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Can Assoc Radiol J ; 70(3): 212-218, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31376884


PURPOSE: Secondary usage of patient data has recently become of increasing interest for the development and application of computer analytic techniques. Strict oversight of these data is required and the individual patients themselves are integral to providing guidance. We sought to understand patients' attitudes to sharing their imaging data for research purposes. These images could provide a great wealth of information for researchers. METHODS: Patients from the Greater Toronto Area attending Sunnybrook Health Sciences Centre for imaging (magnetic resonance imagining, computed tomography, or ultrasound) examination areas were invited to participate in an electronic survey. RESULTS: Of the 1083 patients who were approached (computed tomography 609, ultrasound 314, and magnetic resonance imaging 160), 798 (74%) agreed to take the survey. Overall median age was 60 (interquartile range = 18, Q1 = 52, Q3 = 70), 52% were women, 42% had a university degree, and 7% had no high school diploma. In terms of willingness to share de-identified medical images for research, 76% were willing (agreed and strongly agreed), while 7% refused. Most participants gave their family physicians (73%) and other physicians (57%) unconditional data access. Participants chose hospitals/research institutions to regulate electronic images databases (70%), 89% wanted safeguards against unauthorized access to their data, and over 70% wanted control over who will be permitted, for how long, and the ability to revoke that permission. CONCLUSIONS: Our study found that people are willing to share their clinically acquired de-identified medical images for research studies provided that they have control over permissions and duration of access.

Confidencialidade/psicologia , Diagnóstico por Imagem/psicologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Troca de Informação em Saúde/estatística & dados numéricos , Opinião Pública , Sujeitos da Pesquisa/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Canadá , Segurança Computacional , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
Stud Health Technol Inform ; 264: 70-73, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437887


Unstructured electronic health records are valuable resources for research. Before they are shared with researchers, protected health information needs to be removed from these unstructured documents to protect patient privacy. The main steps involved in removing protected health information are accurately identifying sensitive information in the documents and removing the identified information. To keep the documents as realistic as possible, the step of omitting sensitive information is often followed by replacement of identified sensitive information with surrogates. In this study, we present an algorithm to generate surrogates for unstructured electronic health records. We used this algorithm to generate realistic surrogates on a Health Science Alliance corpus, which is constructed specifically for the use of development of automated de-identification systems.

Anonimização de Dados , Registros Eletrônicos de Saúde , Algoritmos , Confidencialidade , Humanos
Stud Health Technol Inform ; 264: 1140-1144, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438103


The volume of unstructured health records has increased exponentially across healthcare settings. Similarly, the number of healthcare providers that wish to exchange records has also increased and, as a result, de-identification and the preservation of privacy features have become increasingly important and necessary. Governance guidelines now require sensitive information to be masked or removed yet this remains a difficult and often ad-hoc task, particularly when dealing with unstructured text. Annotators are typically used to identify such sensitive information but they may only be effective in certain text fragments. There is at present no hybrid, sustainable framework that aggregates different annotators together. This paper proposes a novel framework that leverages a combination of state-of-the-art annotators in order to maximize the effectiveness of the de-identification of health information.

Anonimização de Dados , Privacidade , Confidencialidade , Sistemas Computadorizados de Registros Médicos
Stud Health Technol Inform ; 264: 1189-1193, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438113


Enforcement of General Data Protection Regulation strengthens privacy in Europe and especially emphasizes protection of special categories of data as required in health care. Layered Privacy Language intends to model privacy policies to enforce them. Hereby, a special focus lays on the Policy-based De-identification process, which is based on anonymization and privacy models. Motivated by a health care scenario, this work shows pseudonymization capabilities are essential for health care. An overview of pseudonymization methods is given, showing a great variety of methods for different use cases. Therefore, a pseudonymization extension for Layered Privacy Language is introduced to define several pseudonymization methods. Furthermore, pseudonymization is added to Policy-based De-identification process of the overarching privacy framework of Layered Privacy Language. An example policy configuration is given demonstrating the introduced pseudonymization extension on the given health care example. The results are discussed, concluded, and future work is introduced.

Confidencialidade , Privacidade , Segurança Computacional , Europa (Continente) , Linguagem
Stud Health Technol Inform ; 264: 1361-1365, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438148


Little is known about data sharing preferences for care and research of behavioral health patients. Eighty-six behavioral health patients (n = 37 Latinos; n = 32 with serious mental illness) completed questionnaires, in either English or Spanish, with items assessing their views on privacy and sensitivity of health record information. Most patients (82.5%) considered mental health information as sensitive. In general, there was a direct correspondence between perceived sensitivity of information and willingness to share with all or some providers. A main motivation for sharing data with providers was improving the patient's own care (77.8%). Most participants (96.5%) indicated they would be extremely to somewhat willing to share their data for research with their care facilities and universities. Follow-up patient interviews are being conducted to further elucidate these findings.

