Confidentiality Of Health Information Research Articles

Privacy-aware quantum convolutional neural network for blockchain-based IoT health care data

Nowadays, the Internet of Things (IoT) is widely used in many applications, including healthcare to monitor the health condition of patients. However, it faces privacy and security issues due to the massive growth of hacking systems that provide illegal access to confidential health information. Blockchain (BC) is applied in IoT healthcare systems to manage healthcare data securely by using transparency features. In this research, a novel CAViaR Jellyfish Swarm Optimization enabled Quantum Convolutional Neural Network (CJSO-QCNN) is developed for the removal of noise in a privacy-aware BC-based IoT healthcare system. The CJSO is the combination of Conditional Autoregressive Value at Risk (CAViaR) and Jellyfish Search Optimizer (JSO). The data privacy is ensured according to the user preference by the service provider. The data is classified initially for identifying the sensitive data and is allowed for the treatment of noise, which is then stored in BC. Later, the user accesses the data by removing the noise using the CJSO-QCNN model. The valid data credentials are stored at the service provider according to user preferences. In addition, the superiority of the designed model is computed by comparing the performance with other prevailing approaches. The experimental results revealed that the CJSO-QCNN attained a maximum accuracy of 88.79%, a True Positive Rate (TPR) of 88.20%, and a True Negative Rate (TNR) of 88.61%.

Adolescent Privacy and the Electronic Health Record - Electronic Health Record Adolescent Confidentiality in a Safety Net Setting.

The 21st Century Cures Act provides improved access to one's medical record but presents new challenges to adolescent confidentiality in the domain of healthcare information technology. Adolescent patients, who have the right to confidential care in certain areas as dictated by state law, face the prospect of parents and guardians erroneously accessing their confidential health information. Our institution, the largest safety net hospital in our region, sought to quantify the proportion of adolescent patient portal accounts likely being accessed by guardians and to implement corrective measures for the patient portal sign-up process in our electronic health record (EHR) system. We manually reviewed our institution's adolescent patient portal accounts based on email addresses associated with adolescents' accounts. We implemented EHR changes to address the potential for breach of confidentiality as a result of adolescent patient portal account creation by parents/guardians. One intervention was creating a "guardrail rule" to prevent guardians from creating adolescent patient portal accounts with their own email addresses. After email reminders to adolescent patients to update their accounts, we deactivated accounts with concern for erroneous guardian access. Sixty percent of our institution's adolescent patient portal accounts had possible direct access by guardians. Following requests to update account access, 425 (18.8%) of accounts had email addresses updated by adolescent patients and 1830 (81.2%) accounts were deactivated. More nuanced EHR functionality for adolescent patients and their guardians can help healthcare systems provide confidential, patient-centered care for adolescents, while allowing guardians to access appropriate health information to facilitate care. There is an opportunity for a national consensus on how adolescents and their guardians can access health information by patient portal.

Intrusion Detection in Wireless Body Area Network using Attentive with Graphical Bidirectional Long-Short Term Memory

Recently developed low-power networked systems, wireless communications, and wireless sensors have all contributed to the rise of Wireless Sensor Networks (WSNs) as a potentially useful tool in the medical field. Securing Wireless Body Area Networks (WBANs) is essential for their widespread use in healthcare environments because the data they send frequently includes private and confidential patient health information. The study's goal is to create a system for detecting intrusions in WBAN. To best identify attacks in such systems, we present a novel “Attention-based Bi-directional Long Short-Term Memory with Graph Construction” (ABL-GC) here. The suggested approach ensures that the intrusion detection system uses only the features essential to detect a given attack, reducing the processing complexity.

Legal issues pertaining to the collection of sociodemographic data in emergency departments.

Legal issues pertaining to the collection of sociodemographic data in emergency departments.

