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Results for “secured computing”

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PubMed1995

Australian healthcare: a smart card for a clever country.

In this paper we give an overview of smart card technology how a smart card could be used as a healthcare card and the benefits that would most likely result from doing so. The smart card memory can be zoned into different security levels. The top security zone may contain an individual's full medical history while the lowest security zone may contain the cardholders name and address. Access to the different zones depends on the level of security of the zone. The higher the security level the more restrictive the access method. Were smart cards adopted for the storage of medical histories it would change the form of medical information recorded, not merely convert paper files to electronic ones. Storage of an individual's medical history on a smart card raises important privacy issues. These privacy issues are discussed particularly as they relate to the Australian community.

Australia↗

PubMed1998

Availability of health data: requirements and solutions.

There is an increasing recognition of the importance of the health data available for the corporate healthcare system model with the electronic patient record as the central unit of the healthcare information systems. There is also increasing recognition of the importance of developing simple international standards for record components, including clinical and administrative requirements. Aspects of security and confidentiality have to be reviewed in detail. The advantages of having health data available when and where it is required will modify healthcare delivery and support cost control with economies of scale and sharing of resources. The infrastructure necessary to make this model a reality is being developed through different international initiatives, which have to be integrated and co-ordinated to have common disaster planning strategies and better funding alternatives.

Computer Communication Networks↗

PubMedDate not supplied

Computer networking in an ambulatory health care setting.

Computers are a ubiquitous part of the ambulatory health care environment. Although stand-alone computers may be adequate for a small practice, networked computers can create much more powerful and cost-effective computerized systems. Local area networks allow groups of computers to share peripheral devices and computerized information within an office or cluster of offices. Wide area networks allow computers to securely share devices and information across a large geographical area. Either singly or in combination, these networks can be used to create robust systems to help physicians automate their practices and improve their access to important clinical information. In this article, we will examine common network configurations, explain how they function, and provide examples of real-world implementations of networking technology in health care.

Ambulatory Care↗

PubMed2006

Comparing approaches for advanced e-health security infrastructures.

OBJECTIVES: The healthcare systems of all developed countries face the challenge for improving quality, efficiency and safety of patients' care. For meeting this challenge, health is moving from being organisation-centred to process-based care. This process will continue in the future turning health towards person-centred architectures. This system transformation is combined with extended and advanced communication and collaboration supported and enabled by appropriate information and communication technologies (ICT), also called e-health. The resulting solutions have to be trustworthy. METHODS: There is a set of security services needed for realising trustworthy e-health solutions. Those security services must be comprehensively integrated in the e-health application. Furthermore, a set of infrastructure services has to be specified and implemented. For keeping the solutions future-proof, they have to comply with architectural principles and paradigms. RESULTS: After shortly introducing meanwhile internationally acknowledged architectural paradigms for applications, means and infrastructures providing security services, existing, or specified advanced solutions are described and compared. In that context, the Electronic Health Record as e-health core application has been especially considered. Based on published work as well as on explored solutions, the security services needed are summarised and evaluated. The pros and cons of investigated examples are collected and interpreted. In that context, especially the German health telematics framework architecture and security infrastructure and the corresponding implementable solutions on the one hand and the USA Veterans Health Administration approach to security have been carefully considered. CONCLUSION: Processes and systems are determined by policies, which define and distinguish constraints for communication and collaboration. Therefore, formally modelling policies and performing policy bridging are the main challenges to be met. As result of investigations, recommendations have been derived for establishing the trustworthiness required for any e-health solution at different level from regional to national, European, and even global scale, which are included in the conference summary.

Computer Security↗

PubMedDate not supplied

A national agenda for public health informatics: summarized recommendations from the 2001 AMIA Spring Congress.

The AMIA 2001 Spring Congress brought together members of the the public health and informatics communities to develop a national agenda for public health informatics. Discussions of funding and governance; architecture and infrastructure; standards and vocabulary; research, evaluation, and best practices; privacy, confidentiality, and security; and training and workforce resulted in 74 recommendations with two key themes-that all stakeholders need to be engaged in coordinated activities related to public health information architecture, standards, confidentiality, best practices, and research; and that informatics training is needed throughout the public health workforce. Implementation of this consensus agenda will help promote progress in the application of information technology to improve public health.

Computer Security↗

PubMed2003

Database design to ensure anonymous study of medical errors: a report from the ASIPS Collaborative.

