THE UNIQUE PATIENT IDENTIFICATION (UPI) DEBATE: IMPLEMENTING A U.S. PATIENT IDENTIFICATION STANDARD

This study provides a comparison and contrast of the merits surrounding the implementation of a US national unique patient identification (UPI) system. Based on the lack of trust created in the minds of current US patients in how current medical records are distributed throughout the US medical system, this study reviews the UPI initiative in India, public trust concerns in the United Kingdom (UK), and trials and feedback from research and clinical review by the US medical community concerning the pros and cons of such a system. This study leads to a proposed patient trusted solution that could be implemented for the purpose of tracking and protecting confidential patient information in the US via the latest cloud based technologies. The proposed solution intends to bring more patient trust to the entire US national medical information technology system as a whole

Bringing health and fitness data together for connected health care: Mobile apps as enablers of interoperability

Background: A transformation is underway regarding how we deal with our health. Mobile devices make it possible to have continuous access to personal health information. Wearable devices, such as Fitbit and Apple's smartwatch, can collect data continuously and provide insights into our health and fitness. However, lack of interoperability and the presence of data silos prevent users and health professionals from getting an integrated view of health and fitness data. To provide better health outcomes, a complete picture is needed which combines informal health and fitness data collected by the user together with official health records collected by health professionals. Mobile apps are well positioned to play an important role in the aggregation since they can tap into these official and informal health and data silos. Objective: The objective of this paper is to demonstrate that a mobile app can be used to aggregate health and fitness data and can enable interoperability. It discusses various technical interoperability challenges encountered while integrating data into one place. Methods: For 8 years, we have worked with third-party partners, including wearable device manufacturers, electronic health record providers, and app developers, to connect an Android app to their (wearable) devices, back-end servers, and systems. Results: The result of this research is a health and fitness app called myFitnessCompanion, which enables users to aggregate their data in one place. Over 6000 users use the app worldwide to aggregate their health and fitness data. It demonstrates that mobile apps can be used to enable interoperability. Challenges encountered in the research process included the different wireless protocols and standards used to communicate with wireless devices, the diversity of security and authorization protocols used to be able to exchange data with servers, and lack of standards usage, such as Health Level Seven, for medical information exchange. Conclusions: By limiting the negative effects of health data silos, mobile apps can offer a better holistic view of health and fitness data. Data can then be analyzed to offer better and more personalized advice and care

MoSIoT: Modeling and Simulating IoT Healthcare-Monitoring Systems for People with Disabilities

The need to remotely monitor people with disabilities has increased due to growth in their number in recent years. The democratization of Internet of Things (IoT) devices facilitates the implementation of healthcare-monitoring systems (HMSs) that are capable of supporting disabilities and diseases. However, to achieve their full potential, these devices must efficiently address the customization demanded by different IoT HMS scenarios. This work introduces a new approach, called Modeling Scenarios of Internet of Things (MoSIoT), which allows healthcare experts to model and simulate IoT HMS scenarios defined for different disabilities and diseases. MoSIoT comprises a set of models based on the model-driven engineering (MDE) paradigm, which first allows simulation of a complete IoT HMS scenario, followed by generation of a final IoT system. In the current study, we used a real scenario defined by a recognized medical publication for a patient with Alzheimer’s disease to validate this proposal. Furthermore, we present an implementation based on an enterprise cloud architecture that provides the simulation data to a commercial IoT hub, such as Azure IoT Central.This work was supported by the Spanish Ministry of Science and Innovation under contract PID2019-111196RB-I00, called “Development of IoT Systems for People with Disabilities” (Access@IoT), and also was partially funded by the GVA through the AICO/2020/143 project

Desarrollo de una propuesta de arquitectura para el soporte de servicios heterogéneos en entornos hospitalarios

Actualmente muchos hospitales y otras instituciones de salud están utilizando sistemas de comunicación para optimizar recursos y agregar una nueva generación de servicios a los pacientes. Sin embargo algunos servicios y recursos tecnológicos están limitados a la flexibilidad, disponibilidad y compatibilidad de la infraestructura de comunicación, ya sea por utilización de sistemas cerrados o a las características fijas de una red hospitalaria. Este trabajo de Fin de Master propone el desarrollo de una Arquitectura para el Soporte de Servicios Heterogéneos en Entornos hospitalarios la cual está basada en nuevas tecnologías de Internet, y está enfocada en mejorar la manera en que los servicios son ofrecidos, a la vez que se mantiene la interoperabilidad con estándares médicos de comunicación. Aspectos como la movilidad en casos de emergencias y la interacción con equipo médico son tomados en cuenta con el fin de soportar un futuro despliegue de una plataforma de servicios. En este documento se propone una Arquitectura de Comunicación enfocada en entornos Médicos que pueda soportar múltiples tecnologías en distintos niveles, tanto de software como de hardware. Además de ello se plantea la adhesión de nuevas tecnologías, que puedan aprovechar al máximo una colaboración entre la red troncal hospitalaria y los distintos nodos y sensores desplegados. Es importante resaltar que para poder soportar una colaboración entre servicios y red, deben existir distintos módulos y middlewares que permitan una abstracción de ciertas capas. En este trabajo se plantea por lo tanto una arquitectura de nodos y servidores genéricos que puedan extender servicios ya existentes, así como también estándares y protocolos como SIP, HL7 y RFID. Otro de los aspectos que se definen es la inclusión de una plataforma genérica de servicios que permita la inclusión de funcionalidades de manera rápida, flexible, y segura. Para un primer desarrollo se ha elegido el framework OSGi, sobre el cual se implementarán todos los servicios, por su enfoque nativo orientado a la modularidad. Se planteará el uso de tecnologías P4P y P2PSIP en entornos hospitalarios, a la vez que propondrá funcionalidades que puedan dar paso a la inclusión de otro tipo de nuevas tecnologías y desarrollo

