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Enabling the sharing of neuroimaging data through well-defined intermediate levels of visibility.

The sharing of neuroimagery data offers great benefits to science, however, data owners sharing their data face substantial custodial responsibilities, such as ensuring data sets are correctly interpreted in their new shared context, protecting the identity and privacy of human research participants, and safeguarding the understood order of use. Given choices of sharing widely or not at all, the result will often be no sharing, due to the inability of data owners to control their exposure to the risks associated with data sharing. In this context, data sharing is enabled by providing data owners with well-defined intermediate levels of data visibility, progressing incrementally toward public visibility. In this paper, we define a novel and general data sharing model, Structured Sharing Communities (SSC), meeting this requirement. Arbitrary visibility levels representing collaborative agreements, consortium memberships, research organizations, and other affiliations are structured into a policy space through explicit paths of permissible information flow. Operations enable users and applications to manage the visibility of data and enforce access permissions and restrictions. We show how a policy space can be implemented in realistic neuroinformatic architectures with acceptable assurance of correctness, and briefly describe an open source implementation effort.

Academies and Institutes↗

The Health Insurance Portability and Accountability Act: implications for the dental profession.

HIPAA is generating long-awaited change in the health care world. Administrative, operational, and technical solutions are being created in response to the requirements of HIPAA. The current rules emphasize that the regulations' provisions are scalable and allow all entities, whenever possible, to determine how extensively they will address certain issues. The larger the organization, the more complex the HIPAA strategy must be. Implementation in a small dental practice requires a simple strategy compared to that of a health care plan or clearinghouse. It still takes time and resources for a dental practice to accommodate the numerous HIPAA requirements, however. Although a dentist may find the rules at HHS Web site or other Internet sites, he or she may wish to rely on vendors, consultants, and the guidance of the ADA and other dental organizations to help implement them. The dentist also should keep in mind that HIPAA compliance is an evolutionary process; future modifications are necessary. As a result, some of the information contained in this material may not be accurate by the time this issue in printed. Dentists always should consult sources such as the ADA or HHS Web site to procure current HIPAA information.

Computer Security↗

Professional ethics as basis for legal control of health care information.

The development of uniform, ethical and internationally enforceable standards for handling computerised electronic patient records is a major requirement for the implementation of the next generation of health information systems. This paper develops a model code of ethics to address this issue.

Canada↗

The use of personal health information for controlling the costs of delivering health care: does the end justify the means?

With the increasing costs of medical care many countries are seeking ways of controlling costs. Two approaches are discussed; the accounting control of costs and the medicalised control of costs. The former provides a very blunt and insensitive instrument while the latter can support best practice and reduce unnecessary examinations. However, the medicalised approach requires limited access to the patients' medical files thus breaching the medical secret. The paper discusses the strict controls necessary to make this approach work in an acceptable fashion.

Computer Security↗

Designing clinical databases.

Evidence-based medicine has always relied on databases. Anyone who needs to know anything about the outcome of a treatment needs a database, but individual practitioners may feel that database design is beyond them for various reasons. Effective database design does not require complexity. This article seeks to be a practical guide for those who are contemplating development of their own database.

Computer Security↗

Alteration of computer dental radiography images.

This study was designed to determine if digital images stored on the hard drive of a Schick computer dental radiography system could be exported, altered, and then restored to the drive without any visible signs of alteration. Digital images were downloaded from the computer dental radiography system using an I-Omega Zip Drive, 100-MB capacity, and then opened in Corel Photo Paint where images were altered and manufacturer export symbols were edited. The resulting images were printed to a default printer (Fargo Foto Fun). The ease of manipulation of the exported digital images reflects the need for the manufacturer to implement safeguards so that the integrity of digital imaging cannot be compromised. Computer dental radiography has many advantages: conservation of time (instant radiographs), less radiation (50 to 60%), no chemical waste, and many viewing options. However, questions that might be raised regarding the ability of persons with minimal computer expertise, using a commercially available program to alter images should be addressed.

Computer Security↗

The Zipper: a method for using personal identifiers to link data while preserving confidentiality.

OBJECTIVE: This report describes a method for linking separate confidential data sets that contain personal identifying information while preserving required anonymity. METHODS: Research data were linked with child abuse and neglect (CAN) report data by an independent "safe" analyst using an identical set of unique identifier codes assigned to each case in both data sets after all personal identifiers had been removed. RESULTS: The research team never learned CAN report status of individuals, the state agency never saw the research data, and the desired analyses were completed using the merged data set. CONCLUSIONS: The method was successfully used to merge data from separate sources without divulging confidential information.

Abstracting and Indexing↗