Patient information recorded in electronic medical records is the most significant set of information of the healthcare system. It assists healthcare providers to introduce high quality care for patients. The aim of this study identifies the security threats associated with electronic medical records and gives
recommendations to keep them more secured. The study applied the qualitative research method through a case study. The study conducted seven interviews with medical staff and information technology technicians. The study results classified the issues that face electronic medical records into four main categories which were availability, accessibility, privacy, and safety of health information.
MANAGING THE INFORMATION SECURITY ISSUES OF ELECTRONIC MEDICAL RECORDSijsptm
All healthcare providers should have enough knowledge and sufficient information to understand the potential risk, which can lead to a breach in the Jordanian health information system (Hakeem program). This study aims to emphasise the importance of sharing sensitive health information among healthcare providers, create laws and regulations to keep the electronic medical records secure, and increase the
awareness about health information security among healthcare providers. The study conducted seven interviews with medical staff and an information technology technician. The study results showed that sharing sensitive information in a secure environment, creating laws and regulations, and increasing the
awareness about health information security render the electronic medical records of patients more secure and safe
Modern medicine is facing a complex environment, not from medical technology but rather government regulations and information vulnerability. HIPPA is the government’s attempt to protect patient’s information yet this only addresses traditional record handling. The main threat is from the evolving security issues. Many medical offices and facilities have multiple areas of information security concerns. Physical security is often weak, office personnel are not always aware of security needs and application security and transmission protocols are not consistently maintained. Health insurance needs and general financial opportunity has created an emerging market in medical identity theft. Medical offices have the perfect storm of information collection, personal, credit, banking, health, and insurance. Thieves have realized that medical facilities have as much economic value as banks and the security is much easier to crack. Mostly committed by insiders, medical identity theft is a well-hidden information crime. In spite of its covert nature, the catastrophic ramification to the victims is overt. This information crime involves stealing patients’ records to impersonate the patients in an effort of obtaining health care services or claiming Medicare on the patients’ behalf. Unlike financial identity theft, there is a lack of recourse for the victims to recover from damages. Medical identity theft undermines the quality of health care information systems and enervates the information security of electronic patient record.
MANAGING THE INFORMATION SECURITY ISSUES OF ELECTRONIC MEDICAL RECORDSijsptm
All healthcare providers should have enough knowledge and sufficient information to understand the potential risk, which can lead to a breach in the Jordanian health information system (Hakeem program). This study aims to emphasise the importance of sharing sensitive health information among healthcare providers, create laws and regulations to keep the electronic medical records secure, and increase the
awareness about health information security among healthcare providers. The study conducted seven interviews with medical staff and an information technology technician. The study results showed that sharing sensitive information in a secure environment, creating laws and regulations, and increasing the
awareness about health information security render the electronic medical records of patients more secure and safe
Modern medicine is facing a complex environment, not from medical technology but rather government regulations and information vulnerability. HIPPA is the government’s attempt to protect patient’s information yet this only addresses traditional record handling. The main threat is from the evolving security issues. Many medical offices and facilities have multiple areas of information security concerns. Physical security is often weak, office personnel are not always aware of security needs and application security and transmission protocols are not consistently maintained. Health insurance needs and general financial opportunity has created an emerging market in medical identity theft. Medical offices have the perfect storm of information collection, personal, credit, banking, health, and insurance. Thieves have realized that medical facilities have as much economic value as banks and the security is much easier to crack. Mostly committed by insiders, medical identity theft is a well-hidden information crime. In spite of its covert nature, the catastrophic ramification to the victims is overt. This information crime involves stealing patients’ records to impersonate the patients in an effort of obtaining health care services or claiming Medicare on the patients’ behalf. Unlike financial identity theft, there is a lack of recourse for the victims to recover from damages. Medical identity theft undermines the quality of health care information systems and enervates the information security of electronic patient record.
Health information technology (Health IT) is an area of information technology that includes the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and compatible healthcare information systems will continue to improve healthcare and healthcare, reduce costs, increase efficiency, reduce errors and increase patient satisfaction, and optimize cost recovery for outpatient and inpatient health care providers.
Health care providers have become prime targets of cyber criminals, since they hold a treasure trove of irresistible data, including Social Security numbers and medical records (think access to prescription painkillers). As cyber criminals become more sophisticated, medical practices are more vulnerable than ever.
In this webinar "Data Breach: It Can Happen To You," hosted by the Cooperative of American Physicians, Inc. (CAP), viewers will learn:
+ What a data breach is
+ Its economic impact
+ Why the threat is growing
+ Steps to take to protect yourself
+ The must-dos in the event of a breach
Watch the webinar here —> https://youtu.be/mqdMA-UZNy0
About Our Presenters:
Melvin Osswald, Vice President Program Underwriting, NAS Insurance — Ms. Osswald joined NAS in 2002 and specializes in health care, cyber liability, employment practice, directors and officers coverage. Ms. Osswald currently supports NAS’ reinsurance programs and oversees the underwriting and product development of Billing Errors and Omissions, Cyber Liability, Employment Practices Liability, and Directors and Officers programs created to address the new exposures facing health care providers. She has been featured as a guest speaker at various industry conferences addressing the evolving professional liability risks in health care, and served on the Steering Committee of the Southern California Chapter of the Professional Liability Underwriting Society.
Chris Reese, Vice President, Director of Underwriting, NAS Insurance — As part of NAS’ key management team, Ms. Reese provides insurance solutions for clients in the health care industry. She has held leadership positions on both the underwriting and retail broker sides of the business, and has worked in the London market for a reinsurance intermediary. Ms. Reese has been involved with cyber risk insurance for the health care industry since 2004, providing coverage to physicians, medical groups, and integrated delivery systems.
MORE SLIDESHARE PRESENTATIONS
http://www.slideshare.net/capphysicians/presentations
VISIT OUR WEBSITE
http://www.cappphysicians.com
LET'S CONNECT
Twitter: http://www.twitter.com/CAPphysicians
LinkedIn: https://www.linkedin.com/company/cooperative-of-american-physicians-inc-
Facebook: http://www.facebook.com/CooperativeofAmericanPhysiciansInc
Youtube: http://youtube.com/CAPphysicians
Google+: http://www.google.com/+Capphysicians
Survey of open source health information systemshiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
Security framework for cloud based Electronic Health Record (EHR) system IJECEIAES
Health records are an integral aspect of any Hospital Management System. With newer innovations in technology, there has been a shift in the way of recording health information. Medical records which used to be managed using various paper charts have now become easier to organize and maintain, thereby increasing the efficiency of medical staff. The Electronic Health Records (EHR) System is becoming a high-tech medical management technology developed for the economic or emerging economic countries like India. In a national health system, the EHR integrates the Electronic Medical Records (EMR) in all collaborating hospitals through different networks. EHR gives healthcare professionals a way to share and manage patient data quickly and effectively. Due to the mass storage of confidential patient data, healthcare organizations are considered as one of the most targeted sectors by intruders. This paper proposes a security framework for EHR system, which takes into consideration the integrity, availability, and confidentiality of health records. The threats posed to the EHR system are modeled by STRIDE modeling tool, and the amount of risk is calculated using DREAD. The paper also suggests the security mechanism and countermeasures based on security standards, which can be utilized in an EHR environment. The paper shows that the utilization of the proposed methods effectively addresses security concerns such as breach of sensitive medical information.
Speeding up Healthcare Application with HTTP/2CitiusTech
Healthcare data is being increasingly accessed over the public internet. With the rapid adoption of EHRs and patient portals, more and more healthcare technology providers are looking at providing the same features over the internet in a SaaS model to reduce feature to market time. As they embrace trends and begin supporting new use cases such as wearables, mobile health, AI and chat bots, more data gets transferred over the same public internet infrastructure
Secondly, there is a pressing need to optimize the time healthcare professionals spend on IT per patient instead of patient care. Hence, getting timely and accurate information is of utmost importance to ensure better patient care.
