ABSTRACT
The objective of this study was to develop a method to hide information in a portable electronic health record (PEHR). In compliance with HIPAA guidelines, a hiding function for personal identifiers in a PEHR was implemented by recognizing and hiding techniques. The method emphasizes the feasibility of embedding a hiding function in a PEHR. The hiding function could be executed to hide identifiers in offline mode. The present study showed that embedding the hiding function in a PEHR is a practical way not only satisfies data confidentiability needs, but also meets patient's personal privacy requirements. The effects of executing the hiding function would be the same as through de-identification or anonymization process.
Subject(s)
Confidentiality , Electronic Health Records , Health Records, Personal , Hypermedia , HumansABSTRACT
In this paper, we demonstrate how to digitally sign a content manifest of a presentable clinical document that contains multiple clinical data with presentations. Only one signature is needed for an entire clinical document with multiple data resources, which can reduce the computation time during signing and verifying processes. In the radiology field, a report may contain text descriptions, images, and annotations that are stored separately in different data resources. The manifest signature would be a proper means for integrity checking for all the clinical data within the manifest. The manifest signature can be extended with a trusted third party to add a digital time signature for long-term verifiability. The performance of the manifest signing compared with that of a traditional digital signing was evaluated. The new manifest signature can be used for signing different types of presentable clinical documents, such HL7 CDA documents and DICOM image reports.
Subject(s)
Computer Security , Confidentiality , Electronic Data Processing/trends , Medical Records Systems, Computerized , Electronic Data Processing/standards , Forms and Records Control , Health Records, Personal , Humans , Medical Record Linkage , Practice Patterns, Physicians' , Quality Control , Radiology Information Systems/standards , Radiology Information Systems/trendsABSTRACT
As patients face the possibility of copying and keeping their electronic health records (EHRs) through portable storage media, they will encounter new risks to the protection of their private information. In this study, we propose a method to preserve the privacy and security of patients' portable medical records in portable storage media to avoid any inappropriate or unintentional disclosure. Following HIPAA guidelines, the method is designed to protect, recover and verify patient's identifiers in portable EHRs. The results of this study show that our methods are effective in ensuring both information security and privacy preservation for patients through portable storage medium.
Subject(s)
Computer Security , Confidentiality , Medical Records Systems, Computerized , Computer Security/legislation & jurisprudence , Computer Security/statistics & numerical data , Computer Systems , Confidentiality/legislation & jurisprudence , Health Insurance Portability and Accountability Act , Medical Records Systems, Computerized/legislation & jurisprudence , Medical Records Systems, Computerized/statistics & numerical data , Patient Identification Systems/legislation & jurisprudence , Patient Identification Systems/statistics & numerical data , Software Design , Taiwan , United StatesABSTRACT
Some studies have demonstrated that the assessments of autonomic activities from the alterations of heart rate variations (HRVs) after autonomic blockade and during exercise of high intensity by the spectral analysis of HRV seemed inconsistent with actual situation. The inconsistency is probably caused by the contributions of fluctuating magnitudes and mean levels of autonomic activities on HRV having not been clarified. The alterations of HRV after autonomic blockade and during exercise of high intensity using a mathematical model were simulated. The autonomic activity in normal condition was assumed first according to some experimental evidence. Then autonomic activities after sympathetic blockade, vagal blockade and during exercise of high intensity were appropriately adjusted accordingly. The HRVs in response to these given autonomic activities were simulated. We found that the effect on HRV influenced by the mean level of autonomic activity is helpful to explain alterations of HRV in these conditions. After vagal blockade, a largely reduced low frequency (LF) power could be caused by the reduced mean heartbeat interval induced by a decreased mean level of vagal activity. Increased low and high frequency powers after sympathetic blockade could be caused by the increased mean heartbeat interval induced by a decreased mean level of sympathetic activity. A decreased LF power during exercise of high intensity, in addition to the withdrawal of vagal activity, could also be caused by the decreased mean heartbeat interval induced by an increased mean level of sympathetic activity.