SeSPHR A Methodology for Secure Sharing of Personal Health Records in the Cloud

The widespread acceptance of cloud-based services in the healthcare sector has resulted in cost effective and convenient exchange of Personal Health Records (PHRs) among several participating entities of the e-Health systems. Nevertheless, storing the confidential health information to cloud servers is susceptible to revelation or theft and calls for the development of methodologies that ensure the privacy of the PHRs. Therefore, we propose a methodology called SeSPHR for secure sharing of the PHRs in the cloud. The SeSPHR scheme ensures patient-centric control on the PHRs and preserves the confidentiality of the PHRs. The patients store the encrypted PHRs on the un-trusted cloud servers and selectively grant access to different types of users on different portions of the PHRs. A semi- trusted proxy called Setup and Re-encryption Server (SRS) is introduced to set up the public/private key pairs and to produce the re- encryption keys. Moreover, the methodology is secure against insider threats and also enforces a forward and backward access control. Furthermore, we formally analyze and verify the working of SeSPHR methodology through the High Level Petri Nets (HLPN). Performance evaluation regarding time consumption indicates that the SeSPHR methodology has potential to be employed for securely sharing the PHRs in the cloud. Key Words:: Access Control, Cloud Computing, Personal Health Records, Privacy.

Adolescent Consent and Confidentiality: Complexities in Context of the 21st Century Cures Act.

Adolescent Consent and Confidentiality: Complexities in Context of the 21st Century Cures Act.

Lattice-Based Self-Enhancement Authorized Accessible Privacy Authentication for Cyber-Physical Systems

Healthcare cyber-physical system significantly facilitates healthcare services and patient treatment effectiveness by analyzing patients’ health information data conveniently. Nevertheless, it also develops the threats to the confidentiality of health information, patients’ privacy, and decidability of medical disputes. And, with the advances of quantum computing technology, most existing anonymous authentication schemes are becoming a growing threat to traditional cryptosystems. To address these problems, for healthcare cyber-physical systems, we propose a new lattice-based self-enhancement authorized accessible privacy authentication scheme by using a strong designated verifier double-authentication-preventing signature technique, called SEAPA. The SEAPA achieves three security and privacy requirements including unforgeability, anonymity for patients’ information, and self-enhancement for patients themselves. A detailed security proof shows our proposal achieves those required security goals. Finally, our construction is demonstrated by parameter analysis and performance evaluation to have reasonable efficiency.

Cancelable electrocardiogram biometric system based on chaotic encryption using three‐dimensional logistic map for biometric‐based cloud services

AbstractBiometric features are extensively employed for security purposes, but they are vulnerable to threats and can be lost or compromised. Electrocardiogram (ECG) has been utilized as one of the most favorable biometrics. However, it contains confidential patient health information and personal identification details. Moreover, security flaws take place in hacking scenarios. Therefore, original biometrics must be secured by preventing them from being used in biometric databases. The enhanced security trend in biometric authentication is cancelable biometrics. Cancelable biometric systems can be built by generating regularly repeated distortions of biometric features to secure the sensitive data of the users. When cancelable features are disclosed, distortion parameters are modified, and new cancelable templates are generated. This paper presents a proposed cancelable ECG recognition system based on the 3D chaotic logistic map encryption, which has highly efficient random characteristics with confusion and diffusion properties. Normal and abnormal ECG signals have been used to test the proposed cancelable biometric recognition system, and good access results have been obtained. The results of the simulation indicate that the proposed system is secure, reliable, and practicable even with ECG signals for patients.

Ensuring Adolescent Patient Portal Confidentiality in the Age of the Cures Act Final Rule

PurposeManaging confidential adolescent health information in patient portals presents unique challenges. Adolescent patients and guardians electronically access medical records and communicate with providers via portals. In confidential matters like sexual health, ensuring confidentiality is crucial. A key aspect of confidential portals is ensuring that the account is registered to and utilized by the intended user. Inappropriately registered or guardian-accessed adolescent portal accounts may lead to confidentiality breaches. MethodsWe used a quality improvement framework to develop screening methodologies to flag guardian-accessible accounts. Accounts of patients aged 12–17 were flagged via manual review of account emails and natural language processing of portal messages. We implemented a reconciliation program to correct affected accounts’ registered email. Clinics were notified about sign-up errors and educated on sign-up workflow. An electronic alert was created to check the adolescent’s email prior to account activation. ResultsAfter initial screening, 2,307 of 3,701 (62%) adolescent accounts were flagged as registered with a guardian’s email. Those accounts were notified to resolve their logins. After five notifications over 8 weeks, 266 of 2,307 accounts (12%) were corrected; the remaining 2,041 (88%) were deactivated. ConclusionsThe finding that 62% of adolescent portal accounts were used/accessed by guardians has significant confidentiality implications. In the context of the Cures Act Final Rule and increased information sharing, our institution’s experience with ensuring appropriate access to adolescent portal accounts is necessary, timely, and relevant. This study highlights ways to improve patient portal confidentiality and prompts institutions caring for adolescents to review their systems and processes.

