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PubMed1999

Beef up your information security with the new HIPAA-mandated standards.

Beef up information security using HIPAA standards. This month, the federal Department of Health and Human Services will release the final standards for information security mandated by the 1996 Health Insurance Portability and Accountability Act (HIPAA). To comply with HIPAA, you must perform an applications and data criticality analysis and develop a data backup plan, a disaster recovery plan, and an emergency mode operation plan.

Chronology as Topic↗
PubMed2002

Methodology development for quantitative optimization of security enhancement in medical information systems -Case study in a PACS and a multi-institutional radiotherapy database-.

The target of our study is to establish the methodology for analyzing level of security requirements, for searching suitable security measures and for optimizing security distribution to every portion of medical practice. Quantitative expression must be introduced to our study as possible for the purpose of easy follow up of security procedures and easy evaluation of security outcomes or results. Results of system analysis by fault tree analysis (FTA) clarified that subdivided system elements in detail contribute to much more accurate analysis. Such subdivided composition factors very much depended on behavior of staff, interactive terminal devices, kinds of service, and routes of network. As conclusion, we found the methods to analyze levels of security requirements for each medical information systems employing FTA, basic events for each composition factor and combination of basic events. Methods for searching suitable security measures were found. Namely risk factors for each basic event, number of elements for each composition factor and candidates of security measure elements were found. Method to optimize the security measures for each medical information system was proposed. Namely optimum distribution of risk factors in terms of basic events were figured out, and comparison of them between each medical information systems became possible.

Computer Security↗
PubMed2004

HIPAA: the critical role of identity and access management.

Whether providing patients with online access to their medical records or enabling physicians to place paperless orders, there are several benefits to online electronic systems that ultimately can lead to improved patient care and outcomes. However, as healthcare providers move closer to a paperless environment and Internet-based applications, they must understand the increased risks to privacy and security that are incurred by using electronic systems. Organizations must give careful consideration to ensure that applications, authentication, authorization and provision practices are addressed to ensure HIPAA regulations are met and, more importantly, that patient care is not compromised.

Access to Information↗
PubMed1994

Joint Commission activities. IM.2: confidentiality, security, and integrity.

Confidentiality of data and information has always been at the center of the HIM profession. We have been advocates and educators for years. We must not abandon this practice. It is more important now than ever. I would like to close with a challenge. Be an ambassador for confidentiality--educate others.

Computer Security↗
PubMed2004

The costs of safeguarding privacy: one research organization's experience.

While academic health research has always observed strict vigilance in the guardianship of the rich information found in health databases, new legislation faced by all organizations ups the ante even higher. Research organizations like the Institute for Clinical Evaluative Sciences are delving into even more rigorous policies to keep sensitive information secure while preserving the value that dedicated research provides. The costs of implementing privacy protections are of great concern to Canadian researchers. This report discusses basic costs associated with privacy practices undertaken at the Institute.

Canada↗
PubMed2005

On the verification of intransitive noninterference in mulitlevel security.

We propose an algorithmic approach to the problem of verification of the property of intransitive noninterference (INI), using tools and concepts of discrete event systems (DES). INI can be used to characterize and solve several important security problems in multilevel security systems. In a previous work, we have established the notion of iP-observability, which precisely captures the property of INI. We have also developed an algorithm for checking iP-observability by indirectly checking P-observability for systems with at most three security levels. In this paper, we generalize the results for systems with any finite number of security levels by developing a direct method for checking iP-observability, based on an insightful observation that the iP function is a left congruence in terms of relations on formal languages. To demonstrate the applicability of our approach, we propose a formal method to detect denial of service vulnerabilities in security protocols based on INI. This method is illustrated using the TCP/IP protocol. The work extends the theory of supervisory control of DES to a new application domain.

Algorithms↗
PubMedDate not supplied

Irreversible encryption method by generation of polynomials.

Patient follow up, within the framework of epidemiological studies, poses the problem of linking nominal files. An encryption method of identity is proposed to allow the linkage of medical information on the same patient while respecting the confidentiality of medical data. In contrast with most encryption algorithms, the proposed method is mathematically irreversible in response to the requirement of the French National Commission of Computerized Information Security which demands that the cryptosystem must not be decipherable even by the legitimate recipient. In order to prevent deciphering by frequency analysis, the proposed method introduces polynomial operations so that neither indication concerning the length of the string nor a possible repetition of characters can be obtained by code disclosure. The security of the system is reinforced by the use of two keys, the first one to be defined by the producers of information and the second one by the recipient so that nobody can decrypt the enciphered text.

Algorithms↗
PubMed2001

Expert systems, security and quality assurance: implications of patient records as data-space.

The concept of data-space is fruitful in trying to understand the ethical rights and duties that surround the treatment of patient records. However, it also provides a solution to three apparently unconnected problems: the construction of expert diagnostic systems, the development of an internal security element within the sphere of permitted data-access for health care professionals, and the development of a professional quality assurance mechanism. This paper presents a model of how these diverse aims may be achieved. It does so by developing the notion of the logical form of data within a data-space and by showing how the path taken by a health care professional through a profession-relative data-space can provide checks for the security, quality and appropriateness of the path itself. The result is important in that it provides an integrated method for information specialists to meet their fiduciary obligations towards the patients whose records are in their care, and towards the institutions that employ them.

Computer Security↗
PubMed2002

A HIPAA strategy for dental schools.