Disseminação de Informação , Privacidade , Confidencialidade , Registros Eletrônicos de Saúde , Humanos , Inquéritos e Questionários
Stud Health Technol Inform ; 262: 19-22, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349255


This paper provides a summary of the Privacy Management Analysis method followed for the analysis of the International Patient Summary exchange use cases of Trillium II Project. The objective is to recommend the required security and privacy measures by providing traceability from Regulations/Principles/Preferences to the recommended Security & Privacy Measures that needs to be implemented in pilots.

Segurança Computacional , Privacidade , Confidencialidade , Humanos
Stud Health Technol Inform ; 262: 264-267, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349318


Data sharing, information exchange, knowledge acquisition and health intelligence are the basis of an efficient and effective evidence-based decision-making tool. A decentralized blockchain architecture is a flexible solution that can be adapted to institutional and managerial culture of organizations and services. Blockchain can play a fundamental role in enabling data sharing within a network and, to achieve that, this work defines the high-level resources necessary to apply this technology to Tuberculosis related issues. Thus, relying in open-source tools and in a collaborative development approach, we present a proposal of a blockchain based network, the TB Network, to underpin an initiative of sharing of Tuberculosis scientific, operational and epidemiologic data between several stakeholders across Brazilian cities.

Segurança Computacional , Tuberculose , Brasil , Confidencialidade , Humanos , Disseminação de Informação
Rev. SOBECC ; 24(2): 99-106, abr-.jun.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1006174


Objetivo: Analisar a literatura científica a respeito da comunicação por meios eletrônicos entre profissionais de saúde. Método: Revisão integrativa da literatura, realizada nas bases de dados e/ou portais PubMed, Biblioteca Virtual em Saúde e Cochrane, até agosto de 2018, com descritores combinados, que respondem à pergunta norteadora: "Como ocorre a comunicação eletrônica entre os profissionais de saúde na assistência ao paciente? ”. Resultados: Seis artigos foram incluídos, publicados de 2011 a 2016, no idioma Inglês. Os recursos foram smartphone, pager e tablet. Os aplicativos utilizados foram WhatsApp, Medigram e Serviço de Mensagens Curtas (SMS). Agilidade, facilidade de uso e auxílio na tomada de decisão foram as vantagens encontradas no uso desse recurso na comunicação dos profissionais; dentre as desvantagens estão ausência de privacidade e de confidencialidade das informações, interrupções na assistência e inabilidade no uso do recurso tecnológico. Conclusão: O uso de aplicativos para troca de mensagens e comunicação interdisciplinar de fato proporciona agilidade na comunicação, mas a confidencialidade desses dados ainda é uma questão a ser tratada. Assim, cabe ao enfermeiro conduzir a comunicação com os demais profissionais, preservando a privacidade do paciente.

Purpose: To analyze scientific literature regarding the communication via electronic means between health professionals. Method: Integrative revision of the literature carried through databases and/or portals PubMed, Virtual Health Library and Cochrane, until August 2018, with combined describers, who answer to the leading question: "How does the electronic communication between health professionals in patient assistance occur?". Results: Six articles were included, published from 2011 to 2016 in the English language. Features were smartphone, pager and tablet. The applications used were WhatsApp, Medigram and Short Message Service (SMS). Agility, ease of use and support in decision-making were the advantages found in the use of this resource in the communication of professionals; among the disadvantages are lack of privacy and confidentiality of information, interruptions in assistance and inability to use the technological resource. Conclusion: The use of applications for messaging and interdisciplinary communication does indeed provide agility in communication, but the confidentiality of such data is still an issue to be addressed. Thus, it is up to the nurse to conduct communication with the other professionals, preserving the patient's privacy

Objetivo: Analizar la literatura científica acerca de la comunicación por medios electrónicos entre profesionales de salud. Método: Revisión integrativa de la literatura, realizada en las bases de datos y/o portales PubMed, Biblioteca Virtual em Salud y Cochrane, hasta agosto de 2018, con descriptores combinados, que responden a la pregunta orientadora: "¿Cómo ocurre la comunicación electrónica entre los profesionales de salud en la asistencia al paciente?". Resultados: Seis artículos fueron incluidos, publicados de 2011 a 2016, en el idioma Inglés. Los recursos fueron teléfono inteligente,pager y tablet. Las aplicaciones utilizadas fueron Whatsapp, Medigram y Servicio de mensajes cortos (SMS). Agilidad, facilidad de uso y ayuda em la tomada de decisión fueron las ventajas encontradas en el uso de ese recurso en la comunicación de los profesionales; entre las desventajas están la ausencia de privacidad y de confidencialidad de las informaciones, interrupciones em la asistencia e inhabilidad en el uso del recurso tecnológico. Conclusión: El uso de aplicaciones para el intercambio de mensajes y la comunicación interdisciplinaria de hecho proporciona agilidad en la comunicación, per la confidencialidad de estos datos sigue siendo una cuestión a tratar. Así, corresponde al enfermero conducir la comunicación con os demás profesionales, preservando la privacidad del paciente.

