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European Hospitals' Transition Toward Fully Electronic-Based Systems: Do Information Technology Security and Privacy Practices Follow?

ABSTRACT: BACKGROUND:Traditionally, health information has been mainly kept in paper-based records. This has deeply changed throughout approximately the last three decades with the widespread use of multiple health information technologies. The digitization of health care systems contributes to improving health care delivery. However, it also exposes health records to security and privacy breaches inherently related to information technology (IT). Thus, health care organizations willing to leverage IT for improved health care delivery need to put in place IT security and privacy measures consistent with their use of IT resources. OBJECTIVE:In this study, 2 main objectives are pursued: (1) to assess the state of the implementation of IT security and privacy practices in European hospitals and (2) to assess to what extent these hospitals enhance their IT security and privacy practices as they move from paper-based systems toward fully electronic-based systems. METHODS:Drawing on data from the European Commission electronic health survey, we performed a cluster analysis based on IT security and privacy practices implemented in 1723 European hospitals. We also developed an IT security index, a compounded measure of implemented IT security and privacy practices, and compared it with the hospitals' level in their transition from a paper-based system toward a fully electronic-based system. RESULTS:A total of 3 clearly distinct patterns of health IT-related security and privacy practices were unveiled. These patterns, as well as the IT security index, indicate that most of the sampled hospitals (70.2%) failed to implement basic security and privacy measures consistent with their digitization level. CONCLUSIONS:Even though, on average, the most electronically advanced hospitals display a higher IT security index than hospitals where the paper system still dominates, surprisingly, it appears that the enhancement of IT security and privacy practices as the health information digitization advances in European hospitals is neither systematic nor strong enough regarding the IT-security requirements. This study will contribute to raising awareness among hospitals' managers as to the importance of enhancing their IT security and privacy measures so that they can keep up with the security threats inherently related to the digitization of health care organizations.

SUBMITTER: Uwizeyemungu S

PROVIDER: S-EPMC6452275 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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European Hospitals' Transition Toward Fully Electronic-Based Systems: Do Information Technology Security and Privacy Practices Follow?

Uwizeyemungu Sylvestre S Poba-Nzaou Placide P Cantinotti Michael M

JMIR medical informatics 20190325 1

<h4>Background</h4>Traditionally, health information has been mainly kept in paper-based records. This has deeply changed throughout approximately the last three decades with the widespread use of multiple health information technologies. The digitization of health care systems contributes to improving health care delivery. However, it also exposes health records to security and privacy breaches inherently related to information technology (IT). Thus, health care organizations willing to leverag ...[more]

PMID: 30907732

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Project description:ImportancePatient portals can help caregivers better manage care for patients, but how caregivers access the patient portal could threaten patient security and privacy.ObjectiveTo identify the proportions of hospitals that provide proxy accounts to caregivers of adult patients, endorse password sharing with caregivers, and enable patients to restrict the types of information seen by their caregivers.Design, setting, and participantsThis national cross-sectional study included a telephone survey and was conducted from May 21, 2018, to December 20, 2018. The randomly selected sample comprised 1 independent hospital and 1 health system-affiliated general medical hospital from every US state and the District of Columbia. Specialty hospitals and those that did not have a patient portal in place were excluded. An interviewer posing as the daughter of an older adult patient called each hospital to ask about the hospital's patient portal practices. The interviewer used a structured questionnaire to obtain information on proxy account availability, password sharing, and patient control of their own information.Main outcomes and measuresThe primary outcome was the proportion of hospitals that provided proxy accounts to caregivers of adult patients. Secondary outcomes were the proportion of hospitals with personnel who endorsed password sharing and the proportion that allowed adult patients to limit the types of information available to caregivers.ResultsAfter exclusions, a total of 102 (51 health system-affiliated and 51 independent) hospitals were included in the study. Of these hospitals, 69 (68%) provided proxy accounts to caregivers of adult patients and 26 (25%) did not. In 7 of 102 hospitals (7%), the surveyed personnel did not know if proxy accounts were available. In the 94 hospitals asked about password sharing between the patient and caregiver, personnel in 42 hospitals (45%) endorsed the practice. Among hospitals that provided proxy accounts, only 13 of the 69 hospitals (19%) offered controls that enabled patients to restrict the types of information their proxies could see.Conclusions and relevanceThis study found that almost half of surveyed hospital personnel recommended password sharing and that few hospitals enabled patients to limit the types of information seen by those with proxy access. These findings suggest that hospitals and electronic health record (HER) vendors need to improve the availability and setup process of proxy accounts in a way that allows caregivers to care for patients without violating their privacy.

