The Implementation of Federated Digital Identifiers in Health Care: Rapid Review.

BACKGROUND: Federated digital identifiers (FDIs) have been cited to improve the interoperability of data and information management while enhancing the privacy of individuals verifying their identity on the web. Many countries around the world have implemented FDIs in various sectors, such as banking and government. Similarly, FDIs could improve the experience for those wanting to access their health care information; however, they have only been introduced in a few jurisdictions around the world, and their impact remains unclear. OBJECTIVE: The main objective of this environmental scan was to describe how FDIs have been established and implemented to enable patients' access to health care. METHODS: We conducted this study in 2 stages, with the primary stage being a rapid review, which was supplemented by a targeted gray literature search. Specifically, the rapid review was conducted through a database search of MEDLINE and Embase, which generated a list of countries and their services that use FDIs in health care. This list was then used to conduct a targeted gray literature search using the Google search engine. RESULTS: A total of 93 references from the database and targeted Google searches were included in this rapid review. FDIs were implemented in health care in 11 countries (Australia, Belgium, Canada, Denmark, Estonia, Finland, Iceland, Norway, Singapore, Sweden, and Taiwan) and exclusively used with a patient-accessible electronic health record system through a single sign-on interface. The most common FDIs were implemented nationally or provincially, and establishing them usually required individuals to visit a bank or government office in person. In contrast, some countries, such as Australia, allow individuals to verify their identities entirely on the web. We found that despite the potential of FDIs for use in health care to facilitate the amalgamation of health information from different data sources into one platform, the adoption of most health care services that use FDIs remained below 30%. The exception to this was Australia, which had an adoption rate of 90%, which could be correlated with the fact that it leveraged an opt-out consent model. CONCLUSIONS: This rapid review highlights key features of FDIs across regions and elements associated with higher adoption of the patient-accessible electronic health record systems that use them, like opt-out registration. Although FDIs have been reported to facilitate the collation of data from multiple sources through a single sign-on interface, there is little information on their impact on care or patient experience. If FDIs are used to their fullest potential and implemented across sectors, adoption rates within health care may also improve.

Legal aspects related to digital twin.

The creation of digital replicas of individuals, based on their data, gives birth to what experts in medical field called the 'personal digital twin'. This new 'digital self' raises many difficulties, in sociology, in science and in law. This article presents the main issues from a legal point of view. Most of the structuring concepts of the law are questioned by these special symbiotic systems: the concept of person, identity, entitlement to rights and obligations, legal capacity, liability, data processing, etc. All these notions, which are rooted in the legal tradition, are correlated to the human person and must therefore be profoundly adapted to apply to the digital twin. It is a new experience: the law must devise concepts to take account of an entity that is halfway between people and things. We see this as an opportunity to rethink the legal framework and to consider the advent of future digital human rights. This questioning, barely sketched here, aims to make the law evolve towards a better consideration of symbiotic systems. This article is part of the theme issue 'Towards symbiotic autonomous systems'.

Regulating Libra.

Libra is the first private cryptocurrency with the potential to change the landscape of global payment and monetary systems. Due to the scale and reach provided by its affiliation with Facebook, the question is not whether, but how, to regulate it. This article introduces the Libra project and analyses the potential responses open to regulators worldwide. We conclude that perhaps the greatest impact will come not from Libra itself, but rather from reactions to it, particularly by other BigTechs, incumbent financial institutions and governments around the world.

Defining the Digital Self: A Qualitative Study to Explore the Digital Component of Professional Identity in the Health Professions.

BACKGROUND: Recent medical education literature pertaining to professional identity development fails to reflect the impact social media has on professional identity theory. Social media is transforming the field of medicine, as the web-based medium is now an avenue for professional development and socialization for medical students and residents. Research regarding identity development in social media has been primarily confined to electronic professionalism through best practice guidelines. However, this neglects other potential aspects pertinent to digital identity that have not yet been explored. OBJECTIVE: This study aims to define the properties and development of the digital self and its interactions with the current professional identity development theory. METHODS: A qualitative study was conducted using thematic analysis. A total of 17 participants who are social media education and knowledge translation experts were interviewed. The initial participants were from emergency medicine, and a snowball sampling method was used following their respective web-based semistructured interviews to enable global recruitment of other participants from interprofessional disciplines. The research team consisted of a diverse group of researchers including one current social media knowledge translation physician clinician educator, one postdoctoral researcher who is regularly engaged in social media knowledge translation, and 3 nonphysician research assistants who are not social media users. Half of the team conducted the initial coding and analysis, whereas the other 2 investigators audited the procedures followed. RESULTS: A total of 4 themes were identified that pertain to digital identity. In the first theme, origins of initial digital identity formation were found to be derived from perceived needs in professional roles (eg, as a medical student or resident). The second theme consisted of the cultivation of digital identity, in which digital identity was developed parallel to professional identity. The third theme that emerged was the management between the professional and personal components of digital identity. Participants initially preferred keeping these components completely separate; however, attempts to do so were inadequate while the integration of both components provided benefits. The fourth theme was the management of real-life identity and digital identity. Participants preferred real-life identity to be wholly represented on the web. Instances of misalignment resulted in identity conflict, compromising one of the identities. CONCLUSIONS: Social media introduces new features to professional identity in the digital world. The formation of digital identity, its development, and reconciliation with other identities were features captured in our analysis. The virtual component of professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development.

