Exchange Of Medical Information Research Articles

Blockchain for Healthcare Management Systems : A Survey on Interoperability and Security

In recent years it has been shown that the secure exchange of medical information significantly benefits people’s life quality, improving their care and treatment. The interoperability of the entire healthcare ecosystem is a constant challenge, and even more, with all the risks posed to the security of healthcare information. Blockchain technology is emerging as one of the main alternatives when it comes to finding a balance in the healthcare ecosystem. However, the constant development of new Blockchain technologies and the evolution of healthcare systems make it difficult to find established proposals. From an architectural point of view, the design of blockchain-based solutions requires trade-offs e.g., security and interoperability. This paper focuses on two main objectives, in the first one, it was carried out a Systematic Literature Review for exploring architectural mechanisms used to support the interoperability and security of Blockchain-based Health Management Systems. Taking into account of results, a series of scenarios were generated where these mechanisms can be used along with their context, issues, and various architectural concerns (interoperability and security). In the second objective, a high-level architecture and its validation were proposed through an experiment for the whole process of developing a Domain Specific Language, using the Model Driven Engineering methodology for specific Smart Contracts.

Pengaruh Penggunaan Aplikasi “Bumil Bahagia” Berbasis Android terhadap Tingkat Pengetahuan Faktor Risiko PEAD pada Ibu Hamil di Kabupaten Banyumas

Preeclampsia is one of the biggest problems in pregnancy and is a cause of infant and maternal death every year in the world. The low knowledge of pregnant women is one of the factors in recognizing the condition of their pregnancy. The use of digital health brings a lot of medical information exchange between patients and health workers, health services in the context of differential diagnosis, access to health is more efficient and cost effective. This study aims to determine the effect of using the android-based "pregnant mother happy" application on the level of knowledge of PEAD risk factors in pregnant women in Banyumas district. Pre-experimental design research. Sempel used the cluster sampling approach for pregnant women aged 20-34 weeks' gestation. The results of the Wilcoxon test with a p value <0.001, before being given the intervention the knowledge of pregnant women was in the good category (51.9%), after being given the intervention it increased (66.7%). There is an effect of the use of the Android-based “happy pregnant woman” application on the level of knowledge of PEAD risk factors in pregnant women in Banyumas district in 2023.

Exploring user interaction patterns in an online physician interactive community based on exponential random graph models

The online physician interactive community (OPIC) is a platform designed for medical workers to discuss medical issues. Physician users can create content in OPIC by posting and replying to posts to discuss the solutions of medical problems with other users. The OPIC plays an important role in bringing together physicians from different medical specialties and disseminating medical experience. However, most OPIC users are not very active in replying to posts, which makes it difficult to fulfill users’ needs for medical information exchange and the development of OPIC is difficult. Current research has given little attention to the communication of physician users in the OPIC. It is necessary to examine how reposting links are established between users in OPIC. This study builds a user interaction network based on the perspective of social network analysis using user repost data from a well-known OPIC in China. Then, an exponential random graph model (ERGM) was applied to quantitatively analyze this user interaction network. Some reposting patterns among OPIC users were discovered. There is significant reciprocity in OPIC of reposting interactions between users. Users with homogeneous characteristics in terms of professional status, community honor status, and geographic location were more likely to interact with each other. In addition, users who added a profile, had a higher level of social effort, and generated more neutral content were more likely to receive responses from others. This study reveals the interaction patterns between physician users in OPIC, which enriches the related research within the OPIC domain and helps to improve communication between users in OPIC.

Electronic Health Record System using Blockchain Technology

The healthcare sector is frequently known for being delicate and intricate.Individuals' sensitive information must be kept safe, secure, and protected.Blocks of the blockchain are secured and bound to each other using cryptographic principles.
 By maintaining the patient at the centre of the medical ecosystem system and establishing greater security, interoperability, and privacy of stored patient records, blockchain has the potential to eradicate the problems ailing the industry and transform healthcare.
 By decentralizing and encrypting health records, blockchain ensures that patient data is securely stored and tamper-proof. Additionally, blockchain can facilitate the seamless exchange of medical information between different healthcare providers, leading to better coordination of care and reduced medical errors. By leveraging Ethereum's smart contract functionality, healthcare organizations can securely store and
 share patient data, ensuring its integrity and confidentiality. Moreover, Ethereum's programmable nature allows for the development of decentralized applications (DApps) that can streamline various healthcare processes, such as medical record management, supply chain tracking, and clinical trials. Overall, the integration of blockchain in the healthcare industry has the potential to revolutionize the way healthcare data is managed, ensuring privacy, security, and efficiency in patient care.

