RESUMO
The use of electronic health records (EHRs) has grown significantly in the past decade. Health information databases contain sensitive patient information, including their names and addresses, tests, diagnoses, treatment, and medical history. This information should be secured and protected from manipulation and fraudulent use by third parties. EHRs are expected to increase efficiency in healthcare delivery, improve healthcare quality, and relieve increased financial pressure. Despite these expected benefits, EHRs are potentially vulnerable to security concerns that may affect the confidentiality and privacy of patients' personal information. This paper presents a literature review of EHRs, factors that support the security and safety of health records, potential security breaches, and solutions to inherent security concerns. The study collects data through a systematic review of past studies that have addressed the topic of EHRs and security issues, and other relevant publications on EHR systems, and procedures that help safeguard health records databases. A total of 30 sources are analyzed for all pertinent information regarding security concerns of health records databases. These sources were obtained through an internet search on credible databases, including Google Scholar, PubMed, and CINAHL databases. The results of the current study reveal the perceived vulnerability of EHRs to security concerns, common security issues, the nature of these common security concerns, Health Insurance Portability and Accountability Act rules, provider responsibilities, and recommendations for reducing EHR security risks. This paper also reveals effective strategies such as privacy-protection awareness and staff training to enhance the security of health records databases.
RESUMO
BACKGROUND: Differences among the top five races in Texas will be explored to determine if racial, geographic, and healthcare disparities exist in patients undergoing treatment for a primary malignant brain tumor. METHODS: Data were obtained from the Texas Cancer Registry from 1995 to 2013. SAS 9.3 (SAS Institute, Inc., Cary, NC) and SEER*Stat 8.3.2 (National Cancer Institute, Bethesda, MD) software were used to analyze death from malignant brain tumors and cause-specific survival. Survival rates were compared using Kaplan-Meier curves and Log-Rank tests. Hazard ratios were estimated using the Cox proportional hazards regression model. RESULTS: Median survival was highest among Asians at 92 months (95% CI: 72, 142) and least among Whites at 20 months (95% CI: 19, 21). Patients living in the Upper Gulf Coast region of Texas had the longest survival time at 31 months (95% CI 29-35%), while those patients in the Texas Panhandle had the shortest survival time at 18 months (95% CI 14-23%). Patients with a poverty index of 0-5% had the highest median survival time of 32 months (95% CI 29-35%), as compared to patients with a poverty index of 10-20% who had a median survival of 22 months (95% CI 21-24%). CONCLUSIONS: Ethnic minorities and higher socioeconomic class demonstrated survival advantage. White males had the worst survival of those with primary malignant brain tumors. Other significant factors affecting a patient's survival rate included geographic location, poverty index, sex, and age, thus suggesting a potential genetic and environmental influence.
