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Making a web based ulcer record work by aligning architecture, legislation and users - a formative evaluation study.

https://arctichealth.org/en/permalink/ahliterature131617
Source
Stud Health Technol Inform. 2011;169:417-21
Publication Type
Article
Date
2011
Author
Anne G Ekeland
Eva Skipenes
Beate Nyheim
Ellen K Christiansen
Author Affiliation
Norwegian Centre for Integrated Care and Telemedicine, Norway.
Source
Stud Health Technol Inform. 2011;169:417-21
Date
2011
Language
English
Publication Type
Article
Keywords
Access to Information
Computer Security
Computers, Handheld
Cooperative Behavior
Databases, Factual
Denmark
Hospital Information Systems
Humans
Internet
Medical Informatics - legislation & jurisprudence - methods
Norway
Registries
Software
Ulcer - diagnosis - epidemiology
Abstract
The University Hospital of North Norway selected a web-based ulcer record used in Denmark, available from mobile phones. Data was stored in a common database and easily accessible. According to Norwegian legislation, only employees of the organization that owns an IT system can access the system, and use of mobile units requires strong security solutions. The system had to be changed. The paper addresses interactions in order to make the system legal, and assesses regulations that followed. By addressing conflicting scripts and the contingent nature of knowledge, we conducted a formative evaluation aiming at improving the object being studied. Participatory observation in a one year process, minutes from meetings and information from participants, constitute the data material. In the technological domain, one database was replaced by four. In the health care delivery domain, easy access was replaced by a more complicated log on procedure, and in the domain of law and security, a clarification of risk levels was obtained, thereby allowing for access by mobile phones with today's authentication mechanisms. Flexibility concerning predefined scripts was important in all domains. Changes were made that improved the platform for further development of legitimate communication of patient data via mobile units. The study also shows the value of formative evaluations in innovations.
PubMed ID
21893784 View in PubMed
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[Professionally adequate health care on the Internet].

https://arctichealth.org/en/permalink/ahliterature184756
Source
Tidsskr Nor Laegeforen. 2003 Jun 26;123(13-14):1854-5
Publication Type
Article
Date
Jun-26-2003
Author
Ellen K Christiansen
Leif Erik Nohr
Author Affiliation
Nasjonalt senter for telemedisin, Universitetssykehuset Nord-Norge, Tromsø. ellen.christiansen@telemed.no
Source
Tidsskr Nor Laegeforen. 2003 Jun 26;123(13-14):1854-5
Date
Jun-26-2003
Language
Norwegian
Publication Type
Article
Keywords
Computer Security - legislation & jurisprudence
Confidentiality - legislation & jurisprudence
Health Education - legislation & jurisprudence - standards
Humans
Internet - legislation & jurisprudence
Norway
Patient Education as Topic - legislation & jurisprudence - standards
Quality Assurance, Health Care - legislation & jurisprudence - standards
Abstract
The Internet is a growing and important source of a multitude of health-related services, the majority of which are information services. New kinds of services are, however, being established, on which the users are patients and the providers are health care professionals.
Health-related websites are considered from a legal point of view, especially in relation to the legal term of "health care" and the requirements in Norwegian legislation concerning adequate services from the health care professions.
Health-related websites need to be categorised for the purpose of considerations of when to apply the health care legislation and how the requirements in this legislation can be applied in practice.
We shall soon see that the increasing demand for and use of various health-related websites on the Internet will lead to more services being offered. This is an interesting trend, but quality assurance will require that it be clarified what status they have under the legislation.
PubMed ID
12830264 View in PubMed
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Shared Electronic Health Record Systems: Key Legal and Security Challenges.

https://arctichealth.org/en/permalink/ahliterature292507
Source
J Diabetes Sci Technol. 2017 Nov; 11(6):1234-1239
Publication Type
Journal Article
Date
Nov-2017
Author
Ellen K Christiansen
Eva Skipenes
Marie F Hausken
Svein Skeie
Truls Østbye
Marjolein M Iversen
Author Affiliation
1 Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway (UNN), Tromsø, Norway.
Source
J Diabetes Sci Technol. 2017 Nov; 11(6):1234-1239
Date
Nov-2017
Language
English
Publication Type
Journal Article
Keywords
Access to Information - legislation & jurisprudence
Computer Security - legislation & jurisprudence
Confidentiality - legislation & jurisprudence
Electronic Health Records - legislation & jurisprudence
Health Policy
Humans
Information Dissemination - legislation & jurisprudence
Norway
Patient care team
Policy Making
Telemedicine - legislation & jurisprudence
Ulcer - diagnosis - therapy
Abstract
Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.
Notes
Cites: J Diabetes Sci Technol. 2011 May 01;5(3):768-77 PMID 21722592
Cites: Stud Health Technol Inform. 2011;169:417-21 PMID 21893784
Cites: JMIR Res Protoc. 2016 Jul 18;5(3):e148 PMID 27430301
PubMed ID
28560899 View in PubMed
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