Buyer Beware: Misinformation in the Healthcare Industry – What Can Clinicians Do?

In today's healthcare landscape, the exchange of medical information between physicians and industry is crucial for advancing knowledge and improving patient care. However, this collaboration also introduces challenges, including the potential for bias and misinformation. Amidst efforts to navigate the post-COVID-19 healthcare environment and maintain market competitiveness, the prevalence of misinformation has become increasingly evident (Ecker, 2022). This article explores the impact of misinformation in the medical industry, particularly concerning its drivers and persistence. Through an analysis of psychological and behavioral factors, the authors identify fear as a primary driver of bias, leading to the dissemination of inaccurate information (Tannenbaum, 2015). Additionally, deliberate efforts to manipulate narratives and facts contribute to the endurance of misinformation, posing significant risks to patient safety and healthcare integrity (Ecker, 2022). The authors highlight various methods employed to deliver misinformation, including social media, professional collaborations, and selective data sharing. These tactics obscure truth and hinder informed decision-making among healthcare practitioners (Rea, 2017). Despite the challenges posed by misinformation, the authors propose practical solutions for clinicians, emphasizing the importance of research, critical analysis, and collaboration with trusted sources to verify information and safeguard patient care (Wu, 2018). This comprehensive exploration of misinformation in the healthcare industry underscores the critical role of healthcare practitioners in combatting false narratives and ensuring the integrity of medical information. By equipping clinicians with the tools to discern truth from misinformation, this article aims to promote evidence-based practice and uphold the highest standards of patient care.

An empirical study on the intention to switch to cloud-based hospital information systems in Korea: a push–pull–mooring model perspective

Purpose Recently, interest and necessity for cloud-based hospital information systems (HISs) have emerged as an appropriate alternative for revitalizing medical information exchange between hospitals, analyzing “big data” medical information and developing the use of new medical technologies. The purpose of this paper is to investigate factors that affect the switching of information systems in existing on-premise environments into cloud-based HISs. Design/methodology/approach A research model was developed using the push–pull–mooring model based on migration theory. The research model was analyzed using confirmatory factor analysis and path analysis using partial least squares structural equation modeling. Findings The results of this study showed that low compatibility, perceived value, low cost and inertia influenced the intention to switch to cloud-based HISs; low flexibility and low compatibility influenced dissatisfaction; and low cost, ease of maintenance and ease of managing indicators influenced perceived value. Originality/value This study is expected to be used as the basis for developing a research model in subsequent studies to analyze the transition to new innovative technologies. Also, in practice, it is expected to contribute to the activation of cloud computing environments in hospitals.

Biosensors and their widespread impact on human health

‘Give a man a biosensor, and you enable him to unlock a world of cost-effective solutions for research, diagnosis, and personalized healthcare’.Biosensors have emerged as a game-changer in the realms of research sciences and healthcare, offering exceptional value for money. The integration of biosensors into these fields holds immense promise, empowering researchers and medical practitioners to unlock intricate mysteries in food and water safety, human biology, and health assessment. These state-of-the-art technologies are a breath of fresh air, revolutionizing disease detection and tracking to unprecedented levels, elevating the ability to monitor the body's response. They have become the linchpin of numerous cost-effective, highly efficient, and streamlined medical devices prevalent in modern healthcare. By harnessing the sensitivity and specificity of biosensors, healthcare professionals can hit the nail on the head, identifying even the subtlest biomarkers and indicators of various ailments, and enabling timely intervention and treatment. The superior quality of these biosensors ensures unrivaled diagnostic accuracy, leading to more reliable and effective healthcare outcomes. In a nutshell, biosensors have raised the bar, making research, public safety, and tailored healthcare options a walk in the park, ultimately enhancing overall health and well-being.Biosensors offer immense potential in medical diagnostics due to their user-friendly nature, scalability, and efficient manufacturing. With intelligent wearable features, they facilitate seamless health monitoring for the elderly, bridging the gap between self-care and healthcare providers. This exchange of medical information reduces interference and hospital visits, opening avenues in wellness, fitness, and athletics for consumers and commercial entities.This paper explores the advancements in Biosensors technology and their promising benefits in medicine, focusing on cardiovascular diseases and using informative diagrams. It examines fourteen key applications of Biosensors in the medical field, highlighting the integration of biomedical devices, apps, firmware, and advanced algorithms. These developments pave the way for innovative medical therapies, real-time evidence-based insights, customized solutions, and informed guidance, shaping a bright future for healthcare.

