Privacy - Preserving Data Exchange and Aggregation in Healthcare

Medical data are often scattered among multiple clinics, hospitals, insurance companies, pharmacies, and research institutions that store and process personal healthcare information. The use of information and communication technologies for health (eHealth) provides us with the means to share healthcare data between authorized parties in an efficient manner. In this thesis, we address some of the challenges of implementing eHealth in practice: to achieve interoperability between data sources, and to ensure privacy for patients. Achieving both of these guarantees is our goal but they seem conflictual, hence the challenge. Once interoperability is achieved and a patientâs data are shared, it becomes evenmore difficult to ensure the patientâs privacy i.e., to provide to a patient control over his data and to guarantee the data anonymity in medical research. We address the aforementioned challenges by studying requirements from medical and legal perspectives, and by developing algorithms and frameworks to support privacy-preserving dynamic data-sharing, exchange, and aggregation from multiple data sources. In the first part of the thesis, we address certain privacy challenges. We present a framework based on the blockchain technology for ensuring traceability and accountability when sharing, exchanging, and aggregating medical data. Our framework ensures privacy, security, availability, and fine-grained access control over highly sensitive patient-data. We also analyze the potential of applying blockchain technology in different eHealth settings: primary care, medical-data research, and connected health. Our second contribution is a framework for privacy-preserving data aggregation: an algorithm for constructing the anonymized database and a protocol that improves the utility of the anonymized database as the database grows. In the second part of the thesis, we focus on achieving interoperability. We design an interface specification that defines communication protocols andmessages supporting integration of a new software tool in clinical practice. Then, we develop a multi-agent system (MAS) for the dynamic aggregation of the data collected and generated by this software tool for the purpose of clinical research. This MAS takes into account the objectives of the research study, the availability of data, and could employ our proposed algorithm for privacy-preserving data aggregation. The negotiation protocol in the framework of theMAS achieves a precise definition of database characteristics, such as schema, content, and privacy parameters, therefore increasing the efficiency of data collection for medical research and ensuring the privacy of patients

Secure and Trustable Electronic Medical Records Sharing using Blockchain

Electronic medical records (EMRs) are critical, highly sensitive private information in healthcare, and need to be frequently shared among peers. Blockchain provides a shared, immutable and transparent history of all the transactions to build applications with trust, accountability and transparency. This provides a unique opportunity to develop a secure and trustable EMR data management and sharing system using blockchain. In this paper, we present our perspectives on blockchain based healthcare data management, in particular, for EMR data sharing between healthcare providers and for research studies. We propose a framework on managing and sharing EMR data for cancer patient care. In collaboration with Stony Brook University Hospital, we implemented our framework in a prototype that ensures privacy, security, availability, and fine-grained access control over EMR data. The proposed work can significantly reduce the turnaround time for EMR sharing, improve decision making for medical care, and reduce the overall costComment: AMIA 2017 Annual Symposium Proceeding

An Agent Framework for Dynamic Health Data Aggregation for Research Purposes

This paper presents a model of a MAS framework for dynamic aggregation of population health data for research purposes. The contribution of the paper is twofold: First, it describes a MAS architecture that allows one to built on the fly anonymized databases from the distributed sources of data. Second, it shows how to improve the utility of the data with the growth of the database

TUCUXI: TUCUXI: An Intelligent System for Personalized Medicine from Individualization of Treatments to Research Databases and Back

Therapeutic Drug Monitoring (TDM) is a key concept in precision medicine. The goal of TDM is to avoid therapeutic failure or toxic effects of a drug due to insufficient or excessive circulating concentration exposure related to between-patient variability in the drug's disposition. We present TUCUXI - an intelligent system for TDM. By making use of embedded mathematical models, the software allows to compute maximum likelihood individual predictions of drug concentrations from population pharmacokinetic data, based on patient's parameters and previously observed concentrations. TUCUXI was developed to be used in medical practice, to assist clinicians in taking dosage adjustment decisions for optimizing drug concentration levels. This software is currently being tested in a University Hospital. In this paper we focus on the process of software integration in clinical workflow. The modular architecture of the software allows us to plug in a module enabling data aggregation for research purposes. This is an important feature in order to develop new mathematical models for drugs, and thus to improve TDM. Finally we discuss ethical issues related to the use of an automated decision support system in clinical practice, in particular if it allows data aggregation for research purposes

A Multiagent System for Dynamic Data Aggregation in Medical Research

The collection of medical data for research purposes is a challenging and long-lasting process. In an effort to accelerate and facilitate this process we propose a new framework for dynamic aggregation of medical data from distributed sources. We use agent-based coordination between medical and research institutions. Our system employs principles of peer-to-peer network organization and coordination models to search over already constructed distributed databases and to identify the potential contributors when a new database has to be built. Our framework takes into account both the requirements of a research study and current data availability. This leads to better definition of database characteristics such as schema, content, and privacy parameters. We show that this approach enables a more efficient way to collect data for medical research

Twenty years of coordination technologies: State-of-the-art and perspectives

Since complexity of inter- and intra-systems interactions is steadily increasing in modern application scenarios (e.g., the IoT), coordination technologies are required to take a crucial step towards maturity. In this paper we look back at the history of the COORDINATION conference in order to shed light on the current status of the coordination technologies there proposed throughout the years, in an attempt to understand success stories, limitations, and possibly reveal the gap between actual technologies, theoretical models, and novel application needs

A Cloud-Based eHealth Architecture for Privacy Preserving Data Integration

Part 8: Mobile and Cloud Services SecurityInternational audienceIn this paper, we address the problem of building an anonymized medical database from multiple sources. Our proposed solution defines how to achieve data integration in a heterogeneous network of many clinical institutions, while preserving data utility and patients’ privacy. The contribution of the paper is twofold: Firstly, we propose a secure and scalable cloud eHealth architecture to store and exchange patients’ data for the treatment. Secondly, we present an algorithm for efficient aggregation of the health data for the research purposes from multiple sources independently