HCPP: Cryptography Based Secure EHR System for Patient Privacy and Emergency Healthcare

BACKGROUND Sharing progress notes as a common social capital is essential in research and education, but the content of progress notes is sensitive and needs to be kept confidential. Publishing actual progress notes are difficult due to privacy concerns. OBJECTIVE This study aims to generate a large repository of pseudo-progress notes of authentic quality. We focused on two requirements for authentic quality: the validity and consistency of the data, from the perspective of medical practice, and the empirical and semantic characteristics of progress notes, such as shorthand styles used for reporting changes in a patient's physical status, long narrative sentences detailing patient anxiety, and interprofessional communications. METHODS We proposed a practical framework that consists of a simulation of the notes and evaluation of the simulated notes. The framework utilized two human cognitive traits: (1) the ability to use imitation to simulate objects with diverse characteristics without background knowledge and (2) the use of comparison as a strategy for deep thinking. This enabled crowd workers to generate a large number of progress notes. Our framework involved three steps. In step 1, crowd workers imitated actual progress notes decomposed into subject data (S), object data (O), and assessment and plan (A/P). These imitated texts were then shuffled and recomposed in S, O, and A/P in order to create simulated progress notes. In step 2, crowd workers identified the characteristics of actual progress notes based on comparisons between actual and dummy progress notes. These characteristics were clustered based on their similarities. Each cluster exhibited the empirical and semantic characteristics of the actual progress notes. Finally, in step 3, the texts from step 1 that exhibited the identified characteristics from step 2 were evaluated as quality-guaranteed progress notes that met the two requirements. All data were preprocessed to protect patient privacy. RESULTS Step 1: By recomposing the 700 imitated texts, 9,856 simulated progress notes were generated. Step 2: 3,938 differences between actual progress notes and dummy progress notes were identified. After clustering, 166 characteristics were evaluated to be appropriate as empirical and semantic characteristics of the actual progress notes. Step 3: 500 crowd workers demonstrated that 83.0% of the simulated progress notes satisfied at least one of the characteristics obtained in step 2. The crowd workers' artificially-reproduced progress notes were evaluated to determine the most realistic, based on four metrics: disease, morpheme, readability, and reality. CONCLUSIONS Our results demonstrated that crowd workers could generate and evaluate highly professional documents. We have made our large repository of high-quality crowdsourced progress notes publicly available, and we encourage their use in the development of medical education and research.

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On the effectiveness of tracking and testing in SEIR models for improving health vs. economy trade-offs

Scientific Reports ◽

10.1038/s41598-021-95415-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoav Kolumbus ◽

Noam Nisan

Keyword(s):

Additional Parameter ◽

Patient Privacy ◽

Economic Costs ◽

Trade Off ◽

Seir Model ◽

Social Question ◽

Social Distancing ◽

Trade Offs ◽

Asymptomatic Individuals ◽

Testing Policies

AbstractWe study the effectiveness of tracking and testing policies for suppressing epidemic outbreaks. We evaluate the performance of tracking-based intervention methods on a network SEIR model, which we augment with an additional parameter to model pre-symptomatic and asymptomatic individuals, and study the effectiveness of these methods in combination with or as an alternative to quarantine and global lockdown policies. Our focus is on the basic trade-off between human-lives lost and economic costs, and on how this trade-off changes under different quarantine, lockdown, tracking, and testing policies. Our main findings are as follows: (1) Tests combined with patient quarantines reduce both economic costs and mortality, however, an extensive-scale testing capacity is required to achieve a significant improvement. (2) Tracking significantly reduces both economic costs and mortality. (3) Tracking combined with a moderate testing capacity can achieve containment without lockdowns. (4) In the presence of a flow of new incoming infections, dynamic “On–Off” lockdowns are more efficient than fixed lockdowns. In this setting as well, tracking strictly improves efficiency. The results show the extreme usefulness of policies that combine tracking and testing for reducing mortality and economic costs, and their potential to contain outbreaks without imposing any social distancing restrictions. This highlights the difficult social question of trading-off these gains against patient privacy, which is inevitably infringed by tracking.

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A Cross-Sectional Study: Patient Privacy According to Doctors and Nurses

Nursing Science Quarterly ◽

10.1177/0894318420987171 ◽

2021 ◽

Vol 34 (2) ◽

pp. 114-122

Author(s):

Nilüfer Demirsoy ◽

Hülya Öztürk ◽

Nurdan Ergün Acar

Keyword(s):

Work Environment ◽

Healthcare Professionals ◽

Emergency Services ◽

Cross Sectional Study ◽

Study Patient ◽

Patient Privacy ◽

Sectional Study ◽

Right To Privacy ◽

Cross Sectional ◽

Building Trust

Confidentiality is fundamental in building trust between patients and healthcare professionals. This research aims at presenting healthcare professionals’ opinions on patient privacy, using a 5-point Likert-type scale titled “Opinion of the Healthcare Professionals on Patient Privacy,” and 262 physicians’ and 231 nurses’ opinions were evaluated. Results showed that nurses and doctors working at emergency services got higher mean scores than those working at other units. Results revealed that doctors had the highest mean score for the item “ It is important that the patient’s body is not seen by other patients and professionals during the treatment,” while nurses had the highest mean score for the item “ I approach with due care to protect privacy in the work environment.” Results of this work highlight that patient’s right to privacy constitutes one of the most significant issues to be noted by healthcare professionals.