Humanos , Assistência ao Paciente , Enfermagem , Revisão , Comunicação , Confidencialidade
Stud Health Technol Inform ; 261: 246-252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156124


Within a healthcare environment, organizational, legal, functional, social, ethical, and technical requirements must be met. In that context, security and safety are important challenges, which highly influence user acceptance. In such a complex scenario, privilege management and access control are critical for data security and patients' privacy. On the other end, the appropriate use of care data should not be prevented by data protection measures. In order to enable an adequate use of data, all the policies ruling the care process must be harmonized. In order to pursue this aim, the health system's architecture must be formally described at the required level of granularity using a system theory based architectural model. The resulting representation can be used as a mean to compare the different access control models governing the different parts of the distributed environment and to perform policy harmonization.

Segurança Computacional , Confidencialidade , Humanos , Informática Médica
Manag Care ; 28(6): 37-39, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31188099


When patients and their medical records are out of whack, it causes harm and wastes money. It gets worse when organizations try to share patient records. Even if two facilities share the same EHR system, match rates may be as low as 50%. Privacy concerns makes this problem difficult to fix.

Registros Eletrônicos de Saúde , Confidencialidade , Humanos , Privacidade
Rev Infirm ; 68(252): 24-25, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31208593


Faced with the multiplication of IT tools, it is necessary to remember certain points concerning data protection and professional confidentiality.

Cuidadores , Confidencialidade , Tecnologia da Informação , Humanos
Stud Health Technol Inform ; 260: 202-209, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118339


Keeping health information confidential is an important aspect of managing health information. This study aimed at determining the performance of health information management departments (HIMD) to identify the policies of these hospitals, their similarities, and differences in their procedures in this respect. Managers of the departments and information disclosure and medical record staff in 22 teaching hospitals were invited to complete a questionnaire regarding their practices in four axes including confidentiality principles, principles of disclosure consent, disclosure information to external and internal users. We found that there are no specific national framework and guidelines for the disclosure of health information. Hospitals are undertaking different ways in this regard. In most cases, patients' consent is not considered necessary for disclosure and only hospital managers' or physicians' consent is sufficient.

Confidencialidade , Gestão da Informação em Saúde , Médicos , Revelação , Humanos , Registros Médicos
Cad. Ibero Am. Direito Sanit. (Impr.) ; 8(1): 95-109, jan.-mar. 2019.
Artigo em Português | LILACS | ID: biblio-996365


Objetivo: avaliar a condição de sigilo do prontuário médico a partir da perspectiva do direito do paciente, considerando as normativas vigentes no país emanadas do Conselho Federal de Medicina. Metodologia: a pesquisa tem natureza bibliográfica e documental, consubstanciando-se em livros e artigos da área jurídica, em legislação ordinária e resoluções do Conselho Federal de Medicina. Resultados: o prontuário médico é documento complexo, que apresenta caráter informativo e científico. Confidencialidade, sigilo e segurança das informações são princípios observados quando da divulgação das informações contidas no documento. Conclusão: o prontuário médico, seja físico, seja digital, mais do que uma ferramenta de trabalho dos médicos e instituições de saúde, é um direito do paciente e que se encontra acobertado pelo sigilo em respeito à intimidade do paciente. (AU)

Objetivo: evaluar la condición de sigilo del prontuario médico desde la perspectiva del derecho del paciente, considerando las normativas vigentes en el país emanadas del Consejo Federal de Medicina. Metodología: la investigación tiene naturaleza bibliográfica y documental, consubstanciándose en libros y artículos del área jurídica, en legislación ordinaria y resoluciones del Consejo Federal de Medicina. Resultados: el prontuario médico es un documento complejo, que presenta carácter informativo y científico. Confidencialidad, confidencialidad y seguridad de la información son principios observados al divulgar la información contenida en el documento. Conclusión: el prontuario médico, ya sea físico, ya sea digital, más que una herramienta de trabajo de los médicos e instituciones de salud, es un derecho del paciente y que se encuentra encubierto por el sigilo en respeto a la intimidad del paciente. (AU)

Objective: to evaluate the confidentiality condition of the medical record from the perspective of the patient's right, considering the regulations in force in the country emanating from the Federal Medical Council. Methodology: the research has bibliographic and documentary nature, in books and articles of the legal area, in ordinary legislation and resolutions of the Federal Council of Medicine. Results: medical records are complex documents, which are informative and scientific. Confidentiality, confidentiality and security of information are principles observed when disclosing the information contained in the document. Conclusion: Medical records, whether physical or digital, are more than a work tool of physicians and health institutions, it is a patient's right and is covered by secrecy with respect to the patient's intimacy. (AU)

Humanos , Registros Médicos/legislação & jurisprudência , Confidencialidade/ética , Direitos do Paciente