as for health information exchange. Local applications might exist independently, but the Belgian federal state has now developed Be-Health, a platform for health professionals, social security personnel and the general public, designed to facilitate a secure common uniform access to certain health data.
Medical database security plays an important role in the overall security of medical information systems. The development of appropriate secure database design and operation methodologies is an important problem in the area and a necessary prerequisite for the successful development of such systems. The general framework for medical database security and a number of parameters of the secure medical database design and operation problem are presented and discussed. A secure medical database development methodology is also presented which could help overcome some of the problems currently encountered.
Medical database security plays an important role in the overall security of medical information systems and networks. This is both because of the nature of this technology and its widespread use today. Database security not only involves fundamental ethical principles, but also essential prerequisites for effective medical care. The development of appropriate secure medical database design and implementation methodologies is an important research problem in the area and a necessary prerequisite for the successful development of such systems. The general framework and requirements for medical database security are given and a number of parameters of the secure medical database design and implementation problem are presented and discussed in this paper. A secure medical database development methodology is also presented which could help overcome some of the problems currently encountered.
To meet the needs of an increasing number of persons who require access to patient information, health systems have devoted significant financial resources to developing computerized medical records. As these enterprisewide information systems go online, however the risk of compromising patient confidentiality increases dramatically. State laws regarding patient confidentiality vary considerably, and national standards have not yet been established. Therefore, health systems need to take steps to ensure that their computerized patient records remain secure and confidential to avoid being found in violation of patients' legal right to privacy.
Within the HemaCAM project which deals with automated differential white blood cell count by image processing, a security infrastructure has been integrated. The security services for this demonstrator have been derived from the German health network ONCONET that enables a trustworthy framework for both health professionals and patients as well as supports clinical studies. For the solution, services assuring both communication security and application security have to be provided. This task has been realised by the use of the security token Health Professional Card and an appropriate Trusted Third Party infrastructure.
A Health Care Establishment (HCE) is an establishment where medical services are rendered. These services are provided by the health care personnel. The infrastructure of a HCE may include Information Technology (IT) equipment that stores and processes HC information. The spread of distributed information technology in HCEs have necessitated the implementation of Network Security in Health Care Information System (HCISs), to assure confidentiality, integrity and availability of HC information being transmitted across HC networks. This paper presents a road map in implementing Network Security guidelines for the provision of Network Security in HCEs, work carried out within the Secure Environment for Information Systems in Medicine (SEISMED) project under the Advanced Informatics in Medicine (AIM) programme.