Special issue on communications and networking approaches for combating COVID-19

The COVID-19 pandemic has had an impact across the globe. This includes the many lives lost and the severe disruption to economies and daily lives. Researchers in a variety of fields have been motivated to use their expertise to help address the many challenges of this on-going pandemic. Communication and Networking researchers are among these. Communications and networking technologies can be utilized to help facilitate contact tracing and other forms of remote health monitoring. Epidemic models developed for studying the propagation of information and viruses in communication networks can be adapted to study the propagation of a true epidemic like COVID-19. Techniques such as machine learning can be utilized to make better predictions from limited public health data. Approaches for security and privacy can be leveraged to protect confidential health information. The goal of this special issue of the Journal of Communications and Networks is to highlight some of the work being done in these important areas.

A Secure Framework for Record Exchange Between Medical Institutions

The Personal Health Record (PHR) is a framework of health information exchange. In the digital age, hospitals and medical institutions are moving to an online platform to store the medical record of patients because physical storage has become quite labor-intensive, expensive and also very inconvenient in terms of maintenance and retrieval while online storage overcomes those obstacles. But there are still numerous privacy concerns as confidential health information may be accessed by unauthorized people. Storage of medical records and other patients related information on third party servers may be vulnerable to breaches as third-party servers usually do not possess a lot of security. To assure the patient’s authority over to their PHRs, this method is used, to encrypt the PHRs before storing on a server and that data is linked with the blockchain. In this paper, we propose a model and mechanism for control of data access to Personal Health Records stored on the cloud. To achieve efficient data access control for Personal Health Records, we use AES and SHA algorithm as an approach to encrypt each PHR file. The analysis and results exhibit the security and efficiency of our proposed scheme.

SeSPHR: A Methodology for Secure Sharing of Personal Health Records in the Cloud

The widespread acceptance of cloud based services in the healthcare sector has resulted in cost effective and convenient exchange of Personal Health Records (PHRs) among several participating entities of the e-Health systems. Nevertheless, storing the confidential health information to cloud servers is susceptible to revelation or theft and calls for the development of methodologies that ensure the privacy of the PHRs. Therefore, we propose a methodology called SeSPHR for secure sharing of the PHRs in the cloud. The SeSPHR scheme ensures patient-centric control on the PHRs and preserves the confidentiality of the PHRs. The patients store the encrypted PHRs on the un-trusted cloud servers and selectively grant access to different types of users on different portions of the PHRs. A semi-trusted proxy called Setup and Re-encryption Server (SRS) is introduced to set up the public/private key pairs and to produce the re-encryption keys. Moreover, the methodology is secure against insider threats and also enforces a forward and backward access control. Furthermore, we formally analyze and verify the working of SeSPHR methodology through the High Level Petri Nets (HLPN). Performance evaluation regarding time consumption indicates that the SeSPHR methodology has potential to be employed for securely shar-ing the PHRs in the cloud.

Decision-making processes of a nurse working in mental health, regarding disclosure of confidential personal health information of a patient assessed as posing a risk