Implementation of Telemedicine in Medical Practice: Opportunities and Barriers

The integration of telemedicine into medical practice represents a transformative shift in healthcare delivery, offering both unprecedented opportunities and encountering significant barriers. This journal article explores the implementation of telemedicine, examining the multifaceted landscape of benefits and challenges associated with its adoption in medical settings.
 The opportunities presented by telemedicine include enhanced accessibility to healthcare services, especially in remote or underserved areas, improved patient outcomes through timely interventions, and increased efficiency in healthcare delivery. Telemedicine also facilitates remote patient monitoring, teleconsultations, and the exchange of medical information, contributing to a more patient-centric and adaptable healthcare system.
 However, the implementation of telemedicine faces several barriers, including regulatory complexities, concerns about data security and privacy, technological infrastructure limitations, and the need for healthcare professionals to adapt to new modes of communication. Cultural and organizational resistance further complicates the seamless integration of telemedicine into established medical practices.
 The article critically analyzes case studies and global implementations of telemedicine, highlighting successful models and lessons learned. It emphasizes the importance of policy frameworks, standardization, and ongoing training for healthcare providers to optimize the benefits of telemedicine while mitigating potential risks.

Consultants’ and referrers’ perceived barriers to closing the cross-institutional referral loop, and perceived impact on clinical care

BackgroundCross-institutional (external) referrals are prone to communication breakdowns, increasing patient safety risks, clinician burnout, and healthcare costs. To close these external referral loops, referring primary care physicians (PCPs) need to receive patient information from consultants at different healthcare institutions. Although existing studies investigated the early phases of external referral loops, we lack sufficient knowledge about the closing phases of these loops. This knowledge could allow health care institutions to improve care coordination and rates of closed referral loops by implementing socio-technical interventions for patient information exchange throughout a referral loop. Human factors engineering (HFE) provides a systematic approach to advance our understanding of barriers perceived by physicians. Using HFE, our objective was to characterize referring and consulting physicians’ barriers to closing referral loops and implications for care. MethodsThis qualitative cross-sectional study included semi-structured interviews with referrers and external consultants. We used the Systems Engineering Initiative for Patient Safety 2.0 framework to conduct rapid qualitative analyses, determining perceived barriers and related implications. Main measures were consultants’ and referrers’ perceptions of, and experiences with, barriers to external referrals. ResultsSix referring PCPs and 12 consultants participated from two healthcare systems and four medical specialties. Physicians perceived three main barriers in external referrals: receipt of excessive and unnecessary faxed documents, missing or delayed documentation, and organizational policies regarding information privacy interfering with closing the loop. Compared to internal referrals, physicians reported increased staff burden, patient frustration, and delays in diagnosis with external referrals. Consultants reported the ability to provide the same level of care to patients with internal or external referrals. However, consultants described communication breakdowns that prohibited confirmation of follow-up plan retrieval, initiation, or effectiveness. ConclusionPhysicians reported technological and organizational barriers to closing cross-institutional referral loops. Promises of HIE technology for external referrals have not fully materialized. Among physicians and patients, retrieval and exchange of medical information increases perceived workload, burden, and frustration. These increases are not accurately captured by traditional organizational metrics. This study provides evidence that informs future human factors engineering research to address perceived barriers and guide future HIE design or implementation.

Implementation of a Patient Summary Web Application According to the International Patient Summary and Validation in Common Use Cases in Japan

