Initial Experiences of Building Secure Access to Patient Confidential Data via the Internet

A project to enable health care professionals (GPs, practice nurses and diabetes nurse specialists) to access, via the Internet, confidential patient data held on a secondary care (hospital) diabetes information system, has been implemented. We describe the application that we chose to distribute (a diabetes register); the security mechanisms we used to protect the data (a public key infrastructure with strong encryption and digitally signed messages, plus a firewall); the reasons for the implementation decisions we made; the validation testing that we performed and the preliminary results of the pilot implementation

Providing secure remote access to legacy applications

While the widespread adoption of Internet and Intranet technology has been one of the exciting developments of recent years, many hospitals are finding that their data and legacy applications do not naturally fit into the new methods of dissemination. Existing applications often rely on isolation or trusted networks for their access control or security, whereas untrusted wide area networks pay little attention to the authenticity, integrity or confidentiality of the data they transport. Many hospitals do not have the resources to develop new ''network-ready'' versions of existing centralised applications. In this paper, we examine the issues that must be considered when providing network access to an existing health care application, and we describe how we have implemented the proposed solution in one healthcare application namely the diabetic register at Hope Hospital. We describe the architecture that allows remote access to the legacy application, providing it with encrypted communications and strongly authenticated access control but without requiring any modifications to the underlying application. As well as comparing alternative ways of implementing such a system, we also consider issues relating to usability and manageability, such as password management

Attitudes towards the use and acceptance of eHealth technologies : a case study of older adults living with chronic pain and implications for rural healthcare

Acknowledgements The research described here is supported by the award made by the RCUK Digital Economy programme to the dot.rural Digital Economy Hub; award reference: EP/G066051/1. MC’s time writing the paper is funded by the Scottish Government’s Rural and Environmental Science and Analytical Services Division (RESAS) under Theme 8 ‘Vibrant Rural Communities’ of the Food, Land and People Programme (2011–2016). MC is also an Honorary Research Fellow at the Division of Applied Health Sciences, University of Aberdeen. The input of other members of the TOPS research team, Alastair Mort, Fiona Williams, Sophie Corbett, Phil Wilson and Paul MacNamee who contributed to be wider study and discussed preliminary findings reported here with the authors of the paper is acknowledged. We acknowledge the feedback on earlier versions of this paper provided by members of the Trans-Atlantic Rural Research Network, especially Stefanie Doebler and Carmen Hubbard. We also thank Deb Roberts for her comments.Peer reviewedPublisher PD

Technology for Older Adults: Maximising Personal and Social Interaction : Exploring Opportunities for eHealth to Support the Older Rural Population with Chronic Pain

Funding The TOPS project is supported by an award made by the RCUK Digital Economy programme to the dot.rural Digital Economy Hub, award reference EP/G066051/1.Peer reviewedPublisher PD

Exploring Security, Privacy, and Reliability Strategies to Enable the Adoption of IoT

The Internet of things (IoT) is a technology that will enable machine-to-machine communication and eventually set the stage for self-driving cars, smart cities, and remote care for patients. However, some barriers that organizations face prevent them from the adoption of IoT. The purpose of this qualitative exploratory case study was to explore strategies that organization information technology (IT) leaders use for security, privacy, and reliability to enable the adoption of IoT devices. The study population included organization IT leaders who had knowledge or perceptions of security, privacy, and reliability strategies to adopt IoT at an organization in the eastern region of the United States. The diffusion of innovations theory, developed by Rogers, was used as the conceptual framework for the study. The data collection process included interviews with organization IT leaders (n = 8) and company documents and procedures (n = 15). Coding from the interviews and member checking were triangulated with company documents to produce major themes. Through methodological triangulation, 4 major themes emerged during my analysis: securing IoT devices is critical for IoT adoption, separating private and confidential data from analytical data, focusing on customer satisfaction goes beyond reliability, and using IoT to retrofit products. The findings from this study may benefit organization IT leaders by enhancing their security, privacy, and reliability practices and better protect their organization\u27s data. Improved data security practices may contribute to social change by reducing risk in security and privacy vulnerabilities while also contributing to new knowledge and insights that may lead to new discoveries such as a cure for a disease

The Successful Implementation of Electronic Health Records at Small Rural Hospitals

Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement EHRs. The focus of this descriptive phenomenological study was to explore lived experiences of hospital leaders and administrators who have used successful strategies to implement EHRs in small rural hospitals. Diffusion of innovation theory shaped the theoretical framework of this study. Data were collected through telephone interviews conducted with participants who successfully deployed EHRs at 10 hospitals in the Appalachian regions of Maryland, Virginia, and West Virginia. Data analysis occurred using a modified Husserlian approach in search of common themes from interview transcripts. The main themes were strategies to address standards and incentives, implementation, and challenges. The exploration of these strategies provides insight that small rural hospital leaders and administrators could consider for implementing EHRs. The study findings might enable small rural hospital leaders and administrators to contribute to positive social change by engaging communities in using EHRs; these findings may also expand information sharing among individuals and organizations and build social relationships with an expectation of future benefits. Results from this study are designed to inform other small rural hospital leaders and administrators to conduct further research on successful strategies for implementation of EHRs