Background Nurses working in mental health routinely face difficult decisions regarding confidentiality and disclosure of patient information. There is public interest in protecting patient confidentiality, and there is a competing public interest in disclosing relevant confidential information to protect the patient or others from harm. However, inappropriate disclosures may constitute a breach of confidentiality. Despite the gravity of this situation, there is a paucity of literature to guide nurses’ decision-making processes regarding confidentiality and disclosure. Aim To examine decision-making processes of a nurse working in mental health, regarding disclosure of personal health information of a patient assessed as posing a risk. Methods Qualitative interpretivist approach using thematic analysis of data derived from an instrumental case study of NK v Northern Sydney Central Coast Area Health Service 2010, a Civil and Administrative Tribunal matter in New South Wales, Australia. Findings Three important legal concerns relevant to nurses’ decision-making processes are illuminated. Firstly, for risk assessment there was an emphasis on a static notion of dangerousness. Secondly, rules of confidentiality and disclosure were not adequately observed. Thirdly, confidential information was disclosed without valid justification. Discussion Inappropriate decision-making processes that may lead to a breach of patient confidentiality were evident in the findings. Gaps in understanding nurses’ decision-making processes pertaining to confidentiality and disclosure of patient information that may be addressed by future research were also revealed. Conclusion Future research that addresses gaps in understanding nurses’ decision-making processes identified by this instrumental case study would provide greater guidance for nurses when making decisions regarding confidentiality and disclosure related to risk.

Court-ordered assessments and routine access to confidential health information: findings from a regional forensic mental health service

Health Assessors undertaking court ordered assessments are granted access to material related to the alleged They do not have access to defendant’s confidential health records. Defendant’s consent must be obtained for their health information to be accessed. One hundred files of court ordered reports were audited, to see whether Health Assessors in a New Zealand regional forensic mental health service had obtained such consent. The results were categorised as follows: Category 1: Consent was provided and health record accessed, c (n = 76). Category 2: Consent was not provided and health information not accessed (n = 5) – included defendants deemed unfit to stand trial and unable to give informed consent (n = 2). Category 3: Consent was not provided but health information accessed (n = 19). Ethical and medico-legal implications of Health Assessors accessing defendant’s confidential health records are discussed. Recommendations are made for improving services so that public trust in the integrity of confidential information can be maintained.

Findings from the Health Information Management Section of the 2020 International Medical Informatics Association Yearbook.

Summary Objectives : To summarize the recent literature and research and present a selection of the best papers published in 2019 in the field of Health Information Management (HIM) and Health Informatics. Methods : A systematic review of the literature was performed by the two section editors with the help of a medical librarian. The search through bibliographic databases for HIM-related papers was achieved using both MeSH headings and keywords in titles and abstracts. A shortlist of 15 candidate best papers was first selected by section editors before being peer-reviewed by independent external reviewers. Results : Over half of the 15 papers addressed the issue of data quality in the electronic health record (EHR). In addition to the focus on data quality, there were papers on other topics of long-standing interest to the field of HIM. These topics include privacy, security, and confidentiality of health information, comparability of different coding vocabularies, classifications and terminologies, and the HIM workforce. Finally, there were papers on newer topics for the HIM field, including mobile Health (mHealth), EHR use by public health departments, and usability of different strategies for displaying information in the EHR. Conclusions : Traditional HIM concerns about HIM practice and workforce as well as issues about data in the EHR including data quality, coding, and privacy and confidentiality continue to be a large part of the HIM research literature. However, newer topics which reflect innovative and emerging technologies, usability assessments, and the application of the EHR outside the traditional clinical setting are starting to appear and more research is needed on these newer areas.

Protection of Genetic Data in Genetic Testing and Gene-Therapy Treatment: IT Law Aspects

The paper explores the problems of protection of genetic data from the perspective of IT law. Methodologically, the study is based on the system approach, methods of analysis and synthesis, comparative legal approach. In the paper, genetic information is defined as confidential health information, an object of population genetics and biometric data. The analysis makes it possible to conclude that the protection of genetic information requires the introduction of special mechanisms of legal protection, namely: the regime of strictly controlled use. Genetic data can be used in two main areas: to examine the characteristics of individuals based on the analysis of their genetic data; to identify individuals by their genetic data prints. Genetic analysis of facial characteristics can only be done for medical or scientific purposes. The person’s consent must be obtained before the study is carried out. Russian legislation requires clarification concerning the form and duration of such a consent. Analysis of DNA images in civil proceedings can only be carried out at the request of the court and with the consent of the person concerned. Prohibition of “discrimination” based on health conditions, including prohibition of taking into account the results of genetic tests predicting a yet unidentified disease or genetic predisposition to a disease, can be interpreted as a general prohibition of the use of “prognostic” genetic tests for economic and social purposes.