BackgroundThe application of standardized patient summaries would reduce the risk of information overload and related problems for physicians and nurses. Although the International Patient Summary (IPS) standard has been developed, disseminating its applications has challenges, including data conversion of existing systems and development of application matching with common use cases in Japan. This study aimed to develop a patient summary application that summarizes and visualizes patient information accumulated by existing systems.MethodsWe converted clinical data from the Standardized Structured Medical Information eXchange version 2 (SS-MIX2) storage at Tohoku University Hospital into the Health Level 7 Fast Healthcare Interoperability Resource (FHIR) repository. Subsequently, we implemented a patient summary web application concerning the IPS and evaluated 12 common use cases of the discharge summary.ResultsThe FHIR resources of seven of the necessary IPS sections were successfully converted from existing SS-MIX2 data. In the main view of the application we developed, all the minimum necessary patient information was summarized and visualized. All types of mandatory or required sections in the IPS and all structured information items of the discharge summary were displayed. Of the discharge summary, 75% of sections and 61.7% of information items were completely displayed, matching 12 common use cases in Japan.ConclusionsWe implemented a patient summary application that summarizes and visualizes patient information accumulated by existing systems and is evaluated in common use cases in Japan. Efficient sharing of the minimum necessary patient information for physicians is expected to reduce information overload, workload, and burnout.

Building an Electronic Medical Record System Exchanged in FHIR Format and Its Visual Presentation.

Currently, the Taiwan Electronic Medical Record Exchange Center uses the Clinical Document Architecture (CDA) framework, which is based on the international medical standard. The CDA R2 standard, defined in 2005, is used for cross-institution retrieval of electronic medical records (Ministry of Health and Welfare, Information Department, 2021). However, CDA R2 only supports the exchange of clinical documents and is limited to the XML format. Due to the lack of a standardized framework for medical data exchange in Taiwan, different standards and specifications result in different data interface methods between systems, requiring customization for each system by healthcare institutions or the government. The inconsistency in data formats requires healthcare institutions and the government to spend more time on data parsing and mapping, resulting in slow integration of medical data. In this study, we simulated healthcare institutions using Fast Healthcare Interoperability Resources (FHIR) for medical information exchange and utilized the exchanged medical information to create a dynamic dashboard to assist healthcare professionals in making medical decisions. To ensure information security, we employed Hyper Text Transfer Protocol Secure (HTTPS) for secure transmission, which encrypts the transmitted medical record data using the Transport Layer Security (TLS) protocol, preventing deliberate interception and tampering of medical record data between the two systems. Finally, to test the load and performance of static and dynamic resources and web applications, we conducted a system performance evaluation using Apache JMeter. The results of this study demonstrate that replacing the gateway of the Electronic Medical Record Exchange Center with an FHIR server effectively reduces the time and cost spent by developers on data format conversion while also mitigating the information security risks associated with the previous VPN solution. Additionally, by utilizing dynamic charts, healthcare professionals are assisted in making medical decisions.

Teleoncology: Novel Approaches for Improving Cancer Care in North America.

Due to widespread healthcare workforce shortages, many patients living in remote and rural North America currently have reduced access to various medical specialists.These shortages, coupled with the aging North American population, highlight the need to transform contemporary healthcare delivery systems.The exchange of medical information via telecommunication technology, known as telemedicine, offers promising solutions to address the medical needs of an aging population and the increased demand for specialty medical services. This progressive movement has also improved access to quality health care by mitigating the current shortage of trained subspecialists. Minimizing the effects of these shortages is particularly urgent in the care of cancer patients, many of whom require regular follow-up and close monitoring.Cancer patients living in remote areas of North America have reduced access to specialized care and, thus,have unacceptably high mortality and morbidity rates. Teleoncology, or the use of telemedicine to provide oncology services remotely, has the ability to improve access to high-quality care and assist in alleviating the burden of some of the severe adverse events associated with cancer. In this review, the authors describe how recent advances in teleoncology can reduce healthcare disparities and improve future cancer care in North America.

Authentication of Medical Documentation with Privacy Protection and Sharing in Cloud

There is a growing need for better medical care as a result of the adoption of clever electronic gadgets and the development of cloud and cloudlet technologies. Data collection, storage, and dissemination are the three main steps in the medical data processing chain. The traditional healthcare system frequently requires the transfer of medical data to the cloud, resulting in the use of sensitive user data and communication energy. The exchange of medical information is a crucial and difficult problem. In this study, we suggest a brand-new human services framework that makes use of cloud let's flexibility. Security assurance, information sharing, and intrusion detection are among the components of cloudlets. We apply the Number Theory Research Unit (NTRU) technique to encrypt the user's bodily data gathered by wearable devices during the data gathering phase. This information is then efficiently transferred to nearby cloudlets. We also present a trust model to help users choose reliable partners that want to share cloudlet-stored data.

