Privacy Preserving based Personal Health Records Sharing Using Rail Fence Data Encryption (RFDE) for Secure Cloud Environment

The prevalence cloud security has privacy preserving problems that major challenges due to humanity's need protect the sensitive and non-sensitive data to decision-making and resolve data leakage problems. One of the most difficult aspects is the reuse and sharing of accurate and detailed clinical data about PHR collected via Personal Health Records (PHRs) cloud transition is difficult. PHRs are often privacy preserving patient-centric models for exchanging medical information outsourced to third parties, such as Cloud Service Providers (CSP). A unique PHR patient information to ensure security with encryption before storage in the cloud. But still, issues such as security issues, flexible access and a valid user privacy risk management, efficiency and remain an important challenge to achieve better data access sensitive and non-sensitive imposition of control in cloud storage. To achieve high efficiency of PHR and modular data access control, Rail Fence Data Encryption (RFDE) algorithm provided to encrypt the PHR file to make high privacy standards. RFDE is also a form of transposition cipher called zigzag encryption, and the unauthorized user can't access the information. The proposed algorithm encrypts the PHR information it generates the secret key. The receiver decrypts the PHR information using the private key. The proposed algorithm provide efficient performance compared with previous algorithm. © 2023 IEEE.

Privacy Preserving Based Personal Health Records Sharing Using Rail Fence Data Encryption (RFDE) for Secure Cloud Environment

The development of cloud technology is a fundamental idea for offering unfettered access to many different sources in the planning of the networking, memory, infrastructure, and software. Computers are becoming more and more widespread across a wide range of industries due to their numerous advantages, notably in the healthcare industry. Typically, it is essential to the interchange of health information. In light of the ongoing issues with password security, sending private medical information via the internet still raises serious privacy concerns. Whether or whether they have complete permission, patients are not forced to divulge any of their private or personal information. This article examines several noteworthy recent studies that address the problems of password security and data privacy for cloud-based health services. These compare the benefits and drawbacks of different physical access preservation techniques. The paper also proposes a combined authentication procedure based on RFDE models. Cloud security is usually greatly hampered by the necessity for information privacy in an effort to protect sensitive and non-sensitive data for decision-making and to solve the problem of information leakage. One of the most challenging parts of the transfer of personal health records (PHRs) to the cloud is the reuse and exchange of accurate, complete medical evidence. When PHRs are outsourced to third-party businesses, such as cloud services, they are often used as patient-centered, private ways of exchanging health information. Data about a particular PHR doctor is coded for protection before being sent to the cloud. However, there are still substantial barriers due to issues with security, things that can be improved, lawful consumer privacy portfolio management, efficiency, and regulation over sensitive and non-sensitive data kept in the cloud. The PHR file may be encrypted using the Rail Fence Data Encryption (RFDE) technique to provide strong confidentiality rules and enable PHR and modular connectivity control to perform at their very best. Unauthorized users are managed to stop from accessing information with the aid of the transposition cypher, also used by RFDE and known as 'zigzag encryption.' The recommended technique generates the secret key while encrypting the PHR information. The recipient decrypts the PHR data using the private key. The algorithm works brilliantly in comparison to the prior strategy. © 2022 IEEE.

Determinants of Shielding Behavior During the COVID-19 Pandemic and Associations With Well-being Among National Health Service Patients: Longitudinal Observational Study.

BACKGROUND: The UK National Health Service (NHS) classified 2.2 million people as clinically extremely vulnerable (CEV) during the first wave of the 2020 COVID-19 pandemic, advising them to "shield" (to not leave home for any reason). OBJECTIVE: The aim of this study was to measure the determinants of shielding behavior and associations with well-being in a large NHS patient population for informing future health policy. METHODS: Patients contributing to an ongoing longitudinal participatory epidemiology study (Longitudinal Effects on Wellbeing of the COVID-19 Pandemic [LoC-19], n=42,924) received weekly email invitations to complete questionnaires (17-week shielding period starting April 9, 2020) within their NHS personal electronic health record. Question items focused on well-being. Participants were stratified into four groups by self-reported CEV status (qualifying condition) and adoption of shielding behavior (baselined at week 1 or 2). The distribution of CEV criteria was reported alongside situational variables and univariable and multivariable logistic regression. Longitudinal trends in physical and mental well-being were displayed graphically. Free-text responses reporting variables impacting well-being were semiquantified using natural language processing. In the lead up to a second national lockdown (October 23, 2020), a follow-up questionnaire evaluated subjective concern if further shielding was advised. RESULTS: The study included 7240 participants. In the CEV group (n=2391), 1133 (47.3%) assumed shielding behavior at baseline, compared with 633 (13.0%) in the non-CEV group (n=4849). CEV participants who shielded were more likely to be Asian (odds ratio [OR] 2.02, 95% CI 1.49-2.76), female (OR 1.24, 95% CI 1.05-1.45), older (OR per year increase 1.01, 95% CI 1.00-1.02), living in a home with an outdoor space (OR 1.34, 95% CI 1.06-1.70) or three to four other inhabitants (three: OR 1.49, 95% CI 1.15-1.94; four: OR 1.49, 95% CI 1.10-2.01), or solid organ transplant recipients (OR 2.85, 95% CI 2.18-3.77), or have severe chronic lung disease (OR 1.63, 95% CI 1.30-2.04). Receipt of a government letter advising shielding was reported in 1115 (46.6%) CEV participants and 180 (3.7%) non-CEV participants, and was associated with adopting shielding behavior (OR 3.34, 95% CI 2.82-3.95 and OR 2.88, 95% CI 2.04-3.99, respectively). In CEV participants, shielding at baseline was associated with a lower rating of mental well-being and physical well-being. Similar results were found for non-CEV participants. Concern for well-being if future shielding was required was most prevalent among CEV participants who had originally shielded. CONCLUSIONS: Future health policy must balance the potential protection from COVID-19 against our findings that shielding negatively impacted well-being and was adopted in many in whom it was not indicated and variably in whom it was indicated. This therefore also requires clearer public health messaging and support for well-being if shielding is to be advised in future pandemic scenarios.