Patient engagement initiatives such as patient education, medication and visit reminder, positively impact patient outcomes and are a huge success if the applications built for the same provide seamless user experience. Internet based applications rely on HTTP. As web application became more prevalent, inefficiencies of HTTP need to be addressed. HTTP/2 (Hypertext Transfer Protocol Version 2) is the update to HTTP protocol that has been built with the aim of improving performance and reducing end user perceived latency, reducing network and server resource usage.This document introduces the features and benefits of HTTP/2 and how you can start using HTTP/2
Building blockchain based Healthcare infrastructure with beyond block labsBeyond Block Labs
The Current healthcare ecosystem mainly consists of seven key stakeholders –
patient, provider, payer, pharma, medical technology, technology vendors and
suppliers, and the government and healthcare regulator.
Given well-publicized data breaches nationally and the spread of health information exchange (HIE), the issue of privacy and security of patient data shared through HIE networks is one of the most complex and sensitive issues in establishing and maintaining trust among consumers, physicians, and other major community stakeholders. In this presentation, we discuss the privacy and security challenges the New Mexico Health Information Exchange (NMHIC) has encountered in its HIE development history and the lessons it has learned concerning them.
Federal and state privacy law compatibility: beyond HIPAA and HITECH
Privacy approaches: opt-out, opt-in, hybrid
Educating consumers and providers about HIE benefits & risks
Privacy policies needed to support interstate information exchange
Engaging consumers, providers, and other community stakeholders about uses of HIE data & other privacy decisions
Personal Health Record over Encrypted Data Using Cloud ServiceYogeshIJTSRD
CBPHR Cloud Based Personal Health Record systems are used for storage and management of patient records. Cloud computing provides real time health care data in a convenient and cost effective manner. Due to the lack of visibility in cloud platform, the users are always concerned with data privacy and security. This is the main obstacle in widely adopting CBPHR systems in health care sector. The paper is discussing a cloud based patient health record management scheme which is highly secured. In this approach, indexes are encrypted under different symmetric keys and also the encrypted data indexes from various data providers can be merge by cloud without knowing the index content. It also provides efficient and privacy preserving query processing using a single data query submitted by the data user. Encrypted data will be processed by cloud from all related data providers without knowing its query content. Dinesh Soni | Dr. Lakshmi JVN "Personal Health Record over Encrypted Data Using Cloud Service" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41230.pdf Paper URL: https://www.ijtsrd.comcomputer-science/computer-security/41230/personal-health-record-over-encrypted-data-using-cloud-service/dinesh-soni
This article is intended for the customer facing risk managers, sales staff, and IT staff of a medical device manufacturer and their medical doctors and IT hospital and clinical counterparts. It is intended to give an overview and highlight process considerations for incident management and reporting of cybersecurity issues.
Why merging medical records, hospital reports, and clinical trial data is a v...Arete-Zoe, LLC
Medical privacy and breaches of personal health information (PHI) has been a hot topic for several years. For the clinical trial industry, the main concerns are decline in recruitment resulting from lack of confidence in data handling and instances of breaches that affect data integrity that adversely affect NDA and MA applications in major markets, which precipitates administrative action taken by national regulators in response to local incidents.
European legislators rely extensively on administrative measures implemented by national competent authorities. Although specific and detailed EU-level legislation exists, specific information about data breaches, cases and incidents, volume and type of affected data, root causes and analysis of consequences is largely missing. According to Howard and Gulyas (2014), this lack of organized event records is currently an empirical obstacle but provides opportunity to generate new knowledge about data and privacy protection that could bolster future trial recruitment.
In the U.S., summary details of breaches that involved more than 500 individuals are available at the OCR portal called Wall of Shame for everyone to analyze. Disclosure obligations in HIPAA made the problem of data breaches in healthcare obvious and protection of the privacy of patients has been an important part of physicians’ code of conduct. This offers lessons learned to mitigate systemic vulnerabilities that undermine trial participation.
Reasons for the Popularity of Medical Record TheftOPSWAT
After a slew of data breaches in 2014, the FBI warned the healthcare industry that cyber-criminals would be directing more attention their way in 2015. The healthcare industry has become an increasingly valuable target for cyber thieves, and in some cases, a much easier target to attack, due to their often less than adequate investment in cyber security. What is it about the healthcare industry that has captured the cyber criminals' interest in the last few years?
This white paper covers various topics including industry data breach statistics, the value of credit card data versus medical record data, healthcare spending on cyber security and the impact of BYOD on industry vulnerability to data breaches. This white paper also highlights various solutions for protecting medical record data including multi-scanning, email security and the protection of endpoint devices.
(Executive Summary)MedStar Health Inc, a leader in the healthcSilvaGraf83
(Executive Summary)
MedStar Health Inc, a leader in the healthcare industry regionally and nation-wide, is a constant target of the malicious attempts of cyber criminals. Over the past 6 years MedStar Health Inc. has faced several instances of data breach most notably, the 2016 breach that compromised 370 computer systems and halted its operations. As the organization continues to digitize and broaden the use of electronic medical records across its facilities, the threat of cyber-attack remains even more pervasive. The purpose of this report is to provide an overview of MedStar Health Inc cybersecurity vulnerabilities, examine the overall causes and impact of the breaches and explore solutions to meet the organization’s cybersecurity challenges.
With a focal point on MedStar Health breaches, a literature-based study was conducted, and various news articles, academic journals and company publications were analyzed. It was found that the 2016 and 2020 data breaches were attacks on the organization’s internet servers. The 2020 hack compromised the records of 668 patients, whereas the 2016 hack was a result of a ransomware infection that compromised 7500 individuals’ records and halted the organizations’ operations. The cost of the virus infection was greater than the $19,000 ransom requested due to additional recovery and remediation costs. It was also revealed that the 2019 breach was due to human error.
To best combat the efforts of cyber criminals, it is recommended that MedStar Health Inc. place greater emphasis on cyber awareness training for employees/professionals, implementing multiple factor authentications and a strong password and identity management system to reinforce its IT infrastructure against future hacks. Failure to effectuate these measures pose significant risk to MedStar Health Inc., its affiliates and patients that extend beyond ransom payments, fines, imprisonment, lawsuits and costs incurred for subsequent identity theft protection services. The damage caused by data security breaches may prove fatal for patients, the company’s most valued asset, compromising public perception and the company’s mission to provide the highest quality of medical care and build long-term relationships with the patients they serve.)
Actual Technical Report
MedStar Medical Vs. Cybercrime
In the health sector, experts "see persistent cyber-attacks as the single greatest threat to the protection of healthcare data" (Moffith & Steffen, 2017). To the world at large, this is not the most absurd news or revelation. Healthcare data embodies some of the most marketable information, and for the black market this is Eldorado – the fictional tale of the city of gold. Healthcare organizations are tasked with fighting the uphill battle of providing quality medical care to their number one stakeholder – patients – while also ensuring that their valuable information is kept safe and secure. Despite their efforts, healthcare organizations sometimes fail in ...
(Executive Summary)MedStar Health Inc, a leader in the healthcMoseStaton39
(Executive Summary)
MedStar Health Inc, a leader in the healthcare industry regionally and nation-wide, is a constant target of the malicious attempts of cyber criminals. Over the past 6 years MedStar Health Inc. has faced several instances of data breach most notably, the 2016 breach that compromised 370 computer systems and halted its operations. As the organization continues to digitize and broaden the use of electronic medical records across its facilities, the threat of cyber-attack remains even more pervasive. The purpose of this report is to provide an overview of MedStar Health Inc cybersecurity vulnerabilities, examine the overall causes and impact of the breaches and explore solutions to meet the organization’s cybersecurity challenges.
With a focal point on MedStar Health breaches, a literature-based study was conducted, and various news articles, academic journals and company publications were analyzed. It was found that the 2016 and 2020 data breaches were attacks on the organization’s internet servers. The 2020 hack compromised the records of 668 patients, whereas the 2016 hack was a result of a ransomware infection that compromised 7500 individuals’ records and halted the organizations’ operations. The cost of the virus infection was greater than the $19,000 ransom requested due to additional recovery and remediation costs. It was also revealed that the 2019 breach was due to human error.