Telemedical consultations on oncology in the Republic of Bashkortostan

BACKGROUND: The COVID-19 worldwide pandemic enabled the expanded use of telemedical technologies in many areas of medicine. Remote consultations helped conserve medical resources and reduce the risk of spreading COVID-19 while preserving patients access to medical care. In addition, telemedicine played a role in caring for patients who live in remote regions. Other benefits include savings in transportation costs and travel time both for patients and caregivers. Telemedicine, together with remote health monitoring technologies, has high potential in developing a preventive healthcare system and increasing the accessibility of medical care and meets current challenges by improving healthcare quality and providing an individual approach to patients. In 2020, the Center of Telemedicine was created in the Republican Clinical Oncological Dispensary (RCOD) to organize and improve telemedical assistance to the population of the Republic of Bashkortostan in the oncology profile.
 AIM: To analyze telemedical consultations (TMCs) on oncology in the Republic of Bashkortostan for the period of 20202022.
 METHODS: Quantitative count and comparison of the TMCs conducted by the RCOD of the Ministry of Health of the Republic of Bashkortostan in 20202022 and sent to the National Medical Research Center (NMRC) were performed. The work on referrals to the NMRC for revision of examination results (computer tomography, magnetic resonance imaging, positron emission tomography/computed tomography, and histological examinations), obtaining a second opinion, and determining treatment tactics was organized.
 RESULTS: In 2020, 32,076 TMCs were conducted, while 225 TMCs were performed with the NMRC. In 2021, the RCOD conducted 52,139 TMCs (a 62% increase compared to 2020), whereas 473 TMCs took place in the NMRC (a 110% increase compared to 2020). During the 12 months of 2022, 57,456 TMCs were performed by RCOD staff (a 10% increase over the previous year), and 672 TMCs were conducted with the NMRC (a 42% increase compared to 2021). For feedback from referring medical organizations and monitoring and evaluating the quality of regional TMCs, conference calls were held with the Ministry of Health of the Republic of Bashkortostan, chief physicians, and oncologists of the Republic of Bashkortostan.
 CONCLUSIONS: TMCs allow for the rapid exchange of medical information, thereby reducing the time of diagnosis and timely prescription of treatment, the implementation of timely routing of patients and improving the quality and availability of medical care in the oncology profile in the Republic of Bashkortostan. The annual increase in the number of TMCs is due to the growing need for this type of specialized medical care in this profile.

Bluetooth-Based Healthcare Information and Medical Resource Management System.

This paper presents a healthcare information and medical resource management platform utilizing wearable devices, physiological sensors, and an indoor positioning system (IPS). This platform provides medical healthcare information management based on the physiological information collected by wearable devices and Bluetooth data collectors. The Internet of Things (IoT) is constructed for this medical care purpose. The collected data are classified and used to monitor the status of patients in real time with a Secure MQTT mechanism. The measured physiological signals are also used for developing an IPS. When the patient is out of the safety zone, the IPS will send an alert message instantly by pushing the server to remind the caretaker, easing the caretaker's burden and offering extra protection for the patient. The presented system also provides medical resource management with the help of IPS. The medical equipment and devices can be tracked by IPS to tackle some equipment rental problems, such as lost and found. A platform for the medical staff work coordination information exchange and transmission is also developed to expedite the maintenance of medical equipment, providing the shared medical information to healthcare and management staff in a timely and transparent manner. The presented system in this paper will finally reduce the loading of medical staff during the COVID-19 pandemic period.

Reinforcing Regional Emergency and Critical Care Networks: The Implementation of Telemedicine Systems in Remote Areas

