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At least 1,297 records · Page 72Linked to original sources
PubMed1998

System for efficient and secure distribution of medical images on the Internet.

Because of the high compressibility of the medical images, data compression is desirable for digital storage despite the availability of inexpensive hardware for mass storage. A progressive transmission algorithm with automatic security filtering features for on-line medical image distribution using Daubechies' wavelets has been developed and is discussed in this paper. The system is practical for real-world applications, processing and coding each 12-bit image of size 512 x 512 within 2 seconds on a Pentium Pro. Besides its exceptional speed, the security filter has demonstrated a remarkable accuracy in detecting sensitive textual information within current or digitized previous medical images. The algorithm is of linear run time.

Algorithms↗
PubMed1995

Medical information retrieval and WWW browsers at Mayo.

Medical information retrieval from "Master Sheet" entries specially indexed for research retrieval has been part of the Mayo culture since 1909. Providing easy to use and universally available WWW access to these and other patient information databases at Mayo via browsers, shines a bright light on issues of privacy and confidentiality, user authentication, need to know, data transmission security, and technical details of interfacing disparate databases on a spectrum of platforms to many types of workstations using a variety of browsers. We review our recent experience, and generalize pertinent issues.

Computer Communication Networks↗
PubMed2004

Organizing safety: conditions for successful information assurance programs.

Organizations must continuously seek safety. When considering computerized health information systems, "safety" includes protecting the integrity, confidentiality, and availability of information assets such as patient information, key components of the technical information system, and critical personnel. "High Reliability Theory" (HRT) argues that organizations with strong leadership support, continuous training, redundant safety mechanisms, and "cultures of high reliability" can deploy and safely manage complex, risky technologies such as nuclear weapons systems or computerized health information systems. In preparation for the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Office of the Assistant Secretary of Defense (Health Affairs), the Offices of the Surgeons General of the United States Army, Navy and Air Force, and the Telemedicine and Advanced Technology Research Center (TATRC), US Army Medical Research and Materiel Command sponsored organizational, doctrinal, and technical projects that individually and collectively promote conditions for a "culture of information assurance." These efforts include sponsoring the "P3 Working Group" (P3WG), an interdisciplinary, tri-service taskforce that reviewed all relevant Department of Defense (DoD), Miliary Health System (MHS), Army, Navy and Air Force policies for compliance with the HIPAA medical privacy and data security regulations; supporting development, training, and deployment of OCTAVE(sm), a self-directed information security risk assessment process; and sponsoring development of the Risk Information Management Resource (RIMR), a Web-enabled enterprise portal about health information assurance.

Communication↗
PubMed1998

Security aspects of medical file regrouping for the epidemiological follow-up.

To carry out epidemiological studies at a regional level, one may need to link information collected by medical doctors working either in hospitals or in private offices or laboratories. The first problem is to respect the European legislation on nominal data processing, which does not allow the linkage of nominal files. As a consequence, we have developed an anonymous record linkage procedure, which ensures an irreversible transformation of identity and allows the linkage of rendered anonymous files. The second problem is to ensure data security during the transmission and we discuss the advantages of different methods of communication such as the norms X400 and Internet protocols.

Computer Communication Networks↗
PubMedDate not supplied

Privacy and computerized medical records.

There are strong incentives to computerize medical records in the present health care environment, yet medical information is frequently personal and is protected by privacy law and by centuries of a tradition of confidentiality. It is not possible to eliminate all risk of inappropriate disclosure and use of medical information, either in a paper or an electronic system. Computerization of records increases the potential for abuse, but with appropriate attention to security measures, medical data can be made reasonably secure while preserving accessibility for those who truly need the information. Both for technical and legal reasons, paper records are still necessary in 1995, to back up electronic medical databases.

Computer Security↗
PubMed2002

Hierarchical data security in a Query-By-Example interface for a shared database.

Whenever a shared database resource, containing critical patient data, is created, protecting the contents of the database is a high priority goal. This goal can be achieved by developing a Query-By-Example (QBE) interface, designed to access a shared database, and embedding within the QBE a hierarchical security module that limits access to the data. The security module ensures that researchers working in one clinic do not get access to data from another clinic. The security can be based on a flexible taxonomy structure that allows ordinary users to access data from individual clinics and super users to access data from all clinics. All researchers submit queries through the same interface and the security module processes the taxonomy and user identifiers to limit access. Using this system, two different users with different access rights can submit the same query and get different results thus reducing the need to create different interfaces for different clinics and access rights.