To best combat the efforts of cyber criminals, it is recommended that MedStar Health Inc. place greater emphasis on cyber awareness training for employees/professionals, implementing multiple factor authentications and a strong password and identity management system to reinforce its IT infrastructure against future hacks. Failure to effectuate these measures pose significant risk to MedStar Health Inc., its affiliates and patients that extend beyond ransom payments, fines, imprisonment, lawsuits and costs incurred for subsequent identity theft protection services. The damage caused by data security breaches may prove fatal for patients, the company’s most valued asset, compromising public perception and the company’s mission to provide the highest quality of medical care and build long-term relationships with the patients they serve.)
Actual Technical Report
MedStar Medical Vs. Cybercrime
In the health sector, experts "see persistent cyber-attacks as the single greatest threat to the protection of healthcare data" (Moffith & Steffen, 2017). To the world at large, this is not the most absurd news or revelation. Healthcare data embodies some of the most marketable information, and for the black market this is Eldorado – the fictional tale of the city of gold. Healthcare organizations are tasked with fighting the uphill battle of providing quality medical care to their number one stakeholder – patients – while also ensuring that their valuable information is kept safe and secure. Despite their efforts, healthcare organizations sometimes fail in ...
Health information technology (Health IT) is an area of information technology that includes the design, development, creation, use and maintenance of information systems for the healthcare industry. Automated and compatible healthcare information systems will continue to improve healthcare and healthcare, reduce costs, increase efficiency, reduce errors and increase patient satisfaction, and optimize cost recovery for outpatient and inpatient health care providers.
Health care providers have become prime targets of cyber criminals, since they hold a treasure trove of irresistible data, including Social Security numbers and medical records (think access to prescription painkillers). As cyber criminals become more sophisticated, medical practices are more vulnerable than ever.
In this webinar "Data Breach: It Can Happen To You," hosted by the Cooperative of American Physicians, Inc. (CAP), viewers will learn:
+ What a data breach is
+ Its economic impact
+ Why the threat is growing
+ Steps to take to protect yourself
+ The must-dos in the event of a breach
Watch the webinar here —> https://youtu.be/mqdMA-UZNy0
About Our Presenters:
Melvin Osswald, Vice President Program Underwriting, NAS Insurance — Ms. Osswald joined NAS in 2002 and specializes in health care, cyber liability, employment practice, directors and officers coverage. Ms. Osswald currently supports NAS’ reinsurance programs and oversees the underwriting and product development of Billing Errors and Omissions, Cyber Liability, Employment Practices Liability, and Directors and Officers programs created to address the new exposures facing health care providers. She has been featured as a guest speaker at various industry conferences addressing the evolving professional liability risks in health care, and served on the Steering Committee of the Southern California Chapter of the Professional Liability Underwriting Society.
Chris Reese, Vice President, Director of Underwriting, NAS Insurance — As part of NAS’ key management team, Ms. Reese provides insurance solutions for clients in the health care industry. She has held leadership positions on both the underwriting and retail broker sides of the business, and has worked in the London market for a reinsurance intermediary. Ms. Reese has been involved with cyber risk insurance for the health care industry since 2004, providing coverage to physicians, medical groups, and integrated delivery systems.
MORE SLIDESHARE PRESENTATIONS
http://www.slideshare.net/capphysicians/presentations
VISIT OUR WEBSITE
http://www.cappphysicians.com
LET'S CONNECT
Twitter: http://www.twitter.com/CAPphysicians
LinkedIn: https://www.linkedin.com/company/cooperative-of-american-physicians-inc-
Facebook: http://www.facebook.com/CooperativeofAmericanPhysiciansInc
Youtube: http://youtube.com/CAPphysicians
Google+: http://www.google.com/+Capphysicians
Survey of open source health information systemshiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
Security framework for cloud based Electronic Health Record (EHR) system IJECEIAES
Health records are an integral aspect of any Hospital Management System. With newer innovations in technology, there has been a shift in the way of recording health information. Medical records which used to be managed using various paper charts have now become easier to organize and maintain, thereby increasing the efficiency of medical staff. The Electronic Health Records (EHR) System is becoming a high-tech medical management technology developed for the economic or emerging economic countries like India. In a national health system, the EHR integrates the Electronic Medical Records (EMR) in all collaborating hospitals through different networks. EHR gives healthcare professionals a way to share and manage patient data quickly and effectively. Due to the mass storage of confidential patient data, healthcare organizations are considered as one of the most targeted sectors by intruders. This paper proposes a security framework for EHR system, which takes into consideration the integrity, availability, and confidentiality of health records. The threats posed to the EHR system are modeled by STRIDE modeling tool, and the amount of risk is calculated using DREAD. The paper also suggests the security mechanism and countermeasures based on security standards, which can be utilized in an EHR environment. The paper shows that the utilization of the proposed methods effectively addresses security concerns such as breach of sensitive medical information.
Speeding up Healthcare Application with HTTP/2CitiusTech
Healthcare data is being increasingly accessed over the public internet. With the rapid adoption of EHRs and patient portals, more and more healthcare technology providers are looking at providing the same features over the internet in a SaaS model to reduce feature to market time. As they embrace trends and begin supporting new use cases such as wearables, mobile health, AI and chat bots, more data gets transferred over the same public internet infrastructure
Secondly, there is a pressing need to optimize the time healthcare professionals spend on IT per patient instead of patient care. Hence, getting timely and accurate information is of utmost importance to ensure better patient care.
Patient engagement initiatives such as patient education, medication and visit reminder, positively impact patient outcomes and are a huge success if the applications built for the same provide seamless user experience. Internet based applications rely on HTTP. As web application became more prevalent, inefficiencies of HTTP need to be addressed. HTTP/2 (Hypertext Transfer Protocol Version 2) is the update to HTTP protocol that has been built with the aim of improving performance and reducing end user perceived latency, reducing network and server resource usage.This document introduces the features and benefits of HTTP/2 and how you can start using HTTP/2
Building blockchain based Healthcare infrastructure with beyond block labsBeyond Block Labs
The Current healthcare ecosystem mainly consists of seven key stakeholders –
patient, provider, payer, pharma, medical technology, technology vendors and
suppliers, and the government and healthcare regulator.
Given well-publicized data breaches nationally and the spread of health information exchange (HIE), the issue of privacy and security of patient data shared through HIE networks is one of the most complex and sensitive issues in establishing and maintaining trust among consumers, physicians, and other major community stakeholders. In this presentation, we discuss the privacy and security challenges the New Mexico Health Information Exchange (NMHIC) has encountered in its HIE development history and the lessons it has learned concerning them.
Federal and state privacy law compatibility: beyond HIPAA and HITECH
Privacy approaches: opt-out, opt-in, hybrid
Educating consumers and providers about HIE benefits & risks
Privacy policies needed to support interstate information exchange
Engaging consumers, providers, and other community stakeholders about uses of HIE data & other privacy decisions
Personal Health Record over Encrypted Data Using Cloud ServiceYogeshIJTSRD
CBPHR Cloud Based Personal Health Record systems are used for storage and management of patient records. Cloud computing provides real time health care data in a convenient and cost effective manner. Due to the lack of visibility in cloud platform, the users are always concerned with data privacy and security. This is the main obstacle in widely adopting CBPHR systems in health care sector. The paper is discussing a cloud based patient health record management scheme which is highly secured. In this approach, indexes are encrypted under different symmetric keys and also the encrypted data indexes from various data providers can be merge by cloud without knowing the index content. It also provides efficient and privacy preserving query processing using a single data query submitted by the data user. Encrypted data will be processed by cloud from all related data providers without knowing its query content. Dinesh Soni | Dr. Lakshmi JVN "Personal Health Record over Encrypted Data Using Cloud Service" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41230.pdf Paper URL: https://www.ijtsrd.comcomputer-science/computer-security/41230/personal-health-record-over-encrypted-data-using-cloud-service/dinesh-soni
This article is intended for the customer facing risk managers, sales staff, and IT staff of a medical device manufacturer and their medical doctors and IT hospital and clinical counterparts. It is intended to give an overview and highlight process considerations for incident management and reporting of cybersecurity issues.