<p>隨著全國每萬人醫師數逐年上升，醫療資源仍集中於都會區域，偏遠地區緊急醫療資源仍相對不足。衛生福利部於2018年「通訊診療治療辦法」放寬遠距醫療之照護對象與模式，並在2021年正式將急診納入「全民健康保險遠距醫療給付計畫」給付範圍。遠距醫療在急重症病人照護已有實證應用，基於遠距醫療專科門診系統建置經驗，結合醫療與資訊科技發展，建置急診遠距醫療會診系統。在面臨緊急醫療搶救，急診遠距醫療須具備好的工具進行資訊傳遞，包含友善操作介面、即時且重要的醫療資訊交換、紀錄留存及綠色通道團隊預先啟動，並可提供大量傷患迅速應變支援，縮短急重症病人醫療處置等待時間。急診遠距醫療會診系統之建置已開啟創新之急重症就醫模式，惟系統功能仍須透過滾動式修正及持續教育訓練，使醫護人員熟悉操作並列入常規系統使用，以作為偏遠地區醫院急診病人第二意見諮詢及轉診評估，降低病人不必要之轉診，提升病人醫療品質。</p> <p> </p><p>Although the number of medical doctors per 10,000 residents in Taiwan has been increasing, most medical resources remain concentrated in metropolitan areas, and emergency medical resources in remote areas remain insufficient. In 2018, the Ministry of Health and Welfare passed the Rules of Medical Diagnosis and Treatment by Telecommunications to expand the coverage of people and models eligible for telemedicine services. In 2021, emergency services were included in the coverage of the National Health Insurance Telemedicine Benefits Plan. Telemedicine has been applied in emergency and critical care with empirical evidence. Based on the experience in establishing a telemedicine specialist outpatient system and the incorporation of medical and information technologies, a remote emergency consultation system was established. To ensure effective emergency care, an emergency telemedicine model must incorporate favorable tools for information transmission, including a user-friendly interface that facilitates real-time and critical medical information exchange and record keeping. The model should also allow for early preparation of the green channel team, ensure that support is at hand for rapid response to a large number of patients, and shorten the waiting time of emergency and critically ill patients for medical treatment. The establishment of the remote emergency consultation system has opened the door to an innovative emergency and critical care model. However, the system functions should be improved on a rolling basis, and continuous staff training is required to familiarize staff with the operation of the system as a routine system. Thus, the system can be used for second opinion consultation and referral assessment for emergency patients in remote hospitals, thereby reducing unnecessary referrals and improving the quality of medical care.</p> <p> </p>

A review of questionnaires used for the assessment of telemedicine.

Telemedicine is the exchange of medical information from one site to another via electronic communications with the goal of improving a patient's clinical health status. Prior studies have identified the absence of a standardized assessment tool for evaluating telemedicine encounters. This study aims to collect and to analyze questionnaires used for the assessment of audiovisual telemedicine encounters from a patient perspective and aims to identify reasons driving the use of self-developed questionnaires. We conducted a systematic search in PubMed for studies that used survey questionnaires to assess synchronous audiovisual telemedicine encounters from 2016 to 2021. We categorized questionnaires used into validated and non-validated types, and for each of them, collected questions, response format, author, year, specialty, and country of publication. We analyzed a total of 71 articles. We found that only 16 studies used three validated questionnaires. The remaining 55 studies used non-validated questionnaires. Non-validated questionnaires had a high variability in length and used Likert scales, binary responses, multiple choice, and open-ended answers. We found only eight studies in which the authors gave a reason for resorting to designing their own questionnaires. This review reveals insufficient standardized survey questionnaires to be used for the assessment of audiovisual telemedicine encounters. Future research initiatives should focus on developing a standardized and validated instrument well accepted by researchers.

The potential of eHealth for cancer patients-does COVID-19 pandemic change the attitude towards use of telemedicine services?

Internet penetration worldwide has increased rapidly over the recent years. With this growth, modern information and communication technologies (ICT) have become increasingly important. They do not only change daily life but also patient-physician interaction and health related information search, which can be summarized as electronic Health (eHealth). eHealth was already known before the emergence of the coronavirus disease 2019 (COVID-19), but this pandemic substantially challenged health systems, physicians and hospitals so profoundly that new services and methods of patient-physician interaction had to be implemented rapidly. This study investigates the attitude of cancer patients towards eHealth and the potential impact of COVID-19 on its use. The study was a multicentered study carried out at the university hospitals Bonn and Aachen. Patients were asked to answer a structured questionnaire in the time span between September 2019 and February 2021. Due to the COVID-19 pandemic, no patients were addressed between March 2020 and July 2020. The questionnaire focused on socio-demographic data, the dissemination of internet-enabled devices, the patients' attitude towards eHealth and the use of modern ICT in daily life and for health-related information search. In total, 280 patients have filled the questionnaire of which 48% were female and 52% were male. Men have a slightly more positive attitude towards the overall potential of eHealth than women which was shown by a significant influence for receiving medical information via e-mail. Hematological-oncological patients with a higher education level reported a significantly higher willingness to send personal health information to their physician and health insurance. A frequency of medical consultation of more than 5 times during the previous year has a significantly positive impact regarding the use of online communication, online video consultation and treatment quality. Younger patients have more concerns about data security than older patients. The study shows a different attitude towards the influence of eHealth on the patient-physician relationship in different therapy situations. While there were no significant changes in patients' attitude towards eHealth after the start of the COVID-19 pandemic, there was a trend towards an increasingly embracing attitude in patients, who answered the questionnaire during COVID-19 pandemic situation. Overall, cancer patients had a positive attitude towards eHealth and the dissemination of internet-enabled devices was high. The study shows that the potential of eHealth is high among hematological-oncological patients. Further eHealth technologies and especially telemedically supported care processes should be implemented to improve patient-physician interaction and cross-sectoral care. COVID-19 pandemic led to a fast initiation and acceleration of new structures and routines for physicians, hospitals and patients. These new processes should be used to promote digitalization in hematological and oncological telemedicine. To successfully implement new eHealth technologies, future research should focus on patients' concerns about data privacy and data availability especially in the context of exchange of medical information in cross sectoral and interdisciplinary care processes.

