Personal Health Records Interoperability

Implementation of Personal Health Record interoperability requires the adoption of national standards. These standards have been driven by regulation. The Center for Information Technology Leadership (CITL) estimates PHRs could result in an annual net value of nineteen-billion dollars. This is based on cost savings to healthcare providers and payers over a ten-year implementation period with an 80% U.S. adoption rate

Secure Management of Personal Health Records by Applying Attribute-Based Encryption

The confidentiality of personal health records is a major problem when patients use commercial Web-based systems to store their health data. Traditional access control mechanisms, such as Role-Based Access Control, have several limitations with respect to enforcing access control policies and ensuring data confidentiality. In particular, the data has to be stored on a central server locked by the access control mechanism, and the data owner loses control on the data from the moment when the data is sent to the requester. Therefore, these mechanisms do not fulfil the requirements of data outsourcing scenarios where the third party storing the data should not have access to the plain data, and it is not trusted to enforce access control policies. In this paper, we describe a new approach which enables secure storage and controlled sharing of patient’s health records in the aforementioned scenarios. A new variant of a ciphertext-policy attribute-based encryption scheme is proposed to enforce patient/organizational access control policies such that everyone can download the encrypted data but only authorized users from the social domain (e.g. family, friends, or fellow patients) or authorized users from the professional\ud domain (e.g. doctors or nurses) are allowed to decrypt it

An overview of electronic personal health records

© 2018 Fellowship of Postgraduate Medicine Electronic Personal Health Record systems are providing health consumers with greater access and control to their health records by shifting these records from being a health provider-centred Electronic Health Record, to a patient-centred, Electronic Personal Health Record (ePHR). Based on the delivery system, ePHR systems are classified into standalone, tethered, and integrated or unified ePHRs. While national approaches of implementing integrated ePHR vary, the middle out method has been recognised as the ideal approach. It is worth considering the adoption of ePHRs has been slow due to several factors, including technical, individual, environmental, social, and legal factors. This paper provides a representative overview of an ePHR system, outlining its definition, types, architectures, and nationwide approaches of its implementation. Additionally, the drivers and hindrances to health consumer adoption are discussed

MyPHRMachines: Lifelong Personal Health Records in the Cloud

Personal Health Records (PHRs) should remain the lifelong property of patients and should be showable conveniently and securely to selected caregivers. Regarding interoperability, current solutions for PHRs focus on standard data exchange formats and transformations to move data across health information systems. In this paper we propose MyPHRMachines, a patient-centric system that takes a radically new architectural solution to health record interoperability. We propose to deploy besides the medical data also the related software to the PHR system. After uploading their medical data to MyPHRMachines, patients can access them again from remote virtual machines that contain the right software to visualize and analyze them without any conversion. Patients can share their remote virtual machine session with a selected health provider, who will need only a Web browser to access the pre-loaded fragments of the lifelong PHR. We illustrate how our prototype already supports the use case of a real-world patient and discuss the research agenda required to translate this prototype into a viable solution for the international healthcare industry

PHR - Personal Health Records

Nesta dissertação, pretende apresentar-seumaproposta baseadanumasoluçãoPHR (PHR-Personal Health Records) para resolver os problemas inerentes à crescente quantidade de informação de saúde que é gerada pelas instituições de saúde relativamente a cada indivíduo de forma independente e dispersa gerando "ilhas de informação" e "fragmentos de dados" [1]. O conceito PHR existe e tem potencial mas, as soluções desenvolvidas não seguem directrizes comuns, não existindo consenso entre os desenvolvedores destas soluções. Assim, é também objectivo deste trabalho apresentar uma lista de directrizes a seguir pelas aplicações PHR. Estas directrizes abrangem essêncialmente aspectos como o tipo de informações a ser contemplada, a segurança e confidencialidade dos registos e operações sobre eles efectuadas, gestão de acessos, serviços a disponibilizar e formas de acesso. É pretendida também, a elaboração de uma proposta de implementação de PHR global onde cada utente de um sistema de saúde, como o Sistema Nacional de Saúde, tenha à disposição uma conta PHR num contexto regional ou nacional à qual as instituições e profissionais de saúde tenham acesso. Como complemento prático da dissertação, foi também desenvolvido um protótipo daquilo que poderá ser o sistema pretendido e descrito no trabalho ou, pelo menos, umaprimeira abordagem. A elaboração desta dissertação, iniciou-se com a investigação dos conceitos em redor do tema e das soluções já desenvolvidas para o mercado, sendo que, estas aplicações irão servir de base para a concretização dos objectivos descritos. Este trabalho resume os desenvolvimentos já efectuados nesta área de investigação, descrevendo os problemas inerentes e os aspectos descurados.In this dissertation, it is intended the presentation of a proposal solution based on PHR (PHR - Personal Healt Records) to solve the problems inherent in growing amount of health information that is generated by health agencies for each individual on an independent and dispersed way which generates "information islands" and "data fragments" [1]. The PHR concept exists and has potential, but the proposed solutions do not follow common guidelines, there is no consensus between the developers of these solutions. Thus, another objective of this work to prepare and submit a list of guidelines / standards that must be followed by applications PHR. These guidelines mainly cover aspects such as the type of information that must be met, the security and confidentiality of records and operations performed on them, access management, services and ways to provide access. It is also intended to prepare a proposal to implement a comprehensive PHR that each user of a health system, such as the National Health System will have at its disposal a PHR account a context that may be regional or national to which the institutions and health professionals may have access. To complement the practical work, we will also develop a prototype of what may be the intended system described in the work or, at least, a first approach. The preparation of this work, began with the research of the concepts around the subject and the solutions already developed for the market, being that these applications will provide the basis for achieving the above objectives. This paper summarizes the developments already made in this area of investigation, when describing the problems and issues neglected

Personal Health Records: Is Rapid Adpoption Hindering Interoperability?

The establishment of Meaningful Use criteria has created a critical need for robust interoperability. A universal definition for a Personal Health Records (PHRs) has not been agreed upon. Standardized code sets have been built for specific entities but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The methodology for this study was conducted following the basic principles of a systematic review, with 61 articles used for this research study. Lagging interoperability has been stemmed from slow adoption by patients, creation of disparate systems due to rapid development for Meaningful Use stages, and rapid early development of PHRs prior to the mandate for integration among multiple systems. Findings of this study suggest that deadlines for implementation to capture Meaningful Use incentive payments are supporting the creation of PHR data silos; thereby, hindering the goal of high-level interoperability