Computer Security↗
PubMed1996

A World Wide Web-based user interface for a data management system for use in multi-institutional clinical trials--development and experimental operation of an automated patient registration and random allocation system.

We have employed the Hypertext Transfer Protocol (HTTP) and Hypertext Markup Language (HTML) to develop an automated patient registration and random allocation system for use in a multi-institutional clinical trial. We made it available on-line to World Wide Web clients in each hospital through a user friendly graphical user interface. During experimental operation, the physicians found it satisfactory from the viewpoint of both ease of operation and response time. For the development of a graphical user interface in network-based information system for use in multi-institutional clinical trials, HTTP/HTML has several advantages over an ordinary client-server model. Therefore, we concluded that we would adopt HTP/HTML for the construction of user interfaces for physicians in each spital and for data managers in our coordinating center.

Chemotherapy, Adjuvant↗
PubMedDate not supplied

Integration of a computer-based patient record system into the primary care setting.

The use of computer-based patient record systems (CPRS) in the primary care setting will increase significantly over the next few years. Real-time, point-of-care use of such systems must provide adequate payback to justify the intrusion into the provider/patient relationship. The authors describe, through the transition of a legacy system into a state-of-the art system, how such a system might be integrated into the primary care setting. Information flow is organized around an event, such as a patient encounter, or around the patient. The Medical Record (TMR) optimizes the provider/computer interaction through the use of protocols and clinical guidelines. Documentation is enhanced through the use of computer-generated progress notes.

Computer Security↗
PubMedDate not supplied

An integrated architecture for deploying a virtual private medical network over the web.

In this paper we describe a pilot architecture aiming at protecting Web-based medical applications through the development of a virtual private medical network. The basic technology, which is utilized by this integrated architecture, is the Trusted Third Party (TTP). In specific, a TTP is used to generate, distribute, and revoke digital certificates to/from medical practitioners and healthcare organizations wishing to communicate in a secure way. Digital certificates and digital signatures are, in particular, used to provide peer and data origin authentication and access control functionalities. We also propose a logical Public Key Infrastructure (PKI) architecture, which is robust, scalable, and based on standards. This architecture aims at supporting large-scale healthcare applications. It supports openness, scalability, flexibility and extensibility, and can be integrated with existing TTP schemes and infrastructures offering transparency and adequate security. Finally, it is demonstrated that the proposed architecture enjoys all desirable usability characteristics, and meets the set of criteria, which constitutes an applicable framework for the development of trusted medical services over the Web.

Certification↗
PubMed2002

Necessary security mechanisms in a PACS DICOM access system with web technology.

The evolution in information and telecommunication technologies has allowed the development of systems that use the Internet infrastructure and Web technology to remotely access a hospital's picture archiving and communication system (PACS). However, one of the main problems in the construction of this type of system is the development of mechanisms that guarantee the security of the medical data that are being consulted. Most countries have specific norms for the protection of such medical data. This work describes security mechanisms that are developed in an access system to PACS DICOM with Web technology and comply with the Spanish legislation concerning the protection of medical data. The proposed security mechanisms are flexible, they leave room for the definition of security policies adjusted to the needs of each particular organization and they can be adapted to comply with new or foreign norms.

Computer Security↗
PubMed1995

The crucial roles of standards and strategy in developing a regional health information network.

Contemporary medical practice increasingly involves the use of inter-professional teams and complex care protocols. Increasing emphasis on value for money, medical audit, quality assurance and optimal outcomes requires that the practitioner has ready access to large amounts of up-to-date information, and that various abstracts and summaries of cases are made available quickly to providers, purchaser/funders, statisticians and researchers, and others. Rapid movements of large quantities of information is vital for the future success of health care: development of health information networks are vital strategic goals. In 1991 New Zealand initiated a widespread process of health services reform, whose success depended upon better availability and faster movements of information. The first phase of a national network to support these needs was successfully implemented in mid 1993: this provided for a point of connection for all individuals and organisations involved in the health sector, using commercial networking services. Fundamental to this development has been the adoption adaptation and development of appropriate standards and specifications for interconnection profiles, communications protocols, message formats, privacy and security requirements classification and coding systems and data element definitions. These have been selected to provide the maximum utility whilst imposing the minimum of constraints on the diversity of end user systems.