Distributed Ledger Technology for eHealth Identity Privacy: State of The Art and Future Perspective.

Electronic healthcare (eHealth) identity management (IdM) is a pivotal feature in the eHealth system. Distributed ledger technology (DLT) is an emerging technology that can achieve agreements of transactional data states in a decentralized way. Building identity management systems using Blockchain can enable patients to fully control their own identity and provide increased confidence in data immutability and availability. This paper presents the state of the art of decentralized identity management using Blockchain and highlights the possible opportunities for adopting the decentralized identity management approaches for future health identity systems. First, we summarize eHealth identity management scenarios. Furthermore, we investigate the existing decentralized identity management solutions and present decentralized identity models. In addition, we discuss the current decentralized identity projects and identify new challenges based on the existing solutions and the limitations when applying it to healthcare as a particular use case.

A Machine Learning-Based Method for Automated Blockchain Transaction Signing Including Personalized Anomaly Detection.

The basis of blockchain-related data, stored in distributed ledgers, are digitally signed transactions. Data can be stored on the blockchain ledger only after a digital signing process is performed by a user with a blockchain-based digital identity. However, this process is time-consuming and not user-friendly, which is one of the reasons blockchain technology is not fully accepted. In this paper, we propose a machine learning-based method, which introduces automated signing of blockchain transactions, while including also a personalized identification of anomalous transactions. In order to evaluate the proposed method, an experiment and analysis were performed on data from the Ethereum public main network. The analysis shows promising results and paves the road for a possible future integration of such a method in dedicated digital signing software for blockchain transactions.

The social life of data points: Antecedents of digital technologies.

Recent technological advances such as microprocessors and random-access memory have had a significant role in gathering, storing and processing digital data, but the basic principles underpinning such data management were established in the century preceding the digital revolution. This paper maps the emergence of those older technologies to show that the logic and imperative for the surveillance potential of more recent digital technologies was laid down in a pre-digital age. The paper focuses on the development of the data point from its use in punch cards in the late 19th century through its manipulation in ideas about correlation to its collection via self-completion questionnaires. Some ways in which medicine and psychology have taken up and deployed the technology of data points are used as illustrative exemplars. The paper concludes with a discussion of the role of data points in defining human identity.

Young Children and the Creation of a Digital Identity on Social Networking Sites: Scoping Review.

BACKGROUND: There is limited understanding of the concept of the digital identity of young children created through engagement on social networking sites. OBJECTIVE: The objective of this scoping review was to identify key characteristics of the concept of digital identity for children from conception to the age of 8 years on social networking sites. METHODS: This scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The key databases searched were EBSCO, Web of Science, ProQuest ERIC, and Scopus. Gray literature sources (National Grey Literature Collection, ProQuest Dissertations and Theses, and Google Scholar) were also searched to identify unpublished studies. Articles were selected if they were published in English and reported data on the digital identity of children in relation to social networking sites. RESULTS: The key terms used in the literature were sharenting, followed by digital footprints and children's identities. Our study revealed 2 approaches to the creation of digital identity: social digital identity and performative digital identity. The articles in this review most commonly used the term sharenting to describe the behavior parents engage in to create digital identities for children on social networking sites. Motivations to post information about children differed among parents; however, the most common reasons were to share with friends and family and create digital archives of childhood photos, termed social digital identity. The second motivation was categorized as performative digital identity. The risk of digital kidnapping and identity theft associated with the creation of digital identities also influenced parents' behaviors. CONCLUSIONS: The creation of a digital identity for children is an emerging concept. Our review develops a deeper understanding of sharenting behaviors that can be used to better support parents and their children in creating a digital identity with children and awareness of the potential future impact. We recommend that future studies explore the perspectives of children as key stakeholders in the creation of their digital identity.