Internet-Of-Things for Cyber Healthcare (L0t4c): Information Dissemination, systems' Interoperability and security

Magister Scientiae - MSc (Computer Science)Cyber Healthcare is becoming one of the fastest growing industries in the world due to an increasing elderly population and a more health conscious word population. On the other hand, IoT devices are emerging from niche areas to provide new services that we could not fathom without the technological advances made in IoT and healthcare elds [1]. Wireless Sensor Networking (WSN) is a promising approach to cyber healthcare as it can enable real-time monitoring of patients and early detection of emergency conditions and diseases [2, 3]. However, there are a number of issues that need to be addressed in order to bene t from the cyber healthcare promises

Active and assisted living ecosystem for the elderly

A novel ecosystem to promote the physical, emotional and psychic health and well-being of the elderly is presented. Our proposal was designed to add several services developed to meet the needs of the senior population, namely services to improve social inclusion and increase contribution to society. Moreover, the solution monitors the vital signs of elderly individuals, as well as environmental parameters and behavior patterns, in order to seek eminent danger situations and predict potential hazardous issues, acting in accordance with the various alert levels specified for each individual. The platform was tested by seniors in a real scenario. The experimental results demonstrated that the proposed ecosystem was well accepted and is easy to use by seniors

Contributions to the privacy provisioning for federated identity management platforms

Identity information, personal data and user’s profiles are key assets for organizations and companies by becoming the use of identity management (IdM) infrastructures a prerequisite for most companies, since IdM systems allow them to perform their business transactions by sharing information and customizing services for several purposes in more efficient and effective ways. Due to the importance of the identity management paradigm, a lot of work has been done so far resulting in a set of standards and specifications. According to them, under the umbrella of the IdM paradigm a person’s digital identity can be shared, linked and reused across different domains by allowing users simple session management, etc. In this way, users’ information is widely collected and distributed to offer new added value services and to enhance availability. Whereas these new services have a positive impact on users’ life, they also bring privacy problems. To manage users’ personal data, while protecting their privacy, IdM systems are the ideal target where to deploy privacy solutions, since they handle users’ attribute exchange. Nevertheless, current IdM models and specifications do not sufficiently address comprehensive privacy mechanisms or guidelines, which enable users to better control over the use, divulging and revocation of their online identities. These are essential aspects, specially in sensitive environments where incorrect and unsecured management of user’s data may lead to attacks, privacy breaches, identity misuse or frauds. Nowadays there are several approaches to IdM that have benefits and shortcomings, from the privacy perspective. In this thesis, the main goal is contributing to the privacy provisioning for federated identity management platforms. And for this purpose, we propose a generic architecture that extends current federation IdM systems. We have mainly focused our contributions on health care environments, given their particularly sensitive nature. The two main pillars of the proposed architecture, are the introduction of a selective privacy-enhanced user profile management model and flexibility in revocation consent by incorporating an event-based hybrid IdM approach, which enables to replace time constraints and explicit revocation by activating and deactivating authorization rights according to events. The combination of both models enables to deal with both online and offline scenarios, as well as to empower the user role, by letting her to bring together identity information from different sources. Regarding user’s consent revocation, we propose an implicit revocation consent mechanism based on events, that empowers a new concept, the sleepyhead credentials, which is issued only once and would be used any time. Moreover, we integrate this concept in IdM systems supporting a delegation protocol and we contribute with the definition of mathematical model to determine event arrivals to the IdM system and how they are managed to the corresponding entities, as well as its integration with the most widely deployed specification, i.e., Security Assertion Markup Language (SAML). In regard to user profile management, we define a privacy-awareness user profile management model to provide efficient selective information disclosure. With this contribution a service provider would be able to accesses the specific personal information without being able to inspect any other details and keeping user control of her data by controlling who can access. The structure that we consider for the user profile storage is based on extensions of Merkle trees allowing for hash combining that would minimize the need of individual verification of elements along a path. An algorithm for sorting the tree as we envision frequently accessed attributes to be closer to the root (minimizing the access’ time) is also provided. Formal validation of the above mentioned ideas has been carried out through simulations and the development of prototypes. Besides, dissemination activities were performed in projects, journals and conferences.Programa Oficial de Doctorado en Ingeniería TelemáticaPresidente: María Celeste Campo Vázquez.- Secretario: María Francisca Hinarejos Campos.- Vocal: Óscar Esparza Martí

Securely sharing dynamic medical information in e-health

This thesis has introduced an infrastructure to share dynamic medical data between mixed health care providers in a secure way, which could benefit the health care system as a whole. The study results of the universally data sharing into a varied patient information system prototypes