A sensitive data access model in support of learning health systems

Given the ever-growing body of knowledge, healthcare improvement hinges more than ever on efficient knowledge transfer to clinicians and patients. Promoted initially by the Institute of Medicine, the Learning Health System (LHS) framework emerged in the early 2000s. It places focus on learning cycles where care delivery is tightly coupled with research activities, which in turn is closely tied to knowledge transfer, ultimately injecting solid improvements into medical practice. Sensitive health data access across multiple organisations is therefore paramount to support LHSs. While the LHS vision is well established, security requirements to support them are not. Health data exchange approaches have been implemented (e.g., HL7 FHIR) or proposed (e.g., blockchain-based methods), but none cover the entire LHS requirement spectrum. To address this, the Sensitive Data Access Model (SDAM) is proposed. Using a representation of agents and processes of data access systems, specific security requirements are presented and the SDAM layer architecture is described, with an emphasis on its mix-network dynamic topology approach. A clinical application benefiting from the model is subsequently presented and an analysis evaluates the security properties and vulnerability mitigation strategies offered by a protocol suite following SDAM and in parallel, by FHIR

Towards interoperable e-Health system in Tanzania: analysis and evaluation of the current security trends and big data sharing dynamics

This research article published by the International Journal of Advanced Technology and Engineering Exploration (IJATEE), Volume-6 Issue-59 October-2019In this paper an insight on various e-health interoperable systems was reviewed to discover strengths and challenges faced during sustainable implementation. It covered local, national and regional coverage of integrated systems towards implementation of a single unified e-health system. Peer reviewed and grey literatures were consulted to discover global and local trend and efforts towards implementations of e-health interoperable systems. The available systems and frameworks from the European Union, Asia, America, Oceania and Africa were analyzed for their strengths and challenges. Various policies, guides as well as free and proprietary standards associated with e-health interoperability was reviewed to understand the common standards adopted by the majority of existing systems. The findings of the analysis are useful for policy makers on the best ways to implement interoperable systems in developing countries by focusing on the existing infrastructures and the environment. Similarly, the strengths and challenges encountered by interoperable systems were also examined to provide recommendations for future studies

An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

vital:59285The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202

An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202