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Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

Hormone Research in Paediatrics ◽

10.1159/000513060 ◽

2020 ◽

Vol 93 (6) ◽

pp. 343-350

Author(s):

Molly O. Regelmann ◽

Rushika Conroy ◽

Evgenia Gourgari ◽

Anshu Gupta ◽

Ines Guttmann-Bauman ◽

...

Keyword(s):

Patient Care ◽

Care Patient ◽

The Novel ◽

Patient Privacy ◽

Pediatric Endocrinology ◽

Quality Of Patient Care ◽

Care Outcomes ◽

Novel Coronavirus ◽

The Impact

Background: Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. Summary: The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. Key Messages: With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

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STHM: A Secured and Trusted Healthcare Monitoring Architecture Using SDN and Blockchain

Electronics ◽

10.3390/electronics10151787 ◽

2021 ◽

Vol 10 (15) ◽

pp. 1787

Author(s):

Ezedin Barka ◽

Sofiane Dahmane ◽

Chaker Abdelaziz Kerrache ◽

Mohamad Khayat ◽

Farag Sallabi

Keyword(s):

Monitoring System ◽

Trust Management ◽

Software Defined Networking ◽

The Elderly ◽

Optimal Level ◽

Security And Privacy ◽

Patient Privacy ◽

Security Technologies ◽

Blockchain Technology ◽

Healthcare Monitoring

Healthcare professionals and scholars have emphasized the need for IoT-based remote health monitoring services to track the health of the elderly. Such systems produce a large amount of data, necessitating the security and privacy of that data. On the other hand, Software Defined Networking (SDN) integration could be seen as a good solution to guarantee both flexibility and efficiency of the network which is even more important in the case of healthcare monitoring. Furthermore, Blockchain has recently been proposed as a game-changing tool that can be integrated into the Internet of Things (IoT) to have the optimal level of security and privacy. However, incorporating Blockchain into IoT networks, which rely heavily on patients’ health sensors, is extremely difficult. In this paper, a secure Healthcare Monitoring System (HMS) is proposed with a focus on trust management issues. The architecture seeks to protect multiple healthcare monitoring system components and preserves patient privacy by developing a security interface where separate security modules can be integrated to run side by side to ensure reliable HMS. The security framework architecture we propose takes advantage of the blockchain technology as a secure and timely information back-end. STHM is a proposal that uses Software-Defined Networking (SDN) as the communication medium that allows users to access SDN’s different functional and security technologies and services. Simulation results show that the use of Blockchain for the SDN-based healthcare monitoring can ensure the desired flexibility and security for a very lightweight additional overhead.

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Current challenges and opportunities for pharmacogenomics: perspective of the Industry Pharmacogenomics Working Group (I-PWG)

Human Genetics ◽

10.1007/s00439-021-02282-3 ◽

2021 ◽

Author(s):

Karina Bienfait ◽

Aparna Chhibber ◽

Jean-Claude Marshall ◽

Martin Armstrong ◽

Charles Cox ◽

...

Keyword(s):

Clinical Trial ◽

Working Group ◽

Direct Sequencing ◽

Risk Scores ◽

Pharmaceutical Companies ◽

Patient Privacy ◽

Clinical Implementation ◽

Genomic Databases ◽

Group I ◽

Trial Participants

AbstractPharmaceutical companies have increasingly utilized genomic data for the selection of drug targets and the development of precision medicine approaches. Most major pharmaceutical companies routinely collect DNA from clinical trial participants and conduct pharmacogenomic (PGx) studies. However, the implementation of PGx studies during clinical development presents a number of challenges. These challenges include adapting to a constantly changing global regulatory environment, challenges in study design and clinical implementation, and the increasing concerns over patient privacy. Advances in the field of genomics are also providing new opportunities for pharmaceutical companies, including the availability of large genomic databases linked to patient health information, the growing use of polygenic risk scores, and the direct sequencing of clinical trial participants. The Industry Pharmacogenomics Working Group (I-PWG) is an association of pharmaceutical companies actively working in the field of pharmacogenomics. This I-PWG perspective will provide an overview of the steps pharmaceutical companies are taking to address each of these challenges, and the approaches being taken to capitalize on emerging scientific opportunities.

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