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3.
J Med Internet Res ; 22(9): e23692, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32897869

RESUMO

Cybersecurity threats are estimated to cost the world US $6 trillion a year by 2021, and the number of attacks has increased five-fold after COVID-19. Although there is substantial literature on the threats technological vulnerabilities have on the health care industry, less research exists on how pandemics like COVID-19 are opportunistic for cybercriminals. This paper outlines why cyberattacks have been particularly problematic during COVID-19 and ways that health care industries can better protect patient data. The Office for Civil Rights has loosened enforcement of the Health Insurance Portability and Accountability Act, which, although useful in using new platforms like Zoom, has also loosened physical and technical safeguards to cyberattacks. This is especially problematic given that 90% of health care providers had already encountered data breaches. Companies must implement well-defined software upgrade procedures, should use secure networks like virtual local area networks, and conduct regular penetration tests of their systems. By understanding factors that make individuals, health care organizations, and employers more susceptible to cyberattacks, we can better prepare for the next pandemic.


Assuntos
Segurança Computacional/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Pandemias , Pneumonia Viral/epidemiologia , Privacidade/legislação & jurisprudência , Registros Eletrônicos de Saúde , Humanos
6.
J Med Internet Res ; 22(6): e16757, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32579128

RESUMO

BACKGROUND: The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) was established to monitor national testing and test outcomes for blood-borne viruses (BBVs) and sexually transmissible infections (STIs) in key populations. ACCESS extracts deidentified data from sentinel health services that include general practice, sexual health, and infectious disease clinics, as well as public and private laboratories that conduct a large volume of BBV/STI testing. An important attribute of ACCESS is the ability to accurately link individual-level records within and between the participating sites, as this enables the system to produce reliable epidemiological measures. OBJECTIVE: The aim of this study was to evaluate the use of GRHANITE software in ACCESS to extract and link deidentified data from participating clinics and laboratories. GRHANITE generates irreversible hashed linkage keys based on patient-identifying data captured in the patient electronic medical records (EMRs) at the site. The algorithms to produce the data linkage keys use probabilistic linkage principles to account for variability and completeness of the underlying patient identifiers, producing up to four linkage key types per EMR. Errors in the linkage process can arise from imperfect or missing identifiers, impacting the system's integrity. Therefore, it is important to evaluate the quality of the linkages created and evaluate the outcome of the linkage for ongoing public health surveillance. METHODS: Although ACCESS data are deidentified, we created two gold-standard datasets where the true match status could be confirmed in order to compare against record linkage results arising from different approaches of the GRHANITE Linkage Tool. We reported sensitivity, specificity, and positive and negative predictive values where possible and estimated specificity by comparing a history of HIV and hepatitis C antibody results for linked EMRs. RESULTS: Sensitivity ranged from 96% to 100%, and specificity was 100% when applying the GRHANITE Linkage Tool to a small gold-standard dataset of 3700 clinical medical records. Medical records in this dataset contained a very high level of data completeness by having the name, date of birth, post code, and Medicare number available for use in record linkage. In a larger gold-standard dataset containing 86,538 medical records across clinics and pathology services, with a lower level of data completeness, sensitivity ranged from 94% to 95% and estimated specificity ranged from 91% to 99% in 4 of the 6 different record linkage approaches. CONCLUSIONS: This study's findings suggest that the GRHANITE Linkage Tool can be used to link deidentified patient records accurately and can be confidently used for public health surveillance in systems such as ACCESS.


Assuntos
Registros Eletrônicos de Saúde/normas , Privacidade/legislação & jurisprudência , Vigilância em Saúde Pública/métodos , Humanos
8.
Can J Public Health ; 111(4): 454-457, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32592023

RESUMO

Sharing data expediently for pandemic response purposes exposes healthcare providers in Canada to significant regulatory uncertainty. Duplicative and contradictory ethical and legal duties flowing from overlapping sources can stifle flows of medical data among clinicians, researchers, and institutions. Authorities should support caregivers and accelerate research by providing clear guidance to the health sector. Institutions should foster robust data stewardship and standardize their practices to those recognized among the international health informatics community. Reform is critical to ensuring Canadian healthcare providers can deliver efficient health responses that are integrated with dispersed and disparate national and international approaches.


Assuntos
Pesquisa Biomédica , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Privacidade/legislação & jurisprudência , Saúde Pública , Canadá/epidemiologia , Humanos
11.
NASN Sch Nurse ; 35(4): 198-202, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32413270

RESUMO

The Family Educational Rights and Privacy Act of 1974 is the federal law that protects the privacy of personally identifiable information from student education records and applies to all education entities that receive funding under any program administered by the U.S. Department of Education. The Health Insurance Portability and Accountability Act of 1996 is the federal law that establishes privacy requirements for patients' protected health information. Together these privacy laws establish rules that guide school nurses in the sharing of student information, even in times of public health emergencies. The U.S. Department of Education and the U.S. Department of Health and Human Services have issued special updates to privacy laws in response to the Novel Coronavirus Disease providing certain waivers of typical privacy requirements and direction to allow the sharing of information during this public health emergency. The purpose of this article is to briefly review the privacy laws as they relate to schools, as well as to provide an overview of the recent waivers to assist school nurses, school administrators, healthcare professionals, and public health agencies in protecting the health and safety of students during this current public health emergency.


