Ehr and Cloud Computing

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briefing paper

Security aspects in electronic personal health record: data access and preservation The world of applied medical informatics is changing rapidly due to an increasing use of the results of Information Systems reports, data trending and images. Recent advances in Information and Communication Technology (ICT) give access to patients with chronic conditions at home through particular e-Health services such as Telemedicine. The development of online services such as “teleconsultation, e-prescription, e-referral, telemonitoring and telecare” has created new, remote health care functions that potentially threaten privacy. Indeed, confidentiality concerns remain a sensitive point of discussion in the digital age. This article describes which measures can be implemented to strengthen personal data security.

Information communication technology (ICT) has had a dramatic impact on our daily lives in recent years, benefiting many areas of the public health including health care delivery, surveillance, research and education. ICT provides more convenient ways to accomplish daily tasks and diminishes the impact of long distances in both personal and business interactions. Interaction between patients and physicians through the use of electronic tools for health-related purposes has been broadly defined as “e-Health” [1-3]. E-Health activities are becoming quite common in our society and using the latest ICT have the potential to transform the health care delivery systems both in advanced and emerging nations by meeting the needs of citizens, patients, healthcare professionals, providers, and policy makers [1-9]. It is recognised that the achievement of the benefits from e-Health are dependent on a secure, robust and reliable organisational and technical framework to enable continuity of healthcare [1-3]. A Global Observatory for e-Health dedicated to understanding the e-Health domain, its growth, evolution, and impact on health systems in all countries has been developed by the World Health organisation [WHO, 9]. Moreover, the European Community considers as a priority action “initiative on telemedicine (TM) for chronic disease management as home health monitoring” and the future “vision for Europe 2020” is based on development of “integrated Telemedicine Services” [10,11]. TM is defined as "medicine practiced at a distance”. It combines the expertise of a professional clinical staff, medical equipment, computer hardware, software and communication technology, through a service centre, to examine, investigate, monitor and treat patients in distant places [3,12]. In 2001 TM opportunities were summarized as: 1) Home Telenursing, 2) Electronic referrals to specialists and hospitals, 3) Teleconsulting between General Practitioners (GPs) and specialists, 4) Call centres’ activities and online health. The present article will develop aspects related to security in the management of electronic personal referral through a TM service.

What is an Electronic Personal Health record?
Although no universally accepted definition exists, EPH can be described as “an electronic application through which individuals access, manage and share their health information… in a private, secure and confidential environment”. Models vary in the extent to which the content of the records and rights of access are controlled by the patient (simple models) or the healthcare provider (complex models), the range of tools used (i.e. telephone, electro-medical devices, Videophone, computers, wireless and internet technologies) and their interactivity. TM can be considered a complex system including integrated information such as medical history, results from examinations, images and documents for which authorized access by the health care team members has to be considered.

EPH pros
Due to the promise of improved quality and efficiency through better maintenance and availability of personal patient data the potential of EPH record...
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