SARS-CoV-2 Infection upon Leaving the Tokyo 2020 Olympic and Paralympic Games.

Objective Just before the Tokyo 2020 Olympic and Paralympic Games in Japan, the number of people infected with coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), started to increase at an unprecedented rate. This study investigated the effectiveness of vaccines in large-scale sporting events under difficult circumstances, such as during adherence to a bubble system and confinement inside the Olympic/Paralympic Village. Methods In collaboration with medical clinics inside and outside the Village, a prospective cohort study was conducted among overseas participants using the results of polymerase chain reaction (PCR) tests for SARS-CoV-2 upon leaving Japan. Results A total of 12,072 foreign participants were enrolled, 13 (0.11%) of whom had a positive PCR test result. None of these cases were broadcasters or members of the press, were tested outside the Olympic Village, or had a history of COVID-19 infection. The effectiveness of full vaccination and vaccination at least once (≥14 days ago) was 74% (95% confidence interval [CI]: 6-93%) and 81% (95% CI: 30-95%), respectively. Three breakthrough infections with the Delta variant were observed in 6,485 fully vaccinated participants (0.05%). The positivity rate was 0.09% among adherents to the bubble system and 0.28% among non-adherents, but this difference was not significant. Conclusion These findings indicate that even huge sporting events such as the Olympic and Paralympic Games can proceed while pandemics are ongoing in the host country by combining countermeasures such as vaccination, frequent testing, social distancing, and adherence to a bubble system.

Ambient Assisted Living and Personal Health Records – Requirements and Challenges

We face enormous medical and health services demands due to the Covid-19 pandemic. This fact implies that the healthcare sector does not manage to cope with the considerable pressure from patients who experienced Covid-19, from which some fail to survive. The hospitals and medical practitioners everywhere were faced with significant stresses, and they were unable to cope with these problems. The patients were scared and unsatisfied with medical help, and the healthcare staff was exhausted everywhere. One of the solutions was implementing the concept of e-health with the usage of e-PHR of the patient and using some components of ambient assisted living (AAL), telemedicine, and telehealth. Many sensors for measuring vital signs of life are available on the market. Some applications can collect these data from IoT devices (sensors), wearables, or other devices that can help monitor the patient’s healthcare condition in a pandemic situation. In this way, healthcare professionals can access patients’ vital conditions and take actions such as e-prescription and e-referral. In the paper, we highlighted some aspects of possible healthcare improvement for the patients using AAL devices who can assist in improving access to medical and healthcare professionals, especially for the patients with chronic diseases, some disabilities, the elderly and children. This concept is based on the e-PHR concept, which understands that the patient owns their data and can access their e-Personal Health Record. © 2022 Copyright for this paper by its authors.

Use of video-based telehealth services using a mobile app for workers in underserved areas during the COVID-19 pandemic: A prospective observational study.

BACKGROUND: The COVID-19 pandemic has limited face-to-face treatment, triggering a change in the structure of existing healthcare services. Unlike other groups, workers in underserved areas have relatively poor access to healthcare. OBJECTIVE: This study aimed to investigate the effects of video-based telehealth services using a mobile personal health record (PHR) app for vulnerable workers with metabolic risk factors. METHODS: A prospective observational study was conducted with 117 participants and 27 healthcare professionals for 16 weeks. Participants visited the research institution three times (at weeks 1, 8, and 16) and underwent health check-ups and used various features of the mobile PHR app. Healthcare professionals observed the participants's data using the monitoring system and performed appropriate interventions. The primary outcome measures were to evaluate the effects of services on changes in the participants' metabolic risk factors, and secondary outcome measures were to analyze changes in the participants' lifestyle and service satisfaction, and to observe service use through usage logs. One-way repeated measures ANOVA and Scheffé's test were performed to observe changes in participants' health status and lifestyle, and a paired t-test was performed to analyze changes in service satisfaction. Finally, in-depth interviews with healthcare professionals were performed using semi-structured questionnaires to understand service providers' perspectives after the end of the study. RESULTS: Systolic blood pressure (F = 7.32, P <.001), diastolic blood pressure (F = 11.30, P <.001), body weight (F = 29.53, P <.001), BMI (F = 17.31, P <.001), waist circumference (F = 17.33, P <.001), fasting blood glucose (F = 5.11, P =.007), and triglycerides (F = 4.66, P =.01) showed significant improvements with time points, whereas high-density lipoprotein cholesterol (F = 3.35, P =.067) did not. The dietary score (F = 3.26, P =.04) showed a significant improvement with time points, whereas physical activity (F = 1.06, P =.34) did not. In terms of service satisfaction, only lifestyle improvement (P <.001) showed a significant difference. COVID-19 has affected the performance of healthcare professionals, thereby changing the perspectives toward healthcare technology services. CONCLUSIONS: We evaluated the effectiveness of video-based telehealth services supporting workers' health status and lifestyle interventions using healthcare technologies such as the mobile PHR app, tele-monitoring, and video teleconsultation. Our results indicate that as a complementary means, its utility can be expanded in the field of occupational safety and health to overcome the limitations of face-to-face treatment due to COVID-19 in the future.