Why merging medical records, hospital reports, and clinical trial data is a v...Arete-Zoe, LLC
Medical privacy and breaches of personal health information (PHI) has been a hot topic for several years. For the clinical trial industry, the main concerns are decline in recruitment resulting from lack of confidence in data handling and instances of breaches that affect data integrity that adversely affect NDA and MA applications in major markets, which precipitates administrative action taken by national regulators in response to local incidents.
European legislators rely extensively on administrative measures implemented by national competent authorities. Although specific and detailed EU-level legislation exists, specific information about data breaches, cases and incidents, volume and type of affected data, root causes and analysis of consequences is largely missing. According to Howard and Gulyas (2014), this lack of organized event records is currently an empirical obstacle but provides opportunity to generate new knowledge about data and privacy protection that could bolster future trial recruitment.
In the U.S., summary details of breaches that involved more than 500 individuals are available at the OCR portal called Wall of Shame for everyone to analyze. Disclosure obligations in HIPAA made the problem of data breaches in healthcare obvious and protection of the privacy of patients has been an important part of physicians’ code of conduct. This offers lessons learned to mitigate systemic vulnerabilities that undermine trial participation.
Reasons for the Popularity of Medical Record TheftOPSWAT
After a slew of data breaches in 2014, the FBI warned the healthcare industry that cyber-criminals would be directing more attention their way in 2015. The healthcare industry has become an increasingly valuable target for cyber thieves, and in some cases, a much easier target to attack, due to their often less than adequate investment in cyber security. What is it about the healthcare industry that has captured the cyber criminals' interest in the last few years?
This white paper covers various topics including industry data breach statistics, the value of credit card data versus medical record data, healthcare spending on cyber security and the impact of BYOD on industry vulnerability to data breaches. This white paper also highlights various solutions for protecting medical record data including multi-scanning, email security and the protection of endpoint devices.
(Executive Summary)MedStar Health Inc, a leader in the healthcSilvaGraf83
(Executive Summary)
MedStar Health Inc, a leader in the healthcare industry regionally and nation-wide, is a constant target of the malicious attempts of cyber criminals. Over the past 6 years MedStar Health Inc. has faced several instances of data breach most notably, the 2016 breach that compromised 370 computer systems and halted its operations. As the organization continues to digitize and broaden the use of electronic medical records across its facilities, the threat of cyber-attack remains even more pervasive. The purpose of this report is to provide an overview of MedStar Health Inc cybersecurity vulnerabilities, examine the overall causes and impact of the breaches and explore solutions to meet the organization’s cybersecurity challenges.
With a focal point on MedStar Health breaches, a literature-based study was conducted, and various news articles, academic journals and company publications were analyzed. It was found that the 2016 and 2020 data breaches were attacks on the organization’s internet servers. The 2020 hack compromised the records of 668 patients, whereas the 2016 hack was a result of a ransomware infection that compromised 7500 individuals’ records and halted the organizations’ operations. The cost of the virus infection was greater than the $19,000 ransom requested due to additional recovery and remediation costs. It was also revealed that the 2019 breach was due to human error.
To best combat the efforts of cyber criminals, it is recommended that MedStar Health Inc. place greater emphasis on cyber awareness training for employees/professionals, implementing multiple factor authentications and a strong password and identity management system to reinforce its IT infrastructure against future hacks. Failure to effectuate these measures pose significant risk to MedStar Health Inc., its affiliates and patients that extend beyond ransom payments, fines, imprisonment, lawsuits and costs incurred for subsequent identity theft protection services. The damage caused by data security breaches may prove fatal for patients, the company’s most valued asset, compromising public perception and the company’s mission to provide the highest quality of medical care and build long-term relationships with the patients they serve.)
Actual Technical Report
MedStar Medical Vs. Cybercrime
In the health sector, experts "see persistent cyber-attacks as the single greatest threat to the protection of healthcare data" (Moffith & Steffen, 2017). To the world at large, this is not the most absurd news or revelation. Healthcare data embodies some of the most marketable information, and for the black market this is Eldorado – the fictional tale of the city of gold. Healthcare organizations are tasked with fighting the uphill battle of providing quality medical care to their number one stakeholder – patients – while also ensuring that their valuable information is kept safe and secure. Despite their efforts, healthcare organizations sometimes fail in ...
(Executive Summary)MedStar Health Inc, a leader in the healthcMoseStaton39
(Executive Summary)
MedStar Health Inc, a leader in the healthcare industry regionally and nation-wide, is a constant target of the malicious attempts of cyber criminals. Over the past 6 years MedStar Health Inc. has faced several instances of data breach most notably, the 2016 breach that compromised 370 computer systems and halted its operations. As the organization continues to digitize and broaden the use of electronic medical records across its facilities, the threat of cyber-attack remains even more pervasive. The purpose of this report is to provide an overview of MedStar Health Inc cybersecurity vulnerabilities, examine the overall causes and impact of the breaches and explore solutions to meet the organization’s cybersecurity challenges.
With a focal point on MedStar Health breaches, a literature-based study was conducted, and various news articles, academic journals and company publications were analyzed. It was found that the 2016 and 2020 data breaches were attacks on the organization’s internet servers. The 2020 hack compromised the records of 668 patients, whereas the 2016 hack was a result of a ransomware infection that compromised 7500 individuals’ records and halted the organizations’ operations. The cost of the virus infection was greater than the $19,000 ransom requested due to additional recovery and remediation costs. It was also revealed that the 2019 breach was due to human error.
To best combat the efforts of cyber criminals, it is recommended that MedStar Health Inc. place greater emphasis on cyber awareness training for employees/professionals, implementing multiple factor authentications and a strong password and identity management system to reinforce its IT infrastructure against future hacks. Failure to effectuate these measures pose significant risk to MedStar Health Inc., its affiliates and patients that extend beyond ransom payments, fines, imprisonment, lawsuits and costs incurred for subsequent identity theft protection services. The damage caused by data security breaches may prove fatal for patients, the company’s most valued asset, compromising public perception and the company’s mission to provide the highest quality of medical care and build long-term relationships with the patients they serve.)
Actual Technical Report
MedStar Medical Vs. Cybercrime
In the health sector, experts "see persistent cyber-attacks as the single greatest threat to the protection of healthcare data" (Moffith & Steffen, 2017). To the world at large, this is not the most absurd news or revelation. Healthcare data embodies some of the most marketable information, and for the black market this is Eldorado – the fictional tale of the city of gold. Healthcare organizations are tasked with fighting the uphill battle of providing quality medical care to their number one stakeholder – patients – while also ensuring that their valuable information is kept safe and secure. Despite their efforts, healthcare organizations sometimes fail in ...
Running head Information security threats 1Information secur.docxwlynn1
Running head: Information security threats 1
Information security threats 7
Information security threats
Khaleem Pasha Mohammad
Campbellsville University
Introduction
The development of technology has been greatly embraced in hospitals, saved innumerable lives, and improved the quality of care provision. Not exclusively has technology changed patients knowledgeable and of their families but further consideration has had a significant impact on the strategy and practices of practitioners. One in every five of the areas that have greatly embraced technology is care data. Technology has helped inside the treatment of care records through the introduction of electronic health records, that's exchange paper records. With the availability of electronic care record (EHR) systems, a nurse can merely check for patients’ allergies, case history, weight, age, and prescription through the press of a button. However, the most quantity as institutions are clasp technology to stay up their health records, there are series of risks associated with these technologies. Since the start of technology inside the upkeep of care records, the care trade has been a primary target for cyber crimes. The motives behind cyber-attacks on care are clear as insurance firms, hospitals, care clinics, and totally different care suppliers keep health records that contain valuable information. The use of America Department of Health and Human Services for Civil Rights has acknowledged that over 100 million people square measure suffering from care data security breach. Gregorian calendar month 2015 was a foul month for electronic data jointly of the most important hacks on health care records on Anthem Blue Cross resulting in over seventy-eight million patients’ health data was taken. The cyber-attack scarf sensitive data that contained social securities, names, and residential addresses of people. Constant year, Premera Blue Cross reported that a cyber-attack has exposed medical information of over eleven million customers. Back in 2011, over 4.9 million health records were taken electronically from Science Application International Corporation. These are few cases of a care data breach with sensitive data falling into the hands of third parties. In guaranteeing that there are privacy and security in care records, bureau insurance mobility and responsibility (HIPPA) is providing legislation that hospital and totally different institutions that handle patient’s data to adopt in guaranteeing that varied security measures are enforced in protecting data.