Digital identification and adulteration analysis of Pulsatilla Radix and Pulsatilla Cernua based on "digital identity" and UHPLC-QTOF-MSE.

Under the background of digitalization of traditional Chinese medicine (TCM), to realize the quick identification and adulteration analysis of Pulsatilla Radix (PR), adhering to digital conviction, this study conducted UHPLC-QTOF-MSE analysis on PR and its adulterant-Pulsatilla Cernua (PC) from different batches and based on digital conversion, the shared ions were extracted from different batches of PR and PC as their "ions representation", respectively. Further, the data set of unique ions of PR relative to PC and PC relative to PR were screened out as the "digital identities" of PR and PC respectively. Further, above the "digital identities" of PR and PC were used as the benchmarks for matching and identifying to feedback give a matching credibility (MC). The results showed that based on the "digital identities" of PR and PC, the digital identification of two herbal samples can be realized efficiently and accurately at the individual level with the MC≥70.00 %, even if 5 % of PC in the mixed samples can still be identified efficiently and accurately. The study is of great practical significance for improving the identification efficiency of PR and PC, cracking down on adulterated and counterfeit drugs, and strengthening the quality control of PR. In addition, it has important reference significance for developing non-targeted digital identification of herbal medicines at the individual level based on UHPLC-QTOF-MSE and the "digital identity", which was beneficial to the construction of digital Chinese medicine and digital quality control.

Digital Identity Infrastructures: a Critical Approach of Self-Sovereign Identity.

The shift from electronic identification to digital identity is indicative of a broader evolution towards datafication of identity at large. As digital identity emerges from the fringes of technical challenges towards the legal and socio-technical, pre-existing ideologies on the reform of digital identity re-emerge with a newfound enthusiasm. Self-sovereign identity is one representative example of this trend. This paper sets out to uncover the principles, technological design ideas, and underlying guiding ideologies that are attached to self-sovereign identity infrastructures, carrying the promise of user-centricity, self-sovereignty, and individual empowerment. Considering the flourishing of digital identity markets, and the subsequent institutional interest on a European level in the techno-social promises that this identity architecture carries, this paper explores how the implementation of EU-wide self-sovereign identity shifts the already existing historical power balances in the construction of identity infrastructures. In this contribution, we argue that the European-wide adoption of self-sovereign ideals in identity construction does not address the shortcomings that identity and identification have historically faced and that instead of citizen empowerment, it puts individuals (a category broader than citizens) in a rather vulnerabilized position.

The role of pediatricians in social media: digital identity. Good practice recommendations. / El rol del pediatra en las redes sociales: identidad digital. Recomendaciones de buena práctica.

The digital revolution resulting from the emergence of the Web 2.0 and the arrival of social media have changed how human beings communicate, and the physicianpatient relationship is not an exception to this new environment. The origin of a digital identity is critical for our participation in social media as social communicators, but digital professionalism should be framed within good practice recommendations with well-defined legal and ethical outlines. The objective of this article is to provide tools for the adequate use of social media and digital presence, taking the protection of personal image and disseminated information into consideration.

La revolución digital que se produjo con la llegada de la web 2.0 y el advenimiento de las redes sociales, ha cambiado la forma de comunicación entre los seres humanos, y la relación médico-paciente no escapa a este nuevo ecosistema. La génesis de una identidad digital es fundamental para poder participar como comunicadores en las redes sociales, pero el profesionalismo digital debe enmarcarse en las recomendaciones de buena práctica con marcos ético-legales bien definidos. El objetivo de este documento es brindar herramientas para el buen uso de las redes sociales y la presencia digital, considerando el cuidado de la imagen personal y de la información que se difunde.

The (un)making of electoral transparency through technology: The 2017 Kenyan presidential election controversy.

Marked by the killing of a senior ICT professional working for the Electoral Commission and the invalidation of the presidential election by the Supreme Court, the 2017 Kenyan elections make for a good case through which to study how digital technologies shape contemporary electoral practice. This article examines the practice of electoral transparency through technology and argues that it can be conceived as a socio-technical device based both on distancing people from knowledge of the electoral infrastructure and on staging a simplified discourse on public access to the electoral infrastructure. Drawing on interviews with key actors in election technology implementation and ethnographic observations of public events around it, the article argues that digital technology has had three sets of implications for elections. First, it has shaped the electoral infrastructure and the nature of the final result (now a paper and digital hybrid). Second, it has shaped the distribution of knowledge among electoral professionals, giving a central role to ICT actors, objects, and knowledge in the definition of electoral transparency. Third, the centrality of ICTs in elections and the order of knowledge they bring are highly controversial and criticized by other electoral actors who demand for material proof for understanding the inner workings of elections.