ОКРЕМІ ПРОБЛЕМИ АДМІНІСТРАТИВНО-ПРАВОВОГО ЗАБЕЗПЕЧЕННЯ ВИКОРИСТАННЯ ІНФОРМАЦІЙНИХ СЕРВІСІВ В МЕДИЦИНІ У КОНТЕКСТІ ВОЄННОГО СТАНУ В УКРАЇНІ

In times of war, fast and accurate exchange of medical information is crucial for the wounded and sick. However, incorrect or incomplete information can lead to misdiagnosis and mistreatment, including fatal outcomes. Therefore, ensuring the reliability and timely transmission of information between military hospitals, field support hospitals, and other medical facilities is essential, with data security being a paramount concern in the field of medicine. The use of information services in medicine during a state of war in Ukraine should be based on compliance with administrative and legal principles that ensure effective, prompt, and secure handling of medical information. In our view, administrative and legal principles play a crucial role in the use of information services in medicine. On the one hand, they guarantee the protection of patient confidentiality and privacy, and on the other hand, they significantly contribute to the development and innovation in the medical field. However, as evidenced by the analysis of a significant portion of scientific sources, the use of information services also faces its own challenges and risks. This article explores the importance of administrative and legal principles in the use of information services in medicine during a state of war in Ukraine. It examines the legal aspects of protecting the confidentiality and personal information of patients under these conditions, as well as the influence of international norms and standards on the administrative and legal regime. Additionally, potential reforms aimed at improving the healthcare delivery system in times of war through the use of information technologies are discussed. The article also addresses the facilitation of using information services to improve medical diagnostics and treatment through telemedicine. One of the key advantages of information services is their impact on the development of telemedicine. Telemedicine represents an innovative approach to providing medical care remotely. It involves the use of video conferencing, electronic exchange of medical data, and other information technologies to facilitate medical consultation and diagnosis. During times of war, telemedicine can prove exceptionally beneficial as it enables doctors to consult patients and provide recommendations even in combat zones and areas with limited access. It facilitates the rapid exchange of medical information, which is critical in situations where every second counts. Resolving legal aspects related to the confidentiality of medical data, licensing of medical professionals, and compliance with legislation is an essential part of the development of telemedicine. These aspects are crucial to ensuring the quality and safety of medical care in military conflicts and other emergency situations.

An advanced cloud based framework for privacy and security in medical data using cryptographic method

The exchange of medical information has been drastically altered by patient-centered developments such as personal health records (PHR). By giving patients a place to handle their own PHR on a unified transactional platform, personal health record (PHR) services increase the efficiency with which medical information may be kept, accessed, and transferred. With the ultimate objective of providing patients with total surveillance under data, our findings is focused on creating a state-of-the-art infrastructure for the safe transfer of personal health data via cloud computing. Patients have the option of encrypting their PHR files, which provides an additional layer of security and allows them to set access control limits such as who has access to their files and to what degree. When data is encrypted in the cloud, only approved users may access it. Using cloud-based platforms to share health records raises concerns over confidentiality and privacy, which are addressed by the proposed method. Patients may still benefit from data interchange for the goal of better healthcare thanks to the framework’s provision of an encrypted PHR file option. This framework may accommodate attribute-based encryption (ABE) and other kinds of granular security. These measures ensure that people may continue to have access to, and make changes to, their own medical data, even when they are stored on the cloud. This article presents research that attempts to meet the demands of patients while also providing a safe method of transferring individual health information through cloud computing.