HIPPA and Security Compliance
As much as institutions are clasp technology in storing care data, it is vital for institutions like HIPPA to regulate these bodies to substantiate that shopper rights are protected. The HIPAA Security Rule provides that electronic records of patients got to be protected in any respect times from any unauthorized access nonetheless the information being at rest or in transit.
Virtual Mentor American Medical Association Journal of Ethi.docxsheronlewthwaite
Virtual Mentor
American Medical Association Journal of Ethics
September 2012, Volume 14, Number 9: 712-719.
STATE OF THE ART AND SCIENCE
Electronic Health Records: Privacy, Confidentiality, and Security
Laurinda B. Harman, PhD, RHIA, Cathy A. Flite, MEd, RHIA, and Kesa Bond, MS,
MA, RHIA, PMP
Health Information Systems: Past and Present
To understand the complexities of the emerging electronic health record system, it is
helpful to know what the health information system has been, is now, and needs to
become. The medical record, either paper-based or electronic, is a communication
tool that supports clinical decision making, coordination of services, evaluation of
the quality and efficacy of care, research, legal protection, education, and
accreditation and regulatory processes. It is the business record of the health care
system, documented in the normal course of its activities. The documentation must
be authenticated and, if it is handwritten, the entries must be legible.
In the past, the medical record was a paper repository of information that was
reviewed or used for clinical, research, administrative, and financial purposes. It was
severely limited in terms of accessibility, available to only one user at a time. The
paper-based record was updated manually, resulting in delays for record completion
that lasted anywhere from 1 to 6 months or more. Most medical record departments
were housed in institutions’ basements because the weight of the paper precluded
other locations. The physician was in control of the care and documentation
processes and authorized the release of information. Patients rarely viewed their
medical records.
A second limitation of the paper-based medical record was the lack of security.
Access was controlled by doors, locks, identification cards, and tedious sign-out
procedures for authorized users. Unauthorized access to patient information triggered
no alerts, nor was it known what information had been viewed.
Today, the primary purpose of the documentation remains the same—support of
patient care. Clinical documentation is often scanned into an electronic system
immediately and is typically completed by the time the patient is discharged. Record
completion times must meet accrediting and regulatory requirements. The electronic
health record is interactive, and there are many stakeholders, reviewers, and users of
the documentation. Because the government is increasingly involved with funding
health care, agencies actively review documentation of care.
The electronic health record (EHR) can be viewed by many users simultaneously and
utilizes a host of information technology tools. Patients routinely review their
electronic medical records and are keeping personal health records (PHR), which
Virtual Mentor, September 2012—Vol 14 www.virtualmentor.org 712
contain clinical documentation about their diagnoses (from the physician or health
care websites).
The.
Quickly made presentation in two hours
Security Risk Management in Healthcare on Cloud using NIST guidelines
More details: (blog: http://sandyclassic.wordpress.com ,
linkedin: ie.linkedin.com/in/sandepsharma/)
The emergence of Internet of things IoT , new computing networking paradigms such as cloud computing and fog computing , cloud computing, and machine learning has revolutionized traditional healthcare and led to the dawn of a new era of smart healthcare. Smart healthcare is a huge market opportunity because it improves lots of lives with the smart health solutions. Stakeholders around the globe are seeking innovative, cost effective ways to deliver patient centered, technology enabled smart health care, both inside and outside hospital walls. This paper provides a primer on smart healthcare. Matthew N. O. Sadiku | Adedamola Omotoso | Sarhan M. Musa1 ""Smart Healthcare: A Primer"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-4 , June 2019, URL: https://www.ijtsrd.com/papers/ijtsrd25076.pdf
Paper URL: https://www.ijtsrd.com/home-science/health-and-hygiene/25076/smart-healthcare-a-primer/matthew-n-o-sadiku"
The healthcare industry is a perfect candidate for disruptive technology. Social media, cloud computing and mobile devices lead the way. However the transformation is not without its risks. This presentation looks at the top security risks of these technologies and how vendors can address them to increase adoption.
Page 1 Executive Summary Policy makers are looking.docxsmile790243
Page 1
Executive Summary
Policy makers are looking carefully at the best ways to improve our healthcare system with much
emphasis being placed on the need for electronic health records for every American. This effort also
includes creating an infrastructure to allow the exchange of these records at the regional, state and
national levels. With the passing of the American Recovery and Reinvestment Act of 2009 (ARRA), the
federal government is poised to invest over $19 billion in healthcare information technology (HITECH
Act).1 This investment will provide significant incentives for healthcare providers to implement electronic
medical record (EMR) systems over the next five years. This action has the potential to dramatically
change the landscape of modern medicine and is generally seen as a tremendous step forward; however,
we must ensure that this course achieves the ultimate goals of this initiative.
If we are to improve healthcare information management, we must start with the accurate identification of
each person receiving or providing healthcare services, and anyone accessing or using this information.
As we move away from paper-based medical records that are controlled by physical access to buildings,
rooms, and files, we need to have an infrastructure that supports strong identity and security controls.
The issues with establishing identity are compounded as electronic medical records are used by many
different organizations at the regional, state, and national levels. There must be a way to uniquely and
securely authenticate each person across the healthcare infrastructure, whether that interaction is in
person or over the Internet.
Until now, there has been a slow and uncoordinated transition toward electronic medical records. There
are a myriad of systems on the market today, each with its own methods for handling patient and record
identification and each with varying levels of security and privacy controls. Many systems rely on simple
usernames and passwords to identify and control access. Far fewer implement strong multi-factor
authentication (such as smart cards). It is critical that a set of standards be established for identifying the
patient, the medical provider, and all others handling electronic records so that information across
different locations can be shared easily and securely and so that patient privacy is maintained. Accurate
identification and authentication seem like capabilities that should already exist in healthcare; however,
identification and authentication are currently uncontrolled and not standardized among medical systems,
locations, and organizations within the healthcare community.
This paper introduces the current challenges and explains why identity management in healthcare is an
essential and foundational element that must be made a priority by policy makers in order to achieve the
goals of widespread use of electronic health records to support t.
1)Health data is sensitive and confidential; hence, it should .docxteresehearn
1)
Health data is sensitive and confidential; hence, it should be kept safe. Data security is one of the critical activities which has become challenging for many organizations (Frith, 2019). Due to technology advancements, people can save their health data online. Similarly, people are also able to share data with close friends or any other person of interest. Using online platforms to store the data has brought a lot of benefits. The primary benefit is the fact that individuals can share data with medical experts easily. By, this the medical experts will be able to assist the sick people if possible. The data is always accessible as long as one is authorized.
I read different articles that shared information concerning health data breaches. Various health organizations have been affected by data breaches (Garner, 2017). A good example is the University of Washington Medicine. This organization reported that 974,000 patients' data was affected. The attack was noticed by a patient who found some files containing personal information on public sites. The patient then notified the organization, which claimed that some employees made some errors, which led to the leakage. The files were accessible through Google, so the organization had to ask Google to remove the data. Fortunately, the files were removed from the search list, and this occurred in January 2019.
It was risky to let the files containing personal information available on the website (Ronquillo, Erik Winterholler, Cwikla, Szymanski & Levy, 2018). The organization was lucky that the data breach was not significant, and hence, the patients were not significantly affected. It is good to ensure that files containing health data are handled carefully to avoid some problems. In keeping the health data secure, it is good to ensure that the systems are well-protected. The systems can be protected by making use of firewalls which prevent unauthorized people from accessing them. During the data sharing process, a health organization should ensure that the information is encrypted. Encryption prevents unauthorized people from understanding the message that is being shared using different channels. Users should make sure that they use strong passwords.
2)
Protection of patient’s information is the top most priority of health care providers and professionals. Patient’s health information contains personal data and their health conditions hence the federal laws requires to maintain security and privacy to safeguards health information. Privacy, as distinct from confidentiality, is viewed as the right of the individual client or patient to be let alone and to make decisions about how personal information is shared (Brodnik, 2012). Health data is usually stored on paper or electronically, in both these ways it is important to respect the privacy of the patients and hence follow policies to maintain security and privacy rules.