Medical error reporting systems are important information sources for designing strategies to improve the safety of health care. Applied Strategies for Improving Patient Safety (ASIPS) is a multi-institutional, practice-based research project that collects and analyzes data on primary care medical errors and develops interventions to reduce error. The voluntary ASIPS Patient Safety Reporting System captures anonymous and confidential reports of medical errors. Confidential reports, which are quickly de-identified, provide better detail than do anonymous reports; however, concerns exist about the confidentiality of those reports should the database be subject to legal discovery or other security breaches. Standard database elements, for example, serial ID numbers, date/time stamps, and backups, could enable an outsider to link an ASIPS report to a specific medical error. The authors present the design and implementation of a database and administrative system that reduce this risk, facilitate research, and maintain near anonymity of the events, practices, and clinicians.

Computer Security↗

PubMed1996

The EDITH approach: the management of authorisations and security in healthcare information systems.

This paper provides a summary of the approach adopted by EDITH for the definition and management of the security aspects within a generic healthcare information system, organised according to a common architecture based on characteristics of modularity, openness and federation of the individual healthcare organisations and healthcare information systems. The specification and actual development of the Authorisation Server, shortly described in this paper, is the result of the joining of the activities carried out by GESI in the frame of the NUCLEUS (AIM 2025) and EDITH-Italy (ESPRIT 7058) projects.

Authorship↗

PubMed2000

HIPAA brings new requirements, new opportunities.

The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) brought with it the need for Federal rules to implement the act's simplification and cost-reduction efforts. HHS has published proposed rules related to security for the electronic transmission of health information, privacy of individually identifiable health information, transactions and code sets, and national provider and employer identifiers. Additional proposed rules will be published this year for claims attachments and health plan identifiers. Although HIPAA does not require providers to conduct business electronically, the new standards give providers the opportunity to reduce healthcare administrative costs significantly and undertake electronic commerce efficiently and cost-effectively.

Computer Security↗

PubMed1995

The implementation of security in health care information systems: closing the gap between theory and practice.

Even if all necessary information is available, the implementation of security in Hospital Information Systems is a complex process; the gap between theory and practice is still considerable. This paper describes the efforts made at Leiden University Hospital (AZL) to overcome this problem (at least partially), by using a database method to provide some structure in the data. This work is part of the SEISMED-project [1,2], sponsored by the European Union through its AIM-programme (Advanced Informatics in Medicine).

Computer Security↗

PubMedDate not supplied

Evaluating HIPAA compliance: a guide for researchers, privacy boards, and IRBs.

The purpose of this article is to describe implications of the Health Information Portability and Accountability Act of 1996 (HIPAA) for nurses engaged in human and health services research. In general, a person's private health information (PHI) may only be disclosed for treatment, payment, and business procedures related to healthcare service delivery. Access and/or use of the same information for research purposes necessitates another layer of review and may require a separate process of authorization. A brief historical overview of regulatory requirements regarding health information privacy and security standards for the electronic transformation of data and protection of electronically kept medical records is discussed and related to the role and responsibilities of researchers and organizations where research is conducted. In addition, a generic document template adaptable for use by an individual or organization is presented that can provide a quick, systematic review of HIPAA compliance when a research proposal is being developed or is received that seeks access to PHI.

Computer Security↗

PubMed2000

HIPAA security: compliance in radiology--an academic radiology department's plan contrasted with a small private practice.

In complying with the HIPAA security regulations, the large, multi-site academic radiology department is quite different from the small, private radiology practice. This article compares and contrasts the methods each of these two model organizations use to achieve compliance. In common between the two organizations is that complete documentation of the procedures and processes involved in data management must be prepared and reviewed. Although not required in the regulations, having the documentation conform to the regulation allows for easy monitoring, auditing, and certification of compliance by future independent bodies. The level to which each organization must secure their data, perform threat assessments, and implement security procedures and intrusion detection systems are very different. The regulations do not specify what level of due diligence is required. This must be determined by each organization using their own common-sense dictum. Although the solutions used by these two types of organizations may not be the same as those adopted by other radiology departments and practices, the approaches may still serve as useful templates to guide compliance efforts by others.

Academic Medical Centers↗

PubMed2001

Shared experience in 13 local Danish EPR projects: the Danish EPR Observatory.

