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Implementing security on a prototype hospital database.

This paper describes the methodology used and the experience gained from the application of a new secure database design approach and database security policy in a real life hospital environment. The applicability of the proposed database security policy in a major Greek general hospital is demonstrated. Moreover, the security and quality assurance of the developed prototype secure database is examined, taking into consideration the results from the study of the user acceptance.

Computer Security↗

Uniting security forces against risk.

Threats to your facility's physical and information security become more complex all the time. To create a truly effective security program, consider developing an integrated security program that encompasses both traditional and information technology protection. The result? A strong, streamlined program that enables--not inhibits--healthcare delivery.

Computer Security↗

Empowering children and families with information technology.

Patient empowerment is the enhanced ability of patients to actively understand and influence their health status. Information is the key to patient empowerment. Without information, children and families cannot engage in meaningful discussions or make thoughtful decisions regarding medical care. Information sharing is a model for patient interaction with the health care system that may significantly improve the care of children and families. This article focuses on information technologies that utilize user-centered design principles and interactive capabilities to facilitate information sharing and to empower children and families. Examples include electronic pediatric personal medical records, customized health information systems, and interactive physician offices with electronic mail (e-mail) and telemedicine capabilities. Ideally, these systems would all be integrated. Successful implementation of new technologies will require thoughtful attention and balanced solutions to tensions between information sharing vs security, and curatorship vs censorship. Issues related to access and the digital divide must also be addressed. Acceptance and usability of new technologies is predicated on close collaboration among physicians, researchers in informatics, librarians, educators, and other professionals with expertise in the human-computer interface. Child and family empowerment will be both the driving force and ultimate outcome of information-sharing technologies.

Child↗

Use of medical information by computer networks raises major concerns about privacy.

The development of computer data-bases and long-distance computer networks is leading to improvements in Canada's health care system. However, these developments come at a cost and require a balancing act between access and confidentiality. Columnist Michael OReilly, who in this article explores the security of computer networks, notes that respect for patients' privacy must be given as high a priority as the ability to see their records in the first place.

Civil Rights↗

Communication security in open health care networks.

Fulfilling the shared care paradigm, health care networks providing open systems' interoperability in health care are needed. Such communicating and co-operating health information systems, dealing with sensitive personal medical information across organisational, regional, national or even international boundaries, require appropriate security solutions. Based on the generic security model, within the European MEDSEC project an open approach for secure EDI like HL7, EDIFACT, XDT or XML has been developed. The consideration includes both securing the message in an unsecure network and the transport of the unprotected information via secure channels (SSL, TLS etc.). Regarding EDI, an open and widely usable security solution has been specified and practically implemented for the examples of secure mailing and secure file transfer (FTP) via wrapping the sensitive information expressed by the corresponding protocols. The results are currently prepared for standardisation.

Computer Communication Networks↗

Challenges associated with privacy in health care industry: implementation of HIPAA and the security rules.

This paper discusses the challenges associated with privacy in health care in the electronic information age based on the Health Insurance Portability and Accountability Act (HIPAA) and the Security Rules. We examine the storing and transmission of sensitive patient data in the modem health care system and discuss current security practices that health care providers institute to comply with HIPAA Security Rule regulations. Based on our research results, we address current outstanding issues that act as impediments to the successful implementation of security measures and conclude the discussion and offer possible avenues of future research.

Computer Security↗

Information security concepts and practices: the case of a provincial multi-specialty hospital.

In recent years, major and widely accepted information security understandings and achievements confirm that the problem is complex. They clarify that technologies are fundamental tools, but management processes have even bigger relevance, as also prestigious international magazines dossier clearly explained recently. Such a magazine attention outlines the wide impact that the subject has on watchful decision makers. ISO17799 is an emerging standard in information security. In principle there are no reasons for considering it not applicable to the health care sector. In practice, because of both the just conceptual level of the standard and the peculiarities of the health care data and institutions, a lot of analysis and design work need to be invested any time a health care institution decides to deal with the subject. CEN/ENV 12924 is another emerging standard certainly more on the spot of the health care. Nevertheless, it also asks for evident further investigation. The practical case of information security design, implementation, management, and auditing inside a multi-specialty provincial Italian hospital will be described.

Computer Security↗

Privacy, security, and reliability risks of artificial intelligence in healthcare: a systematic review of empirical evidence.

BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare information systems, supporting clinical decision-making, imaging analysis, and predictive modeling. While these applications offer operational and clinical benefits, they also introduce emerging risks to patient privacy, data security, and system reliability. OBJECTIVE: To systematically review empirical evidence on privacy breaches, security vulnerabilities, and misuse associated with AI applications in healthcare settings. METHODS: PubMed, Embase, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library were searched for empirical studies published between January 2015 and November 2025 that evaluated AI use or misuse in clinical diagnosis, treatment, or decision-making. Two reviewers independently screened studies and extracted data using a standardized form. Findings were synthesized narratively due to heterogeneity in study designs, AI methods, and reported outcomes. RESULTS: Of 7,285 records identified through database searches and 205 through citation screening, 22 empirical studies met the inclusion criteria, spanning multiple clinical domains and data modalities, predominantly medical imaging applications. Five recurring threat categories were identified: patient re-identification, membership inference, unauthorized access and adversarial exploitation, input manipulation, and misuse or overinterpretation of AI outputs. Across studies, AI models were shown to encode latent biometric signals across diverse data types, limiting the effectiveness of traditional anonymization and synthetic data approaches. Adversarial attacks and input manipulation were also shown to compromise diagnostic performance and system integrity. CONCLUSION: This systematic review provides empirical evidence suggesting that contemporary AI systems in healthcare introduce privacy and security risks that may challenge traditional assumptions about data protection. These findings underscore the need for privacy- and security-by-design approaches and governance frameworks that address risks across the AI lifecycle.