Use of Medical Information and Digital Services for Self-Empowerment before, during, and after a Major Disaster.

Disaster response procedures have been developed and improved following the Great East Japan Earthquake. Innovative services have also been created through digital transformation, including an acceleration and deepening of artificial intelligence technology. Things that were once technically impossible are now possible. These innovative technologies will spread across various fields, and disaster response will not be an exception. The Ministry of Health, Labour and Welfare is promoting the use of personal health records in a way that effectively supports the management of treatments by using data from wearable devices and specific applications. During the COVID-19 pandemic, the trade-off between protecting personal information and enabling social benefits, such as in the use of digital tracking, and infodemics, including misinformation, have become new social challenges. Reviewing past disaster preparedness and the services and value provided by digital transformation indicates what new disaster preparedness should be. Digital transformation does not require literacy (ability to collect, analyze, and use information) but competence (beneficial behavioral traits derived from experience). Understanding behavior through data and enabling rational behavior are crucial. By increasing human productivity, we can save time and improve self- and mutual-help in times of disaster. Medical information and digital services must be properly used in normal times. A society that uses such services will be more disaster resilient.

Assessing the information quality and usability of My Health Record within a health literacy framework: What's changed since 2016?

BACKGROUND: This study examined the health literacy demands of My Health Record (MyHR) in the context of preparing for a government-announced opt-out system by repeating two studies of health information and usability conducted in 2016. OBJECTIVE: To examine whether Australia's MyHR meets the information and usability needs of people at risk of low health literacy and changes since 2016. METHOD: Content analysis: Informed by the 2016 methods and findings, measures of information quality, themes and target audiences were recorded and reported for each online consumer-facing health information resource. Heuristic evaluation: An evaluation of the MyHR and supporting information website was conducted using a predetermined checklist of usability criteria. A list of usability violations for both websites was identified. RESULTS: Total number of resources grew from 80 in 2016 to 233 in 2018. There was little change since 2016 to average readability levels, target audiences, presentation style, links between resources and usability of MyHR. Compared to 2016, this study demonstrated increases in resources from non-government organisations; video resources; translated resources; and resources with themes of privacy, security and post-registration use. CONCLUSION: This study identified some improvements in information quality since 2016, but gaps remain in information quality and usability which may negatively impact the ability for people with low health literacy to access and use MyHR. IMPLICATIONS: This study provides a framework for ongoing monitoring and evaluation of the suitability of MyHR for people at risk of low health literacy.

A Technology Acceptance Model for Deploying Masks to Combat the COVID-19 Pandemic in Taiwan (My Health Bank): Web-Based Cross-sectional Survey Study.

BACKGROUND: The successful completion of medical practices often relies on information collection and analysis. Government agencies and medical institutions have encouraged people to use medical information technology (MIT) to manage their conditions and promote personal health. In 2014, Taiwan established the first electronic personal health record (PHR) platform, My Health Bank (MHB), which allows people to access and manage their PHRs at any time. In the face of the COVID-19 pandemic in 2020, Taiwan has used MIT to effectively prevent the spread of COVID-19 and undertaken various prevention measures before the onset of the outbreak. Using MHB to purchase masks in an efficient and orderly way and thoroughly implementing personal protection efforts is highly important to contain disease spread. OBJECTIVE: This study aims to understand people's intention to use the electronic PHR platform MHB and to investigate the factors affecting their intention to use this platform. METHODS: From March 31 to April 9, 2014, in a promotion via email and Facebook, participants were asked to fill out a structured questionnaire after watching an introductory video about MHB on YouTube. The questionnaire included seven dimensions: perceived usefulness, perceived ease of use, health literacy, privacy and security, computer self-efficacy, attitude toward use, and behavioral intention to use. Each question was measured on a 5-point Likert scale ranging from "strongly disagree" (1 point) to "strongly agree" (5 points). Descriptive statistics and structural equation analysis were performed using SPSS 21 and AMOS 21 software. RESULTS: A total of 350 valid questionnaire responses were collected (female: 219/350, 62.6%; age: 21-30 years: 238/350, 68.0%; university-level education: 228/350, 65.1%; occupation as student: 195/350, 56.6%; average monthly income