The Health Insurance Portability and Accountabili.
Running Head Stage 2 Sharing Data1Stage 2 Sharing Data3.docxjeanettehully
Running Head: Stage 2: Sharing Data1
Stage 2: Sharing Data3
Stage 2: Sharing Data
Alesix Tieku
Dr.Lindsey hopper
IFSM 305
July 11th, 2019
Table of Contents
A.Introduction2
B.Need to Share Data2
C.Types of Data to be shared3
D.Data Interchange Standards4
E.Summary4
Stage 2: Sharing DataA. Introduction
Medical care institutions have provided care for their patients since old times before the digital technology era that we are in today. Medical institutions like clinics and hospitals which existed during those previous times, used paper based methods to get most of their basic operations done within the institutions. Operations like obtaining, saving and updating customer details, keeping appointment schedules, and sharing customer data with other institutions. Now in the modern era of technology, the same operations are needed but are simpler now than back then, thanks to digital technology.
The sharing of data between institutions is necessity in the medical profession in for various reasons. The institutions that require such data have different reasons for that as well. For these reasons, data sharing between institutions needs to be properly set and streamlined process for maximum efficiency.B. Need to Share Data
Of the many institutions that exist in the medical industry, two institutions are very crucial to the process of administering medical help to patients; Laboratories and Insurance companies.
Laboratories are essential to the process of diagnosing and treating an illness in a patient for various reasons. First of all, a patient’s diagnosis process can be a difficult problem and a rather complicated one too. When a doctor listens to a patient describe the symptoms of an illness, he/she gets a general idea of what a patient is suffering from and may need further information from a laboratory to confirm his findings. In such a scenario, the doctor sends the patient to a laboratory either within the institution or outside the institution. The laboratory will most definitely require accurate information about the patient to understand the basic nature of the condition of which the patient is required to be tested on, background information like allergies and any other relevant information. This information is usually given by the doctor or retrieved from data storage facilities like a file or a digital database.
Insurance companies are also essential in the process of treating a patient for various reasons. The major reason however is for the purposes of billing of patients expenses. These companies need information about the expenses incurred by a patient during treatment. Such information may include: laboratory test costs, drugs and medicine costs and doctor consultation fees. Proper communication and data sharing frameworks need to be put in place for this purpose as well.
C. Types of Data to be shared
Medical care institutions often need to share patient information with external institutions for the purposes of sa ...
Page 9 of 15Capstone ProjectYaima OrtizIDS-4934.docxkarlhennesey
Page 9 of 15
Capstone Project
Yaima Ortiz
IDS-4934
March 1st, 2020
Abstract
Topic:
Privacy- What medical information should be confidential? Who, if anybody, should have access to medical records?
Thesis Statement
In healthcare centers and overall privacy is the right of every US citizen that should be protected in all its forms by the healthcare organization.
Rationale
1. The purpose of this paper is to identify why security measures are necessary to protect one’s privacy in the medical industry.
2. There are numerous laws, policies and healthcare organizational rules and regulations and statistics that would be helpful for conducting this research.
3. Privacy of a person whether this is me or you, is important then everything. I want to talk on this topic because I think most of us do not know what is happening to us.
4. I have selected textual analysis of books and available internet sources. The reason of this limited research methodology is that I cannot perform field study because of shortage of time.
Rough Draft Ideas
Identity theft in healthcare industry become a common practice and leads to information leakage that may destroy someone’s life. We can eliminate this human right violation by enforcing effective and practical laws. Healthcare organizations should understand their responsibilities and tighten security to protect information of patients.
Table of Contents
Introduction 3
Overview of Privacy Protections with Respect to Medical Records 4
Data Breaches in the Healthcare Industry 5
Healthcare is the biggest Target for Cyber Attack 7
Penalties and Punishments for Hacking Personal Information 9
Penalties 9
Devastating Consequences of Healthcare Data Breaches 10
Conclusion 10
Recommendations 11
Bibliography 12
Introduction
While operating in healthcare organizations need to gather patient’s information that is mostly personal information. It is the moral and legal responsibility of health care organizations to protect the information of their patients and do not share it with people outside of the organization without the patient’s consent. Protecting patient’s information is a crucial element of respect and essential for patients' autonomy and trust in the organization — the US healthcare industry currently facing patient mistrust that is caused because of a lack of trust. When patients experience a lack of confidence they do not share their information with a healthcare professional that causes ineffective treatment. In a 2018 study, Levy, Scherer, Zikmund-Fisher, Larkin, Barnes, & Fagerlin concluded that approximately 81.1% of people withheld medically relevant information from their health-care providers. Patients fail to disclose medically relevant information in front of their clinicians undermine their health and cause patient harm (Levy, 2018).
There are numerous components of patient privacy in healthcare that are personal space, religious and cultural affiliations, physical privacy ...
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AVAILABILITY, ACCESSIBILITY, PRIVACY AND SAFETY ISSUES FACING ELECTRONIC MEDICAL RECORDS
1. International Journal of Security, Privacy and Trust Management (IJSPTM) Vol 7, No 1, February 2018
DOI : 10.5121/ijsptm.2018.7101 1
AVAILABILITY, ACCESSIBILITY, PRIVACY AND
SAFETY ISSUES FACING ELECTRONIC
MEDICAL RECORDS
Nisreen Innab
Information SecurityDepartment, College of Computer and Information Security,
Naif Arab University for Security Sciences, Al-Riyadh, Saudi Arabia.
ABSTRACT
Patient information recorded in electronic medical records is the most significant set of information of the
healthcare system. It assists healthcare providers to introduce high quality care for patients. The aim of
this study identifies the security threats associated with electronic medical records and gives
recommendations to keep them more secured. The study applied the qualitative research method through a
case study. The study conducted seven interviews with medical staff and information technology
technicians. The study results classified the issues that face electronic medical records into four main
categories which were availability, accessibility, privacy, and safety of health information.
KEYWORDS
Healthcare information security, electronic medical records security, availability, accessibility, privacy,
and safety.
1. INTRODUCTION
Healthcare services are increasingly embracing information technology that allows the
automation and digitalisation of health information and manual records. The benefits of this
evolution are the convenience and reduction in the cost to healthcare providers, health insurance
companies and patients. Medical records at healthcare organisations contain sensitive information
about patients. Therefore, these organisations should ensure the security of information,
especially because the patients' data is increasingly stored and can be accessed online [1].
Patient information stored in electronic medical records is the most significant set of information
of the healthcare system. It assists healthcare providers in offering high quality care for their
patients. In hospitals or healthcare centres, electronic medical records contain sensitive
information about patients. An electronic medical record contains a patient's demographic data
such as the patient's name, gender, contact number and address. Moreover, it contains the
diagnosis, procedures, treatments, x-ray images, test results, and any other medical interventions
[2].Therefore, it is essential for healthcare providers to have some well-organised form or
structure to run electronic medical records data and the patient’s information in the health
information system. As a result of the sensitivity of patient information, a well-organised
structure of sensitive information in health services aims to offer great opportunities of healthcare
based on the provision of correct information. Stakeholders could share a patient's electronic
2. International Journal of Security, Privacy and Trust Management (IJSPTM) Vol 7, No 1, February 2018
2
medical records in order to achieve uniformity of data and simplify the care process. However,
without proper security protocols in place, the electronic medical record information may
constitute a threat to the patient's privacy and security of information and may be misused by the
healthcare provider, insurance companies, or any organisation or party interested in accessing this
information for personal use [3].
Healthcare users exhibit an increasing dependency on the available information and specifically,
on the information that addresses the valuable assets for healthcare. Thus, the electronic medical
records of patients have a critical role in the healthcare system and must be appropriately
safeguarded and secured from unauthorised users. Moreover, the communication process among
healthcare users regarding patient information must be safe and secured. Healthcare providers
should have a security process in place to maintain the confidentiality of a patient’s records [4].