Exploring the use of self-sovereign identity for event ticketing systems.

Ticket fraud and ticket scalping activities often cause high costs as well as trust concerns for fans buying event tickets, especially in the secondary ticketing market. To address these issues, several publications and projects have proposed using blockchain technology to enable digital trust and ticket verifiability and thus to improve event ticketing systems. However, these approaches exhibit considerable privacy challenges and fall short concerning reliable, efficient visitor identification, which is necessary for controlling secondary market transactions. We demonstrate how a novel paradigm for end-user digital identity management, called self-sovereign identity (SSI), can be utilized to gain secondary market control. To do so, we follow a rigorous design science research approach to build and evaluate an SSI-based event ticketing framework. Our findings demonstrate that SSI-based event ticketing can enable efficient secondary market control by facilitating a practical implementation of the centralized exchange model. To generalize our results, we derive design principles for the efficient, reliable, and privacy-oriented ticket and identity verification and the use of revocation registries.

A behaviour biometrics dataset for user identification and authentication.

As e-Commerce continues to shift our shopping preference from the physical to online marketplace, we leave behind digital traces of our personally identifiable details. For example, the merchant keeps record of your name and address; the payment processor stores your transaction details including account or card information, and every website you visit stores other information such as your device address and type. Cybercriminals constantly steal and use some of this information to commit identity fraud, ultimately leading to devastating consequences to the victims; but also, to the card issuers and payment processors with whom the financial liability most often lies. To this end, we recognise that data is generally compromised in this digital age, and personal data such as card number, password, personal identification number and account details can be easily stolen and used by someone else. However, there is a plethora of data relating to a person's behaviour biometrics that are almost impossible to steal, such as the way they type on a keyboard, move the cursor, or whether they normally do so via a mouse, touchpad or trackball. This data, commonly called keystroke, mouse and touchscreen dynamics, can be used to create a unique profile for the legitimate card owner, that can be utilised as an additional layer of user authentication during online card payments. Machine learning is a powerful technique for analysing such data to gain knowledge; and has been widely used successfully in many sectors for profiling e.g., genome classification in molecular biology and genetics where predictions are made for one or more forms of biochemical activity along the genome. Similar techniques are applicable in the financial sector to detect anomaly in user keyboard and mouse behaviour when entering card details online, such that they can be used to distinguish between a legitimate and an illegitimate card owner. In this article, a behaviour biometrics (i.e., keystroke and mouse dynamics) dataset, collected from 88 individuals, is presented. The dataset holds a total of 1760 instances categorised into two classes (i.e., legitimate and illegitimate card owners' behaviour). The data was collected to facilitate an academic start-up project (called CyberSignature1) which received funding from Innovate UK, under the Cyber Security Academic Startup Accelerator Programme. The dataset could be helpful to researchers who apply machine learning to develop applications using keystroke and mouse dynamics e.g., in cybersecurity to prevent identity theft. The dataset, entitled 'Behaviour Biometrics Dataset', is freely available on the Mendeley Data repository.

Digital sexual identities: Between empowerment and disempowerment.

In the digital age, people increasingly explore and express their sexual identities online. The management and development of digital sexual identities can provide opportunities of empowerment on the individual, interpersonal, and societal level. At the same time, social media users are confronted with risks of sexual disempowerment in terms of identity de-validation, social exclusion, discrimination or even criminalization. The review article summarizes the current state of research on six selected sexual identities: (1) heterosexual, (2) LGBTIQ+, (3) asexual, (4) kink and fetish, (5) polyamory, and (6) sex worker identities in digital contexts. Covering a variety of social media platforms and cultural backgrounds, the review demonstrates that digital sexual identities are best understood as multifaceted socio-technical phenomena with ambivalent outcomes.

The Online Attention Game for Digital Identity Education: An Exploratory Study.

