Healthc Inform Res.  2019 Apr;25(2):106-114. 10.4258/hir.2019.25.2.106.

Privacy Enhanced Healthcare Information Sharing System for Home-Based Care Environments

• Dzissah DA
• Lee JS
• Suzuki H
• Nakamura M
• Obi T

• KMID: 2445007
• DOI: http://doi.org/10.4258/hir.2019.25.2.106

Abstract

OBJECTIVES
Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems.
METHODS
We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government.
RESULTS
Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions.
CONCLUSIONS
The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.

Keyword

Home Health Nursing; Medical Information Exchange; Electronic Health Records; Privacy; Computer Security

MeSH Terms

Asian Continental Ancestry Group
Certification
Computer Security
Delivery of Health Care*
Electronic Health Records
Health Information Exchange
Health Personnel
Health Smart Cards
Home Care Services
Home Health Nursing
Humans
Information Dissemination*
Insurance
Insurance, Health
Methods
Nursing
Nursing Care
Privacy*
Social Responsibility

Figure

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  Figure 1 Overview of a distributed home-based healthcare environment.

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  Figure 2 Proposed home-based information-sharing architecture.

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  Figure 3 Context-aware authentication trust levels.

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  Figure 4 Overview of the context-aware modules.

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  Figure 5 Context-aware policy management algorithm.

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  Figure 6 Overall authentication and authorization flow.

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  Figure 7 Request for action notification.

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