Ensuring the security of the health information system maintains the integrity and confidentiality
of electronic medical records. When sensitive information is collected and stored in any form or
personally identifiable information exists, then a privacy concern appears. Electronic medical
records are protected by the health information system security from frauds, intruders, and
malware. Protecting patient identifiable information, while sharing this information with different
medical practitioners in different departments or places is the main challenge of maintain the
privacy of electronic medical records. Privacy of information ensures that only the authorised
people get it. This is implemented through many techniques such as data masking, encryption,
and authentication [5].
These days, the hacking of electronic medical records by cybercriminals exhibits a gradual rising
tendency. Patients' electronic medical records were attacked by hackers. The average sell value
differs in some countries from$10 to $1,000 USD of a patient medical record [6, 7].
As shown in table 1in 2015 for each record lost or stolen, the average cost for this break was 363$
in health institutions. Whereas, it was 154$ for the stolen records of other industries [8].
Table 1. Data breach cost per each record in US$ based on industry type.
No. Industry type The average cost of data breach per lost or
stolen record
1 Health 363
2 Education 300
3 Pharmaceuticals 220
4 Financial 215
5 Communications 179
6 Retail 165
7 Industrial 155
8 Services 137
9 Consumer 136
10 Energy 132
11 Hospitality 129
12 Technology 127
13 Media 126
14 Research 124
15 Transportation 121
16 Public Sector 68
3. International Journal of Security, Privacy and Trust Management (IJSPTM) Vol 7, No 1, February 2018
3
It is greatly important for any nation to develop a general health data centre, which will make it
possible to integrate data from various health information systems to be offered for enhanced
health services. However, a national health data centre poses a high risk to the privacy of patients
and information security. Before integration to a national health data centre, the private and
sensitive data of patients reside in a hospital or health centre. Hospitals or health centres are
required by law to protect the privacy of data. Nowadays in the case of general health data
centres, the circumstances are changed. Therefore, in national health data centres the privacy of
patient information may need to be safeguard using appropriate measures [9].
In Jordan, the problem is that electronic medical records have problems in availability,
accessibility, privacy, and safety. Therefore, the government should employs an information risk
management approach for security purposes in order to prevent the risk of hacking of the
electronic medical records. Therefore, this paper aims to identify the security threats that related
to availability, accessibility, privacy, and safety and associated with electronic medical records
and give recommendations to keep them more secured.The technology in continues development,
that leads to continues and variety of difficulties and concerns related to many fields. Our concern
in this research is the electronic medical records area
2. LITERATURE REVIEW
2.1 Operational Definitions
A health information system (HIS) is an application that deals with processing data, information,
and knowledge involving both computer software and hardware related to healthcare procedures.
Moreover, an application is an electronic medical record that includes the clinical decision
support, pharmacy, computerised provider order entry, clinical data warehouse, controlled
medical vocabulary, order entry, and clinical documentation applications [10].Hakeem program is
an electronic medical record applies in Jordan. It depends on a comprehensive open-source health
information system. Moreover, it integrates different types of health information systems,
including laboratory, pharmacy, administrative, radiology, clinical documentation systems, and
computerised physician order entries. The Hakeem program project is constructed on a VistA
system. It is used by many countries and has been customised according to their needs. VistAwas
deployed and implemented by the US Department of Veterans Affairs [11].
2.2 Health Information System Breach
A research study conducted by the International Business Machines Corporation (IBM) and
Ponemon Institute in 2015 revealed that for each incident, on average, more than 18 thousand
medical records were breached. In some countries, the average number of breached medical
records in a breach incidence was as follows: Arabian countries 29,199; India 28,798; United
States 28,070; Germany 24,103; Brazil 22,902; United kingdom 21695; France 20,650; Canada
20,456; Australia 19,788; Japan 19,214: Italy 18,983 [8].For instance in the United States, the
total number of electronic medical records breached in 2015 was seven times higher than the total
number of electronic medical records breached in 2014. The value of breached records increased
from 12.5 Million USD in 2014 to 94 Million USDin 2015[12].
In 2016, hackers attacked the Hollywood Presbyterian Medical Centre. They had shut down the
computer system of the centre for about a week for a payoff of 3.7 million USD. It was a
4. International Journal of Security, Privacy and Trust Management (IJSPTM) Vol 7, No 1, February 2018
4
malicious software application called Ransom ware that turned off the system [13].The Hospital
Corporation of America (HCA) 2016reported that the electronic medical records were breached
as result of staff negligence. The hackers compromised 91,000 electronic medical records for
patients. The data affected were social security numbers, dates of birth, and further private
information [14].In January 2015, the hackers attacked Premera Blue Cross. The hackers reached
the financial and medical data of 11 million patients. Hackers shared financial information, social
security numbers, names, medical claims data, addresses, dates of birth [15].
2.3 Previous Studies
Namoglu and Ulgen (2013)conducted a study for Turkish hospitals to uncover the vital
components of a 21st
century business continuity plan, in the case of which introducing patient
privacy auditing standards was achieved on the basis of laws and regulations. The study was
applied at a private hospital in Turkey. The researchers conducted interviews with the technical
staff in order to determine the technical needs for network security configuration and deployment
and with the hospital medical staff in order to perceive the requirements for patient privacy. The
results showed that the hospital adopted electronic transactions. These transactions could be
accessed by hackers or misused by anyone interested in this information. Therefore, electronic
medical records at hospitals must be protected against any attacks or misuse [16].
Alsalamah, Gray, Hiltonc and Alsalamah (2013) investigated patient-centred healthcare support
systems to focus on information security requirements. The study results showed that information
integrity and confidentiality are the main concerns of the discrete legacy systems in terms of
implementing information security. The study used an experimental study, interviews, and
observation. The study recognised six requirements needed by a legacy system in order to ensure
information security to manage through the circumstances to achieve the balance of security in a
system, thus reassuring the provision of patient centred care in current healthcare services. The
six requirements of information security were the fine-grained access control; role-based access
control; dynamic control; persistent control; circle of trust; and human-level policy awareness
[17].
Ozair, Jamshed, Sharma, and Aggarwal (2015) conducted a study entitled ethical issues in
electronic health records: a general overview. The study aimed to discuss the various ethical
issues arising in the use of the electronic health records and their possible solutions. The study
relied on literature to discuss ethical issues in using electronic health records [18].
While our study highlighted specific security issues in electronic medical records, which were
availability, accessibility, privacy, and safety. Moreover, the study collected the data from people
works in a hospital and deal with electronic medical records. In addition, it focused on electronic
medical records (Hakeem program) in Jordan. Finally, it introduced practical solution to these
issues.
3. METHODOLOGY
The study used the qualitative research method in order to obtain a comprehensive understanding
of the security of the health information system. A case study was conducted to identify the issues
and problems, which have not been extensively studied yet. The case study with interviews is the
most important technique in order to collect relevant information about specified phenomena. The
5. International Journal of Security, Privacy and Trust Management (IJSPTM) Vol 7, No 1, February 2018
5
study conducted seven interviews with medical members of staff and with an information
technology technician (medical record technician, pharmacist, radiologist, medical laboratory
technician, physician, supervisor, and information technology technician), who is in direct contact
with the Hakeem system at a governmental hospital in order to extract qualitative data from
different perspectives so as to know how the security of the health information system was
managed. Most participants were male. Their ages ranged between 25 to 40 years. Their
education was distributed among three levels diploma, bachelor’s and master’s degree.
Preplanned questions were prepared prior to conducting the interviews about the security of
health information systems. The relevant questions were derived from the literature review and
the study goal. Most interview questions were the same. However, the information technology
technician was asked some different questions. The questions were reviewed by healthcare
researchers and professionals to get feedback and confirm that the study questions make it
possible to achieve the study goal. All interviews were conducted at the hospital at a convenient
time for the participants. During the interviews, notes were taken by the interviewer. The results
of the study interviews were analysed and discussed to reach appropriate solutions to keep the
health information system and patients' electronic medical records secure. The interview guide
consisted of 15 main questions to find the best way to keep the Hakeem program secure. In
addition, some more questions related to the security of electronic medical records were asked to
an information technology technician.
