10 research outputs found

    A method to implement fine-grained access control for personal health records through standard relational database queries

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    AbstractOnline personal health records (PHRs) enable patients to access, manage, and share certain of their own health information electronically. This capability creates the need for precise access-controls mechanisms that restrict the sharing of data to that intended by the patient. The authors describe the design and implementation of an access-control mechanism for PHR repositories that is modeled on the eXtensible Access Control Markup Language (XACML) standard, but intended to reduce the cognitive and computational complexity of XACML. The authors implemented the mechanism entirely in a relational database system using ANSI-standard SQL statements. Based on a set of access-control rules encoded as relational table rows, the mechanism determines via a single SQL query whether a user who accesses patient data from a specific application is authorized to perform a requested operation on a specified data object. Testing of this query on a moderately large database has demonstrated execution times consistently below 100ms. The authors include the details of the implementation, including algorithms, examples, and a test database as Supplementary materials

    Bilateral diffuse choroidal hemangioma in Sturge Weber syndrome: a case report highlighting the role of multimodal imaging and a brief review of the literature

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    Purpose: The purpose of this paper is to present a patient with bilateral choroidal hemangioma in Sturge-Weber syndrome (SWS) and highlight multimodal imaging techniques for early detection and management of ocular alterations. Methods: A 37-year-old woman with diagnosis of SWS presented to our unit. The patient had been treated with pulsed dye laser for bilateral nevus flammeus and had right leptomeningeal angiomatosis. She had glaucoma, but ultrasound biomicroscopy did not show anterior chamber or ciliary body alterations. Results: Enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) showed bilateral diffuse choroidal hemangiomas in both eyes with choroidal thickness above 1000 μm. B-scan ultrasound examination showed diffuse choroidal hemangioma in both eyes, with a choroidal thickness of 1.53 mm and 1.94 mm in the right and left eye (RE, LE), respectively. Peripapillary retinal nerve fiber evaluation showed thinning of the retinal nerve fiber layer in both eyes. Conclusions: This report highlights multimodal imaging techniques for the critical assessment of patients with SWS, especially in rare cases with bilateral choroidal hemangioma of the choroid. Novel imaging modalities enable optimal management and follow-up of rare conditions, and our case adds further evidence to the existing literature

    Practice Management Systems for Safety-Net Clinics and Small Group Offices: A Primer

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    Provides an overview of the practice management systems market and the needs, constraints, and key considerations for clinics and small offices choosing a program to integrate standards and electronic health records or to outsource administrative tasks

    Use of Relational Storage and a Semantic Model to Generate Objects: The PENGUIN Project

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    Introduction Relational technology provides a basis for reliable sharing of large bodies of information. Object approaches provide conceptual locality of information to focus users attention. Application systems, similarily, tend to be effective if the data space is well focused and constrained. Future decision-support systems will require the combined use of database and intelligent applications. 2. The PENGUIN project In the penguin project, we demonstrate the hypothesis that relational storage, used to support an object-oriented approach can serve as a unifying framework for developing systems which share information [Wied:86]. Objects offer a consistent framework for users and their applications. Permanently storing information in the form of complex objects, however, can seriously inhibit sharing and flexibility, since an object presents one particular view of the world. A desirable compromise is to exploit existing database technology by d

    Genetic Counseling: Preconception, Prenatal and Perinatal

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