Humans↗

Privacy and security of medical information.

Increasingly, medical information is being stored, accessed, and communicated electronically, which makes this information vulnerable to breaches in security and privacy. Clinicians must be familiar with the best practices for keeping medical information private, as well as the local, state, and federal regulations that govern the security, privacy and patient-identifiable information. Noncompliance carries the potential for civil and criminal penalties.

Computer Security↗

Medical image security in a HIPAA mandated PACS environment.

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information.

California↗

The European TrustHealth project experiences with implementing a security infrastructure.

Accepting the shared care paradigm, communication and co-operation required between health care establishments must be provided in a trustworthy way. The solution for establishing such trustworthy environment has to be based on a common policy framework, on services, and mechanisms, which have been standardised. In Europe, the legal framework, other policy issues, and the services and mechanisms needed have been developed within projects launched by the European Commission, by the European standards body CEN as well as by temporarily established groups. Within the European TrustHealth projects. a security infrastructure for trustworthy health telematics applications has been specified, implemented, and evaluated. It is based on Health Professional Cards and Trusted Third Party services. Experiences regarding organisational and technological implications of the specification, implementation, maintenance, and evaluation of such a security infrastructure are described on the basis of the ONOCONET example. For the complete software lifecycle, the UML methodology has been deployed.

Communication↗

Administrative and security challenges with electronic patient record systems.

EPRS security is clearly an area of concern to all health information management professionals. With the advent of enterprise-wide linkages, as well as community health information networks (CHINs) and other remote linkages, security is a critical issue that must be addressed in detail during system selection and implementation. Strict enforcement of security policies and procedures is mandatory. Technology has given health information management professionals the tools to secure the patient record. Use of these tools is required to meet the challenges presented by the transition to the electronic realm.

Authorship↗

Prototype of a JAVA/DICOM image server with integrated findings and data security.

The transfer of medical data within heterogeneous hard- and software infrastructures requires platform-independent standardized protocols and data formats such as DICOM. To avoid costly vendor-specific solutions a DICOM server was implemented in JAVA thereby enabling the data access via internet browser technology. The most important patient and image acquisition information were extracted from the DICOM images and stored into a relational database. For an integrated view patient information such as radiological findings were transferred from the Radiological Information System (RIS) into the data base. Image data were accessed either by a fast preview tool or using a DICOM viewer. Since DICOM does not include inherent data security mechanisms, a second tool allowed the DICOM-conform encryption of DCIOM data for a secure long term storage on CD-R or across unsecure networks.

Computer Security↗

Electronically signed documents in health care--analysis and assessment of data formats and transformation.

OBJECTIVES: Our objectives were to analyze and assess data formats for their suitability for conclusive and secure long-term archiving and to develop a concept for legally secure transformation of electronically signed documents that are not available in data formats appropriate for long-term archiving. METHODS: On the basis of literature review and Internet searches we developed general evaluation criteria to assess data formats with regard to their suitability for conclusive and secure long-term archiving. The assessment of data formats refers to format specifications and available literature. For the analyses of the transformation of signed documents we analyzed legal requirements on the basis of laws and ordinances as well as technical requirements by means of literature reviews, Internet searches and technical specifications. RESULTS: The following evaluation criteria are suited for this kind of assessment of data formats: transparency and standardization, stability, presentation and security. According to our assessment the following data formats are most suitable for conclusive and secure long-term archiving: PDF for formatted and unstructured text documents, XML for markup languages, TIFF for images in general, DICOM for medical images and S/MIME for the storage of e-mail. To transform electronically signed documents we propose an elementary procedure and universal basic model in form of an XML schema definition that includes the necessary legal and technical information. CONCLUSIONS: If electronic documents are to replace paper-based documents in patient records, they have to conform to the criteria for secure long-term archiving. The analyzed data formats are to be extended by mechanisms to guarantee the long-term security of electronic signatures. To transform large quantities of documents in a legally secure way, our basic model has to be extended for automated procedures.

Archives↗

Empowerment of patients and communication with health care professionals through an electronic health record.

OBJECTIVE: The aim of this project was to design and develop a personal electronic health record (EHR) in order to support patient empowerment and additionally to enhance their communication and information exchange with health professionals through this EHR. METHOD: The functionality of a personal Electronic Healthcare 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 health, based on relevant disease management programs. It is one means to support patient empowerment, additionally supported by tools for building a patient community. Since storage and communication of data in an EHR comprises sensible personal health data, each of those functions needs specific security and access management requirements to be considered and implemented. RESULT: Clinical pilot projects are already done or under development.

Communication↗

Access audit trails: en route to security.

An electronic access audit trail can be an effective security tool if the right conditions are in place. In this article, learn how to ensure that your organization has the right technology, procedures, mechanisms, and plans to implement an audit trial.

Authorship↗