Project description:Dairy farm systems have intensified to meet growing demands for animal products, but public opposition to this intensification has also grown due, in part, to concerns about animal welfare. One approach to addressing challenges in agricultural systems has been through the addition of new technologies, including genetic modification. Previous studies have reported some public resistance towards the use of these technologies in agriculture, but this research has assessed public attitudes toward individual practices and technologies and few studies have examined a range of practices on dairy farms. In the present study, we presented participants with four scenarios describing dairy practices (cow-calf separation, the fate of excess dairy calves, pasture access and disbudding). Citizens from Canada and the United States (n = 650) indicated their support (on a 7-point scale) toward five approaches (maintaining standard farm practice, using a naturalistic approach, using a technological approach, or switching to plant-based or yeast-based milk production) aimed at addressing the welfare issues associated with the four dairy practices. Respondents also provided a text-based rationale for their responses and answered a series of demographic questions including age, gender, and diet. Participant diet affected attitudes toward milk alternatives, with vegetarians and vegans showing more support for the plant-based and yeast-based milk production. Regardless of diet, most participants opposed genetic modification technologies and supported more naturalistic practices. Qualitative responses provided insight into participants' values and concerns, and illustrated a variety of perceived benefits and concerns related to the options presented. Common themes included animal welfare, ethics of animal use, and opposition toward technology. We conclude that Canadian and US citizens consider multiple aspects of farm systems when contemplating animal welfare concerns, and tend to favor naturalistic approaches over technological solutions, especially when the latter are based on genetic modification.

Project description:BackgroundAlong with the proliferation of health information technologies (HITs), there is a growing need to understand the potential privacy risks associated with using such tools. Although privacy policies are designed to inform consumers, such policies have consistently been found to be confusing and lack transparency.ObjectiveThis study aims to present consumer preferences for accessing privacy information; develop and apply a privacy policy risk assessment tool to assess whether existing HITs meet the recommended privacy policy standards; and propose guidelines to assist health professionals and service providers with understanding the privacy risks associated with HITs, so that they can confidently promote their safe use as a part of care.MethodsIn phase 1, participatory design workshops were conducted with young people who were attending a participating headspace center, their supportive others, and health professionals and service providers from the centers. The findings were knowledge translated to determine participant preferences for the presentation and availability of privacy information and the functionality required to support its delivery. Phase 2 included the development of the 23-item privacy policy risk assessment tool, which incorporated material from international privacy literature and standards. This tool was then used to assess the privacy policies of 34 apps and e-tools. In phase 3, privacy guidelines, which were derived from learnings from a collaborative consultation process with key stakeholders, were developed to assist health professionals and service providers with understanding the privacy risks associated with incorporating HITs as a part of clinical care.ResultsWhen considering the use of HITs, the participatory design workshop participants indicated that they wanted privacy information to be easily accessible, transparent, and user-friendly to enable them to clearly understand what personal and health information will be collected and how these data will be shared and stored. The privacy policy review revealed consistently poor readability and transparency, which limited the utility of these documents as a source of information. Therefore, to enable informed consent, the privacy guidelines provided ensure that health professionals and consumers are fully aware of the potential for privacy risks in using HITs to support health and well-being.ConclusionsA lack of transparency in privacy policies has the potential to undermine consumers' ability to trust that the necessary measures are in place to secure and protect the privacy of their personal and health information, thus precluding their willingness to engage with HITs. The application of the privacy guidelines will improve the confidence of health professionals and service providers in the privacy of consumer data, thus enabling them to recommend HITs to provide or support care.

Dataset Information

European Hospitals' Transition Toward Fully Electronic-Based Systems: Do Information Technology Security and Privacy Practices Follow?

Publications

European Hospitals' Transition Toward Fully Electronic-Based Systems: Do Information Technology Security and Privacy Practices Follow?

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