In 1996 a national strategy for the development of electronic patient records (EPR) for the Danish hospitals and primary care was launched. An element in the strategy was to support a number of regional EPR development projects. The EPR-Observatory has in the two recent years collected data from the regional projects, dealing with the expectations in four areas: 1) Impact on organisational issues, 2) Benefits of EPR, 3) Integration of EPR with other information systems and 4) security aspects of EPR. Among the observations an increasing teamwork and im-proved knowledge about the patient was found. What was expected, but not found, was resistance to EPR, as a result of changes in skills and power. The most obvious benefits are increased data accessibility and improved decision ma-king. The most considerable disadvantage is an enormous growth in discontent with the systems performance and the fact, that all the projects are delayed. Many different types of integration solutions are chosen, because of a lack of a common model for integration. Generally the projects find, that EPJ yields increased security, but logistical problems arise in having the systems running 24 hours 7 days a week. Economical benefits cannot be documented. This relates to the fact, that the regional projects are stand-alone projects. The ongoing growth in discontent with the EPR-systems and the fact, that all the projects are delayed must be subject to further exploration.

Attitude to Computers↗

PubMed2003

Health insurance reform: security standards. Final rule.

This final rule adopts standards for the security of electronic protected health information to be implemented by health plans, health care clearinghouses, and certain health care providers. The use of the security standards will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general by establishing a level of protection for certain electronic health information. This final rule implements some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Centers for Medicare and Medicaid Services, U.S.↗

PubMed2002

Access control administration in healthcare applications.

The interconnection of information systems of different parties involved in healthcare applications leads to the need for information sharing across large-scale and highly distributed database systems. Applying appropriate access control policies in an effective and flexible way is a specific task for a number of local security officers that must operate according to a high-level access control administration system. The particular security requirements of healthcare information systems are reflected to the access control system, which must be flexible and dynamically adaptable to the daily activities. Decentralizing access control administration can be achieved in a uniform and consistent way when applying appropriate administrative rules and constraints. In this paper are presented the basic features of an access control administration model for interconnected information systems, as in the healthcare environment.

Access to Information↗

PubMed2003

Secure communication and management of clinical and genomic data: the use of pseudonymisation as privacy enhancing technique.

The growing need of managing both clinical and genetic data raises important legal and ethical challenges. This article introduces some of the privacy protection problems related to genomic medicine and highlights the relevance of Trusted Third Parties and of Privacy Enhancing Techniques (PETs) in the context of e.g. research. Practical approaches based on two pseudonymisation models, for both batch and interactive data collection and exchange, are presented.

Access to Information↗

PubMedDate not supplied

Security, privacy, and confidentiality issues on the Internet.

We introduce the issues around protecting information about patients and related data sent via the Internet. We begin by reviewing three concepts necessary to any discussion about data security in a healthcare environment: privacy, confidentiality, and consent. We are giving some advice on how to protect local data. Authentication and privacy of e-mail via encryption is offered by Pretty Good Privacy (PGP) and Secure Multipurpose Internet Mail Extensions (S/MIME). The de facto Internet standard for encrypting Web-based information interchanges is Secure Sockets Layer (SSL), more recently known as Transport Layer Security or TLS. There is a public key infrastructure process to 'sign' a message whereby the private key of an individual can be used to 'hash' the message. This can then be verified against the sender's public key. This ensures the data's authenticity and origin without conferring privacy, and is called a 'digital signature'. The best protection against viruses is not opening e-mails from unknown sources or those containing unusual message headers.

Computer Security↗

PubMed1996

How to assure security: CEN standards, directives, or European Guidelines?

It is argued, that to assure security, we need to make use of all three vehicles mentioned in the title, provided we select carefully which type to use in what circumstances. Many useful activities in these areas are under way. There is an important danger, however: if we do not take into account the needs of practical applicability, the net result of all efforts might be an increase of the gap between theory and practice, and thus a contrary effect of the intended one.

Computer Security↗

PubMed1998

Security and confidentiality in an electronic medical record.

The maintenance of privacy and confidentially must remain a core principle of the interaction between patients and medical staff. Traditionally, the single paper copy of the medical history has been treated with systematic handling, careful tracking, and respect for the integrity and confidentiality of the contents. The widespread availability of computerized information requires that these principles be maintained in the electronic environment. Security measures should protect sensitive data without hindering medical practice. At Mayo, we have established data security policies and standards for the handling of all electronic information. Dissemination and communication of these standards and guidelines are an ongoing challenge. Technical maneuvers can be employed to protect data integrity, identify users, and monitor compliance. Personnel policies must be updated to reflect the responsibilities and liabilities of the electronic environment. Practice efficiencies and access to clinical data must be balanced by individual responsibility and accountability for privileged patient information.

Computer Security↗