Certain health care organizations, including dental schools, should be readying themselves to comply with the numerous requirements described within the administrative simplification section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The intent of administrative simplification is to streamline the management of health care transactions while protecting the privacy of certain written, oral, and electronic patient information. There are no field-tested plans for implementing the law because only recently has the health care industry begun to respond to the multitude of requirements. It is essential that each organization create a customized compliance plan that best fits its structure and needs. The purpose of this paper is to propose a five-stage theoretical strategy that could assist a dental school in achieving HIPAA compliance. The first stage involves the selection of a HIPAA task force. The second stage selects the applicable HIPAA requirements, determines the current states of confidentiality and security, manages the electronic transactions standards, and composes a gap analysis. The third stage examines risk analysis and management. The fourth stage encompasses technical modifications, policies and procedures, legal input, and training. The fifth stage addresses the maintenance of the implementation.

Advisory Committees↗
PubMed2002

Data protection. Get in on the act.

Informed consent for any use of data beyond immediate care and treatment is fundamental to meeting the requirements of the Data Protection Act. It is important to identify data owners and controllers and to ensure they are aware of their responsibilities to ensure that data is held securely. No data should be passed to third parties without written agreements and unless EU equivalent data protection can be ensured. NHS organisations should ensure they have good policies and training in place to ensure compliance.

Access to Information↗
PubMedDate not supplied

Telecardiology for effective healthcare services.

Continuous monitoring of the electrocardiogram (ECG) and other signals related to current heart activity are necessary for patients who are suffering from cardiac diseases. This paper deals with the work that has been carried out to transmit ECGs from remote sites. Software has been developed which enables the uploading of ECG data from a patient so that the physician can monitor the state of the patient from a distance and at the same time may consult other experts for a second opinion. Records can only be examined by the authorized physician after proper registration and diagnosis or prescription may be sent back to the referring site. Further consultation with the patient through a 'chat' facility is also possible. The suitability of the system over transport control protocol (TCP), internet protocol (IP), local area network (LAN), wide area network (WAN) and World Wide Web (WWW) has been assessed. The bandwidth, latency, availability, security and ubiquity have also been discussed. A study has also been undertaken in order to make the system compatible with available bandwidths and to find out which one out of a number of available techniques is most efficient for ECG data compression. The results indicate that the scheme is suitable for telecardiology and can form part of an overall telemedicine system in a health care network.

Computer Security↗
PubMed2002

A pragmatic discussion on establishing a multicenter digital imaging network.

Multicenter clinical trials for therapy evaluation of rare diseases are necessary. A digital imaging network improves the ability to share information between collaborating institutions for adrenoleukodystrophy. The DICOM 3.0 standard is used to move images over the Internet from contributing sites to the central clinical database and on to the reviewing physicians' workstations. Patient confidentiality and data integrity are ensured during transmission using virtual private network technology. Fifteen sites are participating in the network. Of these sites, 6 use the proposed protocol. The other 9 sites have either security policy issues or technical considerations that dictate alternative protocols. Network infrastructure, Internet access, image management practices, and security policies vary significantly between sites. Successful implementation of a multicenter digital imaging network requires flexibility in the implementation of network connectivity. Flexibility increases participation as well as complexity of the network.

Adrenoleukodystrophy↗
PubMed2002

Data security and protection in cross-institutional electronic patient records.

This paper describes data protection and data security requirements of a cross-institutional electronic patient record, and presents possible solutions for meeting these requirements. A comprehensive analysis of literature and legal documents was performed. Beside the general requirements that the EPR of a single institution must meet, specific requirements exist for cross-institutional EPRs. In Germany, patient information may only be revealed to external physicians within so-called "treatment connections". A secure connection between the EPR-systems of two health institutions in Germany, which jointly treat tumor patients, was established using additional SecuRemote Software. The development and implementation of a cross-institutional EPR is a complicated process, mainly due to data security regulations. However, its introduction is thought to be valuable, since a cross-institutional EPR will improve communication within shared care processes, and, thus, improve the quality of patient care.

Computer Security↗
PubMedDate not supplied

Balanced centralized and distributed database design in a clinical research environment.

Clinical research databases can meet both research and clinical needs, but this ideal is seldom achieved. Priorities often differ for those who collect and ultimately use the data and those who develop data systems. Traditional database designs also create logistical barriers that hamper communication. The Michigan Alzheimer's Disease Research Center has developed a secure, distributed data system with centralized data entry that provides an intuitive, individually customized interface for investigators in their clinics, laboratories and offices. Data are kept in a form that can be readily understood without reference to a code-book. Investigators can modify and query their own copies of the database without knowledge of programming languages. Balancing centralized and distributed designs for research databases enhance the accuracy and completeness of data collection and increases the use of data for research and clinical care.

Aged↗
PubMed1997

Recent implementations of electronic medical records in four family practice residency programs.

Electronic medical records (EMRs) are increasingly replacing paper records, and many residency program directors are interested in incorporating EMR systems into their clinics. The authors describe their experiences implementing EMRs in their family practice residency programs; the four programs are the Eau Claire Family Practice Residency Program, the Galveston Family Practice Residency Program, the Mayo-Scottsdale Residency Program, and the Wyoming Valley Family Practice Residency. The authors provide background information about each program and an overview of the EMR systems; they then describe the implementation processes, addressing training, integration with other software- and paper-based systems, security, costs, and effects on patient volume and staffing levels. Finally, they discuss the general benefits of and barriers to EMR-system implementations, and make recommendations for other programs considering implementing EMRs.

Attitude to Computers↗
PubMed2001

Compact storage of medical images with patient information.

Digital watermarking is a technique of hiding specific identification data for copyright authentication. This technique is adapted here for interleaving patient information with medical images to reduce storage and transmission overheads. The text data are encrypted before interleaving with images to ensure greater security. The graphical signals are compressed and subsequently interleaved with the image. Differential pulse-code-modulation and adaptive-delta-modulation techniques are employed for data compression, and encryption and results are tabulated for a specific example.

Computer Security↗