Computer Communication Networks↗
PubMedDate not supplied

The role of risk analysis in European harmonisation of security for healthcare information systems.

This paper examines the nature of security in the context of health care and explores the importance of the identification of risk. A brief description is given of the results of the risk analysis reviews conducted as part of the AIM project, SEISMED (Secure Environment for Information Systems in Medicine). The conclusion is that the results of some form of risk analysis are essential for providing relevant input to the management decision-making processes.

Computer Security↗
PubMed1998

Security in the management of information systems.

Although security technology exists in abundance in health information management systems, the implementation of that technology is often lacking. This lack of implementation can be heavily affected by the attitudes and perceptions of users and management, the "people part" of systems. Particular operational, organizational, and economic factors must be addressed along with employment of security objectives and accountability. Unique threats, as well as controls, pervade the use of microcomputer-based systems as these systems permeate health care information management.

Attitude to Computers↗
PubMed2002

[Telemedicine and general practice--future or present. Telemedicine, a way to strengthen the gatekeeper role?].

Electronic communication and data-processing are by no means a new phenomenon in general practice. The next logical step might be to include telemedicine, i.e. images, sound, video, and other kinds of medical information in the communication process. The potential for applying telemedicine in the adjoining areas between the general practice and the hospitals and patients is reviewed. We assume that an increase in the use of electronic communication and telemedicine will strengthen the central role of general practice. A representative sample of international literature is reviewed. The findings are that patients have no substantial misgivings against the use of telemedicine, but scientific documentation of the influence on the patient-doctor relationship, on the quality and quantity of the medical work, and on the job satisfaction of general practitioners is still not available. We present a number of suggestions regarding the use of electronic communication between the general practitioner and the patient. The importance of providing clear, in-depth information to the patient about the use of medical IT communication is underlined. The aspect of data-security is evaluated, and for lack of precise guidelines from health officials it is our suggestion that the report from the Danish Ministry of Finance regarding data-security in public administration is consulted. As to data-access, doctors and patients should be placed on two different safety-levels. It's suggested that doctors should be equipped with a digital key, whereas patients should use a pin code and their social security number. The use of traditional e-mail is dissuaded when exchanging sensitive, person-related information. The importance of valid evaluation of new IT functions is underlined.

Computer Communication Networks↗
PubMed2002

Developing a Public Key Infrastructure for a secure regional e-Health environment.

OBJECTIVES: Internet technologies provide an attractive infrastructure for efficient and low cost communications in regional health information networks. The advantages provided by the Internet come however with a significantly greater element of risk to the confidentiality and integrity of information. This is because the Internet has been designed primarily to optimize information sharing and interoperability, not security. The main objective of this paper is to propose the exploitation of public-key cryptography techniques to provide adequate security to enable secure healthcare Internet applications. METHODS: Public-key cryptography techniques can provide the needed security infrastructure in regional health networks. In the regional health-care security framework presented in this paper, we propose the use of state-of-art Public Key Infrastructure (PKI) technology. Such on e-Health PKI consists of regional certification authorities that are implemented within the central hospitals of each region and provide their services to the rest of the healthcare establishments of the same region. RESULTS: Significant experience in this area has been gained from the implementation of the PKI@AUTH project. CONCLUSIONS: The developed PKI infrastructure already successfully provides its security services to the AHEPA university hospital. The same infrastructure is designed to easily support a number of hospitals participating in a regional health information network.

Computer Security↗
PubMed2004

Security requirements in EHR systems and archives.

EHR system is a system for recording, retrieving, and manipulating information in electronic health care records. Archive is an organisation that intends to preserve health records for access and use for an identified group of consumers. There exist many combinations of EHR-systems and archives. EHR-system can be a single on-line system with integrated archiving functions or archive and EHR-system are co-operative or federated systems. This paper describes both common security requirements for EHR-systems and archives and security requirement specific for archives. Requirements are derived from ethical and legal principles. From principles a set of security requirements are derived. Safeguards for implementing security are discussed. In practise EHR-system and archive share many security services. This document is proposing that inside a security domain both the archive and EHR-system have a common security policy. In addition to this the archiving organisation needs a documented policy for information preserving and a policy for access and distribution of information between other archives.

Access to Information↗