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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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Security middleware infrastructure for DICOM images in health information systems.

https://arctichealth.org/en/permalink/ahliterature181791
Source
J Digit Imaging. 2003 Dec;16(4):356-64
Publication Type
Article
Date
Dec-2003
Author
Vijay N V Kallepalli
Sylvanus A Ehikioya
Sergio Camorlinga
Jose A Rueda
Author Affiliation
Department of Computer Science, University of Manitoba, 561 Machray Hall, Winnipeg, Manitoba R3T 2N2, Canada. Vijay@cs.umanitoba.ca
Source
J Digit Imaging. 2003 Dec;16(4):356-64
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Access to Information - legislation & jurisprudence
Canada
Computer Communication Networks - legislation & jurisprudence
Computer Security - legislation & jurisprudence
Confidentiality - legislation & jurisprudence
Database Management Systems - legislation & jurisprudence
Guideline Adherence - legislation & jurisprudence
Health Insurance Portability and Accountability Act - legislation & jurisprudence
Hospital Information Systems - legislation & jurisprudence
Humans
Medical Records Systems, Computerized - legislation & jurisprudence
Radiology Information Systems - legislation & jurisprudence
Signal Processing, Computer-Assisted
United States
Abstract
In health care, it is mandatory to maintain the privacy and confidentiality of medical data. To achieve this, a fine-grained access control and an access log for accessing medical images are two important aspects that need to be considered in health care systems. Fine-grained access control provides access to medical data only to authorized persons based on priority, location, and content. A log captures each attempt to access medical data. This article describes an overall middleware infrastructure required for secure access to Digital Imaging and Communication in Medicine (DICOM) images, with an emphasis on access control and log maintenance. We introduce a hybrid access control model that combines the properties of two existing models. A trust relationship between hospitals is used to make the hybrid access control model scalable across hospitals. We also discuss events that have to be logged and where the log has to be maintained. A prototype of security middleware infrastructure is implemented.
Notes
Cites: J Digit Imaging. 2002;15 Suppl 1:107-1112105707
PubMed ID
14747934 View in PubMed
Less detail