4. RESULTS
Information technology has developed very fast. Therefore, electronic health information systems
have also developed. However, the study investigated whether electronic health information
systems are able to keep sensitive healthcare information secure. As a result, the findings of the
participants with different healthcare and information technology technicians in this case study
emphasised the significance of electronic records. They considered that electronic medical
records are a vital resource of the healthcare system. Most participants mentioned that a secured
database is used to store the electronic medical records in governmental hospitals that implement
the Hakeem program. Based on the participants' perceptions, the issue with traditional medical
records referred to accessing the right information in the right place at the right time. Therefore,
providing required medical records or some information takes a long time. The physician
mentioned 'in the past, the department of medical records was sometimes late to provide me with
traditional medical records that make patients wait more time to get the services'. With electronic
medical records doctors can make a request for any information then they can get it or they can
access the required information easily. Any authorised employees can access a specific part of the
electronic medical record to add, edit or remove information based on their job. The medical
laboratory technician said 'I can access the medical laboratory section and add the laboratory
results of patients'. The system can determine the employee introduced any amendments to an
electronic medical record.
Many participants mentioned that the health information system in Jordan (Hakeem program) has
attempted to protect and secure electronic medical records from unauthorised users’ access. The
Hakeem program allows authorised users to access the program after passing the authentication
and verification process.
They also said the Hakeem program is a well organised program but still needs to be more
secured against unauthorised users and hackers. Changing some information in the electronic
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medical record by unauthorised users, hackers or malware can affect patient health negatively.
Regarding issues of the electronic medical records, the participants classified the issues that face
electronic medical records into four main categories. These categories were availability,
accessibility, privacy and safety of health information.Those classification support to decide
where the security controls and mechanisms should implemented.
4.1 Availability
The participants mentioned that the Hakeem program was designed to keep electronic medical
record secured based on the availability, confidentiality, integrity of information. It is valuable to
be sure that the needed health information records are available the authorized people on time.
Loss of availability could decrease the service quality, provide inadequate treatment for the
patient, financial loss, and some legal issues.
In addition, the system can identify who introduced any amendments to be responsible for that
action in the electronic medical record. The information technology technician said 'we can know
the person who adds or deletes any information from the medical record based on the username
of the person'.
4.2 Accessibility
Participants mentioned that all new medical records for patients are stored in electronic form.
Patients cannot access their electronic medical records. Therefore, if they need a copy of their
medical record they should make a request from an authorised person. The medical record
technician said 'if patients need a copy of their medical record, they should fill a request'. Many
participants mentioned that every user has limited access to electronic medical records. The
access to medical records depends on an employee's task to be performed. This procedure
protects electronic medical records from unauthorised employees.
4.3 Privacy
According to the participants, the Hakeem program prevents the information contained in
electronic medical records from being accessed by unauthorised employees. Every authorised
employee has a username and password. The username consists of the first two letters of the
employee’s name and job number. The password can be customised by the employees. The
password consists of numbers and letters. The aim of this procedure is to authenticate the
authorised person. For example, the employees in medical record departments can access the
basic information about the patient. They can add the patient address, telephone number, and
nationality of the patient and only preview the electronic medical record, but they cannot access
the physician section or add any symptoms of disease or diagnostic.
4.4 Safety of Health Information
The system prompts the employees to change their password regularly. If the employee leaves the
computer room without logging out of the system the computer needs a period of time to logout
automatically. This period constitutes a risk for sensitive information.
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5. DISCUSSION
Electronic medical records are a vital resource of the healthcare system. Therefore, they need to
be more secured again unauthorised users and hackers. Privacy rules give patients the right to see
information in their medical records, regardless of these being paper or electronic records.
Patients have the ability to see or get a copy of their medical record based on the rules of privacy;
correct any mistakes in their medical record; choose suitable time to return to the hospital; and
make a complain if they do not fully benefit from their rights. These rights are the types of
privacy practices given to patients [19]. In addition, protecting the information stored in the
electronic medical records of patients consider the rights of the patients. Therefore, the security of
electronic medical records requires that health care providers have to set up administrative,
physical, and technical protection to maintain patients' electronic medical records safe. A number
of safety procedures could be introduced in order to protect electronic medical records. These
procedures include access controls like PIN numbers and passwords to help limit records access
as well as encrypting techniques [20]. This means that the electronic medical records of patients
cannot be read and understood except by healthcare providers who can decrypt this information
by using a specific key made available to authorised healthcare providers; an audit trail records
who accessed the electronic medical record of a patient, what kind of changes were made and
when.
Securely accessing the information within the health system requires three main steps. These
steps are the identification of the user that was required to enter a login username; authentication
that required users to prove identification via passwords; and authorisation that gives the users the
right to access the electronic medical records [17]. Conversely, access control is theoretically an
element of the authorisation procedure that verifies if users can access the resources they
requested. The healthcare system should include the three steps because the first two steps are
essential to the third. Furthermore, several implementations combine the three steps into one
access control decision. A health information system that involves the implicit access control
policy allowing each employee who is successfully authenticated to access the electronic medical
records of patients. This is the hard granularity of the access control policy, in which each
employee has the same right to access the Hakeem program. Therefore, the authentication
procedure becomes a combined authentication and authorisation mechanism.
The processes of creating an access control system is very complicated and should start with
establishing and defining a structured and access control plan in addition to the access control
models [21].To deliver the information security requirements of the health information system, an
access control plan is needed to determine the rules to be implemented. The naright model of
access control should be selected to model the defined rules in the plan. There three common
access control models. The Role-Based Access Control that connects the rights to groups of
employees according to their job within the healthcare system. The Identity Based Access Control
that connects the rights to specific employees depending on their needs. The Mandatory Access
Control that describes the fixed rules for all employees of the healthcare organisation [22]. More
than one model can be mixed and combined to deal with more varied needs of the healthcare
institution. Both access control procedures and authentication and the correct technology can be
determined and executed merely after the access control model is chosen. The authentication
procedure facilitates the identification and authentication of an employee to the healthcare system
(The login username and password), whereas the access control procedure guards against the
unauthorised use of the requested resources[17]. Both procedures should achieve in a consistent
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and correct manner based on the access control plan and model defined. Providing access control
has become more complex. This is required to be implemented cautiously in the healthcare
system, thus the access control can be accurately applied and developed without hindering the
system’s use.
6. RECOMMENDATIONS
1. A health information system should maintain the confidentiality, integrity, availability,
and security of its electronic medical records.
2. The Ministry of Health should create laws and legislations or follow international
standards to protect sensitive information from unauthorised employees.
3. Implementing the Jordanian health information system (Hakeem program) in all public
and private healthcare institutions.
4. Implementing rigorous security access procedures for electronic medical records such as
sending the passwords as a message with each access attempt or changing the password
compulsory each month.
7. CONCLUSION
One of the significant elements the healthcare system is electronic medical records that needs the
proper security system. Nowadays, attackers in rise of targeting the electronic medical records as
it worthy for them. Thus, this research investigate some issues and some recommendations to
decrease the side impact of those issues. As a result to enhance the security of electronic health
information. The study results showed that availability, accessibility, privacy, and safety are the
main concerns of implementing secured electronic health medical records. Several mechanisms
used to protect the healthcare records to avoid disruption and reduce the risk of information loss.
We suggest that international information security standards needs to be followed in The Ministry
of Health such as the health insurance portability and accountability act HIPPA. Beside enforce
rigorous security access procedures for electronic medical records such as use encrypted
passwords. Moreover, as gradually different developing countries implement electronic medical
records, we suggest to implement the Jordanian health information system (Hakeem program) in
all public and private healthcare institutions.
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AUTHOR
Dr. NisreenInnab got her Ph.D. in 2008 in Computer Information System, she
was employed as full time lecturer, Assistant Professor and MIS department
Chairperson at University of Business and Technology in Saudi Arabia, Jeddah
from 2007 to 2010. Then she was worked from May 2011 to August 2014 as a
honorary researcher and master thesis examiner in the school of science and
technology at University of New England, Armidale, Australia. Finally, from
September / 2016 till now she works in the department of information security at
Naif Arab University for Security Sciences, Riyadh, Saudi Arabia. She published
nine papers in international journals and conferences. Her current research
interests are: information security, data mining, machine learning, modeling and
simulation, ontology, modeling diagrams.