QR code based patient data protection in ECG steganography

Optimization based ECG watermarking in RDWT-SVD domain

With the increase in point of care services, communication of digital patient records through open network has multi-folded. This digital data is used to obtain the remote medical assistance from the smart healthcare centres. Protecting this data during transmission is a very big challenge. One of the most important medical data is electrocardiogram (ECG) signal which detects the cardiovascular diseases and any alteration in the signal may affect the diagnosis. In this work, an ECG watermarking based on redundant discrete wavelet transform (RDWT) and singular value decomposition (SVD) is developed. First, the ECG signal is converted into 2-D matrix using pan-tompkins algorithm. Then, we use the hybrid of RDWT and SVD to conceal the patient data and logo image into the 2-D ECG image. We also use hybrid of optimization scheme to improve the robustness of the watermark. Preliminary experimental results indicate the optimal invisibility and robustness result is more effective up to 97.89% than the traditional schemes respectively, which makes it suitable for ownership authentication of ECG signal.

Bio-signal data sharing security through watermarking: a technical survey

Due to smart healthcare systems highly connected information and communications technologies, sensitive medical information and records are easily transmitted over the networks. However, stealing of healthcare data is increasing crime every day to greatly impact on financial loss. In order to this, researchers are developing various cost-effective bio-signal based data hiding techniques for smart healthcare applications. In this paper, we first introduce various aspects of data hiding along with major properties, generic embedding and extraction process, and recent applications. This survey provides a comprehensive survey on data hiding techniques, and their new trends for solving new challenges in real-world applications. Then, we survey the various notable bio-signal based data hiding techniques. The summary of some notable techniques in terms of their objective, type of data hiding, methodology and database used, performance metrics, important features, and limitations are also presented in tabular form. At the end, we discuss the major issues and research directions to explore the promising areas for future research.

Effective Use of Mobile Electronic Medical Records by Medical Interns in Real Clinical Settings: Mixed Methods Study

Background

In South Korea, most graduated medical students undertake a 1-year internship before beginning residency and specialization. Interns usually work in a tertiary hospital and rotate between different, randomly assigned departments to be exposed to different medical specialties. Their jobs are mostly simple and repetitive but are still essential for the patient care process. However, owing to the lack of experience and overwhelming workload, interns at tertiary hospitals in South Korea are usually inefficient, often delaying the entire clinical process. Health care providers have widely adopted mobile electronic medical records (mEMRs) as they have been shown to improve workflow efficiency.

Objective

This study investigates the association between the frequency of mEMR usage and the clinical task completion interval time among interns in a tertiary hospital.

Methods

This mixed methods study was conducted at the Samsung Medical Center, Seoul, South Korea. Interns who worked at the Samsung Medical Center from March 2018 to February 2019 were included. The hospital electronic medical record (EMR) system known as DARWIN (Data Analysis and Research Window for Integrated kNowledge) was launched with PC and mobile. Both versions are actively used in hospitals by personnel in various positions. We collected the log data from the mEMR server and the intern clinical task time-series data from the EMR server. Interns can manage the process of identifying patients, assigning the clinical task, finishing the requested clinical intern tasks, etc, through the use of the mEMR system. We compared the clinical task completion interval among 4 groups of interns divided by the mEMR frequency quantile. Then, System Usability Score (SUS) questionnaires and semistructured interviews were conducted.

Results

The regular mEMR users were defined as those who logged in more than once a day on average and used the mEMR until the level after login. Among a total of 87 interns, 84 used the mEMR to verify the requested clinical tasks. The most frequently used item was “Intern task list.” Analysis of the 4 intern groups revealed an inverse relationship between the median time of the task completion interval and the frequency of mEMR use. Correlation analysis showed that the intern task completion time interval had a significant inverse relationship with the individual frequency of mEMR usage (coefficient=-0.27; 95% CI -0.46 to -0.04; P=.02). In the additional survey, the mean SUS value was 81.67, which supported the results of the data analysis.

Conclusions

Our findings suggest that frequent mEMR use is associated with improved work efficiency in hospital interns with good usability of the mEMR. Such finding supports the idea that the use of mEMR improves the effectiveness and workflow efficiency of interns working in hospitals and, more generally, in the context of health care.