An investigation of electronic Protected Health Information (e-PHI) privacy policy legislation in California for seniors using in-home health monitoring systems

This study examined privacy legislation in California to identify those electronic Protected Health Information (e-PHI) privacy policies that are suited to seniors using in-home health monitoring systems. Personal freedom and independence are essential to a person\u27s physical and mental health, and mobile technology applications provide a convenient and economical method for monitoring personal health. Many of these apps are written by third parties, however, which poses serious risks to patient privacy. Current federal regulations only cover applications and systems developed for use by covered entities and their business partners. As a result, the responsibility for protecting the privacy of the individual using health monitoring apps obtained from the open market falls squarely on the states. The goal of this study was to conduct an exploratory study of existing legislation to learn what was being done at the legislative level to protect the security and privacy of users using in-home mobile health monitoring systems. Specifically, those developed and maintained by organizations or individuals not classified as covered entities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The researcher chose California due to its reputation for groundbreaking privacy laws and high population of seniors. The researcher conducted a content analysis of California state legislation, federal and industry best practices, and extant literature to identify current and proposed legislation regarding the protection of e-PHI data of those using in-home health monitoring systems. The results revealed that in-home health monitoring systems show promise, but they are not without risk. The use of smartphones, home networks, and downloadable apps puts patient privacy at risk, and combining systems that were not initially intended to function together carries additional concerns. Factors such as different privacy-protection profiles, opt-in/opt-out defaults, and privacy policies that are difficult to read or are not adhered to by the application also put user data at risk. While this examination showed that there is legislative support governing the development of the technology of individual components of the in-home health monitoring systems, it appears that the in-home health monitoring system as a whole is an immature technology and not in wide enough use to warrant legislative attention. In addition – unlike the challenges posed by the development and maintenance of the technology of in-home health monitoring systems – there is ample legislation to protect user privacy in mobile in-home health monitoring systems developed and maintained by those not classified as covered entities under HIPAA. Indeed, the volume of privacy law covering the individual components of the system is sufficient to ensure that the privacy of the system as a whole would not be compromised if deployed as suggested in this study. Furthermore, the legislation evaluated over the course of this study demonstrated consistent balance between technical, theoretical, and legal stakeholders. This study contributes to the body of knowledge in this area by conducting an in-depth review of current and proposed legislation in the state of California for the past five years. The results will help provide future direction for researchers and developers as they struggle to meet the current and future needs of patients using this technology as it matures. There are practical applications for this study as well. The seven themes identified during this study can serve as a valuable starting point for state legislators to evaluate existing and proposed legislation within the context of medical data to identify the need for legislation to assist in protecting user data against fraud, identity theft, and other damaging consequences that occur because of a data breach

The development and applications of serious games in the public services: defence and health

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London.The latest advances of Virtual Reality technologies and three-dimensional graphics, as well as the developments in Gaming Technologies in the recent years, have stemmed the proliferation of Serious Games in a broader spectrum of research applications. Among the most popular areas of application are public services such as Defence and Health, where digital technologies realise new challenges and opportunities for research and development of Serious Games and for a variety of contexts. As with all games, the user engagement is elevated and apart from the entertaining aspect, Serious Games serve as a novel and promising alternative experience to knowledge transfer. Furthermore, Serious Games bring to the end user and the overall society a series of attractive benefits. These benefits include safety, cost-effectiveness, increased motivation and personalisation. Hence, this Thesis aims to investigate novel approaches of developing Serious Games that utilise the recent advances of Virtual Reality and Gaming Technology and facilitate the aforementioned benefits. The process of design and development of the novel tools and applications follow an iterative manner and are driven by the review of the available literature as well as end-user feedbackEPSRC (Engineering and Physical Sciences Research Council ) , MOD (UK), NHS (UK

A Framework for Evaluating Technology-Mediated Collaborative Workflow

The adoption of new technology into collaborative workflows has permeated every aspect of our personal and professional lives with the promise of performing work processes more efficiently and with greater capability. The continued rise of ubiquitous computing and heightened need for collaborative features suggest that a view of enabling technologies in a workflow should include the physical computing infrastructure, the collaborative interaction between humans and computers, and the informatics (i.e., collection and representation of data within the workflow). The development and integration of technology for collaborative workflows introduces many variables that are of great concern to companies, organization, and individuals. These variables include the costs of development, the switching cost associated with migrating from the current workflow to the technology-enhanced workflow, and details of how the technology-mediated workflow functions compare to the current workflow functions. There is, however, no consistent, generalizable approach to evaluate and compare an existing workflow with the enhanced technology-mediated workflow in a manner that identifies improvements and barriers in replicable qualitative and quantitative measures. In order to develop such a consistent, generalizable approach, this research investigates what necessary set of cross-disciplinary metrics and methodology is required to effectively evaluate technology-mediated collaborative workflow through an analysis of related works from four disciplines (Social Sciences, Organization and Behavioral Management, Industrial Engineering, and Human-Computer Interaction). The research introduces the Collaborative Space – Analysis Framework (CS-AF), a cross-disciplinary model and methodology designed to evaluate and compare collaborative workflows. The research includes testing the CS-AF model using two diverse empirical studies designed to evaluate a current-state workflow, compared to a technology-mediated workflow on five key collaborative areas (Context, Technology, Process, Attitude and Behavior, and Outcomes). The research incorporates the CS-AF model and methodology to test the effectiveness of the approach for capturing and analyzing essential quantitative and qualitative parameters of the collaborative workflows. The second empirical study tested hypertensive patients currently involved in clinical maintenance with regular outpatient monitoring. The test included 50 hypertension patients, selected based on matched-pairs for age and gender to test the workflow model in a 3-week trial. All participants were tested on an existing workflow (current-state), then the population was randomly split within pairs. The matched-pairs were assigned to one of two alternative workflows: 25 patients were introduced to a manual hypertension self-exam workflow (control group), and their matched-pair counterparts were introduced to technology-mediated hypertension self-exam workflow. All participants were tested on the existing workflow (current-state), followed by the introduction of an alternate workflow, and then tested a second time (pre-/ post-) with the same CS-AF procedure. The study incorporated the research findings from these two tests and a comparison between the workflows introduced using the CS-AF metrics. Findings from the two diverse empirical studies using the CS-AF (Graphic Communications sales order process, and Health Information Technology hypertension exam workflow) indicate that technology-mediated workflows do improve collaborative performance; however, adoption is not as pronounced as hypothesized. The research findings indicate that the lack of acceptance is due to non-technology factors, such as attitude and behavior, which play a significant role in adoption and need similar attention as technology innovation to drive true adoption and ultimately better collaborative performance. The research findings also indicate that the effectiveness of the CS-AF may have potential as a generalizable approach for evaluating technology-mediated collaborative workflow in a variety of unique domains