Ill-considered postings by young social media users hungry for attention have recently garnered headlines. Imprudent online posts distort the posters' digital identity, which refers to one's online image as perceived by others. Online attention-seeking behaviour may result in digital identities that are separate from a person's true nature, which can lead to social and mental harm. To mitigate these impacts, effective educational material is needed to help non-technical users understand the risks and consequences of thoughtless, attention-seeking online behaviour. This study takes the first step towards fulfilling this educational need by developing the Online Attention Game (OAG), which is played in a laboratory or classroom setting (OAG-CS) or remotely (OAG-R). It replicates the online competition involved in seeking other social media users' attention. Through five OAG games (two OAG-CS games with students, two OAG-CS games with researchers, and one OAG-R game with researchers), we confirmed the tendencies and characteristics of young university students' and adult researchers' online posting behaviour. Through carrying out the OAG-R successfully, we ensured the OAG was useful for digital identity education even at the difficult time of the COVID-19 pandemic.

Health-ID: A Blockchain-Based Decentralized Identity Management for Remote Healthcare.

COVID-19 has made eHealth an imperative. The pandemic has been a true catalyst for remote eHealth solutions such as teleHealth. Telehealth facilitates care, diagnoses, and treatment remotely, making them more efficient, accessible, and economical. However, they have a centralized identity management system that restricts the interoperability of patient and healthcare provider identification. Thus, creating silos of users that are unable to authenticate themselves beyond their eHealth application's domain. Furthermore, the consumers of remote eHealth applications are forced to trust their service providers completely. They cannot check whether their eHealth service providers adhere to the regulations to ensure the security and privacy of their identity information. Therefore, we present a blockchain-based decentralized identity management system that allows patients and healthcare providers to identify and authenticate themselves transparently and securely across different eHealth domains. Patients and healthcare providers are uniquely identified by their health identifiers (healthIDs). The identity attributes are attested by a healthcare regulator, indexed on the blockchain, and stored by the identity owner. We implemented smart contracts on an Ethereum consortium blockchain to facilities identification and authentication procedures. We further analyze the performance using different metrics, including transaction gas cost, transaction per second, number of blocks lost, and block propagation time. Parameters including block-time, gas-limit, and sealers are adjusted to achieve the optimal performance of our consortium blockchain.

Judgments in the Sharing Economy: The Effect of User-Generated Trust and Reputation Information on Decision-Making Accuracy and Bias.

The growing ecosystem of peer-to-peer enterprise - the Sharing Economy (SE) - has brought with it a substantial change in how we access and provide goods and services. Within the SE, individuals make decisions based mainly on user-generated trust and reputation information (TRI). Recent research indicates that the use of such information tends to produce a positivity bias in the perceived trustworthiness of fellow users. Across two experimental studies performed on an artificial SE accommodation platform, we test whether users' judgments can be accurate when presented with diagnostic information relating to the quality of the profiles they see or if these overly positive perceptions persist. In study 1, we find that users are quite accurate overall (70%) at determining the quality of a profile, both when presented with full profiles or with profiles where they selected three TRI elements they considered useful for their decision-making. However, users tended to exhibit an "upward quality bias" when making errors. In study 2, we leveraged patterns of frequently vs. infrequently selected TRI elements to understand whether users have insights into which are more diagnostic and find that presenting frequently selected TRI elements improved users' accuracy. Overall, our studies demonstrate that - positivity bias notwithstanding - users can be remarkably accurate in their online SE judgments.

Utilization and Impact of Social Media in Hand Surgeon Practices.

Background: Social media is an effective tool to enhance reputation and brand recognition and is being used by more than 40% of patients when selecting a physician. This study aimed to evaluate the use of social media in hand surgeon practices, and to assess the impact that one's social media presence has on physician-rating website scores (PRWs). Methods: Randomly selected hand surgeons from across the United States were identified. Sequential searches were performed using the physicians name + the respective social media platform (Facebook, LinkedIn, YouTube, Twitter, Instagram, personal website, group website). A comprehensive social media utilization index (SMI) was created for each surgeon. Utilizing descriptive statistics, we assessed the effect of social media on the PRW. Results: A total of 116 board-certified hand surgeons were included in our study. The sample identified 10.3% of the population used Facebook, 1.7% used Twitter, 25.8% used YouTube, 22.4% used LinkedIn, 27.5% used a personal website, and 36.2% used a group website, 0% used Instagram. The average SMI was 1.53 ± 1.42 (0-6). Physicians with a personal website received higher Healthgrades scores than those without one (P < .05). Analysis of SMI demonstrated that hand surgeons with an index less than 3 received lower Healthgrades scores compared to those with an SMI above 3 (P < .001). Conclusion: Hand surgeons underutilize social media platforms in their practice. A personal website is single most important social media platform to improve HealthGrades score in hand surgeons.