Assuntos
Betacoronavirus , Confidencialidade/legislação & jurisprudência , Infecções por Coronavirus , Disseminação de Informação/legislação & jurisprudência , Pandemias , Pneumonia Viral , Privacidade/legislação & jurisprudência , Serviços de Enfermagem Escolar/legislação & jurisprudência , Serviços de Enfermagem Escolar/normas , Emergências , Guias como Assunto , Humanos , Saúde Pública/legislação & jurisprudência , Saúde Pública/normas , Estados Unidos
13.
Proc Natl Acad Sci U S A ; 117(24): 13405-13412, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32467167

RESUMO

The application of a currently proposed differential privacy algorithm to the 2020 United States Census data and additional data products may affect the usefulness of these data, the accuracy of estimates and rates derived from them, and critical knowledge about social phenomena such as health disparities. We test the ramifications of applying differential privacy to released data by studying estimates of US mortality rates for the overall population and three major racial/ethnic groups. We ask how changes in the denominators of these vital rates due to the implementation of differential privacy can lead to biased estimates. We situate where these changes are most likely to matter by disaggregating biases by population size, degree of urbanization, and adjacency to a metropolitan area. Our results suggest that differential privacy will more strongly affect mortality rate estimates for non-Hispanic blacks and Hispanics than estimates for non-Hispanic whites. We also find significant changes in estimated mortality rates for less populous areas, with more pronounced changes when stratified by race/ethnicity. We find larger changes in estimated mortality rates for areas with lower levels of urbanization or adjacency to metropolitan areas, with these changes being greater for non-Hispanic blacks and Hispanics. These findings highlight the consequences of implementing differential privacy, as proposed, for research examining population composition, particularly mortality disparities across racial/ethnic groups and along the urban/rural continuum. Overall, they demonstrate the challenges in using the data products derived from the proposed disclosure avoidance methods, while highlighting critical instances where scientific understandings may be negatively impacted.


Assuntos
Censos , Disparidades nos Níveis de Saúde , Privacidade/legislação & jurisprudência , Revelação/legislação & jurisprudência , Revelação/tendências , Grupos Étnicos , Humanos , Mortalidade/etnologia , Mortalidade/tendências , População Rural , Estados Unidos , População Urbana
15.
Am J Nurs ; 120(4): 19-20, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32218037

RESUMO

Partnerships between tech companies and health systems challenge privacy expectations and laws.


Assuntos
Confidencialidade/normas , Registros de Saúde Pessoal/ética , Privacidade/legislação & jurisprudência , Confidencialidade/legislação & jurisprudência , Humanos , Governo Estadual
18.
PLoS One ; 15(1): e0227800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978096

RESUMO

The Internet of Things (IoT) brings internet connectivity to everyday electronic devices (e.g. security cameras and smart TVs) to improve their functionality and efficiency. However, serious security and privacy concerns have been raised about the IoT which impact upon consumer trust and purchasing. Moreover, devices vary considerably in terms of the security they provide, and it is difficult for consumers to differentiate between more and less secure devices. One proposal to address this is for devices to carry a security label to help consumers navigate the market and know which devices to trust, and to encourage manufacturers to improve security. Using a discrete choice experiment, we estimate the potential impact of such labels on participant's purchase decision making, along with device functionality and price. With the exception of a label that implied weak security, participants were significantly more likely to select a device that carried a label than one that did not. While they were generally willing to pay the most for premium functionality, for two of the labels tested, they were prepared to pay the same for security and functionality. Qualitative responses suggested that participants would use a label to inform purchasing decisions, and that the labels did not generate a false sense of security. Our findings suggest that the use of a security label represents a policy option that could influence behaviour and that should be seriously considered.


Assuntos
Segurança Computacional/legislação & jurisprudência , Comportamento do Consumidor/economia , Tomada de Decisões , Internet das Coisas/economia , Privacidade/psicologia , Adolescente , Adulto , Idoso , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Internet das Coisas/legislação & jurisprudência , Internet das Coisas/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Políticas , Privacidade/legislação & jurisprudência , Inquéritos e Questionários/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis/economia , Dispositivos Eletrônicos Vestíveis/psicologia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos , Adulto Jovem
20.
BMC Med Inform Decis Mak ; 19(1): 254, 2019 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-31801545

RESUMO

BACKGROUND: This study explored the possible antecedents that will motivate hospital employees' compliance with privacy policy related to electronic medical records (EMR) from a deterrence perspective. Further, we also investigated the moderating effect of computer monitoring on relationships among the antecedents and the level of hospital employees' compliance intention. METHODS: Data was collected from a large Taiwanese medical center using survey methodology. A total of 303 responses was analyzed via hierarchical regression analysis. RESULTS: The results revealed that sanction severity and sanction certainty significantly predict hospital employees' compliance intention, respectively. Further, our study found external computer monitoring significantly moderates the relationship between sanction certainty and compliance intention. CONCLUSIONS: Based on our findings, the study suggests that healthcare facilities should take proactive countermeasures, such as computer monitoring, to better protect the privacy of EMR in addition to stated privacy policy. However, the extent of computer monitoring should be kept to minimum requirements as stated by relevant regulations.


Assuntos
Segurança Computacional/legislação & jurisprudência , Confidencialidade/legislação & jurisprudência , Registros Eletrônicos de Saúde/legislação & jurisprudência , Fidelidade a Diretrizes/legislação & jurisprudência , Recursos Humanos em Hospital/legislação & jurisprudência , Privacidade/legislação & jurisprudência , Adulto , China , Redes de Comunicação de Computadores/legislação & jurisprudência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
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