SOCIAL ENGINEERING AS AN EVOLUTIONARY THREAT TO INFORMATION SECURITY IN HEALTHCARE ORGANIZATIONS

Information security in healthcare settings is overlooked even though it is the most vulnerable for social engineering attacks. The theft of hospital information data is critical to be monitored as they contain patients’ confidential health information. If leaked, the data can impact patients’ social as well as professional life. The hospital data system includes administrative data, as well as employees’ personal information hacked, which can cause identity theft. The current paper discusses types and sources of social engineering attacks in healthcare organizations. Social engineering attacks occur more frequently than other malware attacks, and hence it is crucial to understand what social engineering is and its vulnerabilities to understand the prevention measures. The paper describes types of threats, potential vulnerabilities, and possible solutions to prevent social engineering attacks in healthcare organizations. Keywords: social engineering, hospitals, healthcare organizations, information security.

Electronic Personal Health Records and the Question of Privacy

Personal health records (PHRs), centralized places for consumers to electronically store, manage, and share their personal health information, offer new opportunities to help consumers manage their own health and health care. However, ensuring the privacy and confidentiality of health information contained within PHRs is challenging. This paper analyzes the major properties of existing PHR systems and identifies specific privacy and security issues with each type of PHR. It proposes a consumer-controlled privacy protection approach that includes high-minded privacy principles such as independent consent management, independent privacy and security audits, and regulatory compliance requirements. It further presents a consumer-controlled system architecture that embodies these principles in the web-based PHR system.

A Mobile Health Contraception Decision Support Intervention for Latina Adolescents: Implementation Evaluation for Use in School-Based Health Centers.

BackgroundHealth care providers are a trusted and accurate source of sexual health information for most adolescents, and clinical guidelines recommend that all youth receive comprehensive, confidential sexual health information and services. However, these guidelines are followed inconsistently. Providers often lack the time, comfort, and skills to provide patient-centered comprehensive contraceptive counseling and services. There are significant disparities in the provision of sexual health services for Latino adolescents, which contribute to disproportionately higher rates of teenage pregnancy. To address this, we developed Health-E You or Salud iTu in Spanish, an evidence-informed mobile health (mHealth) app, to provide interactive, individually tailored sexual health information and contraception decision support for English and Spanish speakers. It is designed to be used in conjunction with a clinical encounter to increase access to patient-centered contraceptive information and services for adolescents at risk of pregnancy. Based on user input, the app provides tailored contraceptive recommendations and asks the youth to indicate what methods they are most interested in. This information is shared with the provider before the in-person visit. The app is designed to prepare youth for the visit and acts as a clinician extender to support the delivery of health education and enhance the quality of patient-centered sexual health care. Despite the promise of this app, there is limited research on the integration of such interventions into clinical practice.ObjectiveThis study described efforts used to support the successful adoption and implementation of the Health-E You app in clinical settings and described facilitators and barriers encountered to inform future efforts aimed at integrating mHealth interventions into clinical settings.MethodsThis study was part of a larger, cluster randomized control trial to evaluate the effectiveness of Health-E You on its ability to reduce health disparities in contraceptive knowledge, access to contraceptive services, and unintended pregnancies among sexually active Latina adolescents at 18 school-based health centers (SBHCs) across Los Angeles County, California. App development and implementation were informed by the theory of diffusion of innovation, the Patient-Centered Outcomes Research Institute’s principles of engagement, and iterative pilot testing with adolescents and clinicians. Implementation facilitators and barriers were identified through monthly conference calls, site visits, and quarterly in-person collaborative meetings.ResultsImplementation approaches enhanced the development, adoption, and integration of Health-E You into SBHCs. Implementation challenges were also identified to improve the integration of mHealth interventions into clinical settings.ConclusionsThis study provides important insights that can inform and improve the implementation efforts for future mHealth interventions. In particular, an implementation approach founded in a strong theoretical framework and active engagement with patient and community partners can enhance the development, adoption, and integration of mHealth technologies into clinical practice.Trial RegistrationClinicalTrials.gov NCT02847858; https://clinicaltrials.gov/ct2/show/NCT02847858 (Archived by WebCite at http://www.webcitation.org/761yVIRTp).

Accessing Confidential Health Information by Mobile Devices the Trend of Online Treatment and Use of Social Media for Health Services

The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices.