Security Challenges and Success Factors of Electronic Healthcare System

Iraqi Population Trusts in Electronic Healthcare Records: A Cross-sectional Study

This study investigated the perceptions of Iraqi patients regarding Electronic Healthcare Records (EHRs) in terms of trust and propensity to share and exchange medical and personal information and data within the healthcare ecosystem. During the period of April to June 2022, a researcher-assisted questionnaire was disseminated to adult Iraqi patients attending public or private healthcare facilities in a subset of Iraqi governorates. Data collection was followed by descriptive and inferential analyses. In total, 552 respondents filled out the questionnaire. The findings revealed that 71.6% of respondents were conversant with EHRs and trusted them as data collection and storage systems. In addition, 10% of respondents did not want their EHRs to be shared between healthcare professionals and institutions. However, only 3.6% of participants were willing to share all of their personal information with healthcare professionals. Female respondents were considerably more willing to share their full names with healthcare professionals than male respondents, despite the society's reputation for conservatism. The findings of this study highlighted the necessity of tailoring initiatives to enhance patients' trust in EHRs and their interactions with healthcare professionals other than medical physicians.

Privacy in electronic health records: a systematic mapping study

Main

Electronic health record (EHR) applications are digital versions of paper-based patient health information. Traditionally, medical records are made on paper. However, nowadays, advances in information and communication technology have made it possible to change medical records from paper to EHR. Therefore, preserving user data privacy is extremely important in healthcare environments. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy and at the same time not compromising the performance and interoperability of these systems.

Subject and methods

This systematic mapping study intends to investigate the current research on security and privacy requirements in EHR systems and identify potential research gaps in the literature. The main challenges are providing ways to make EHR systems increasingly capable of ensuring data privacy, and at the same time, not compromising the performance and interoperability of these systems. Our research was carried out in the Scopus database, the largest database of abstracts and citations in the literature with peer review.

Results

We have collected 848 articles related to the area. After disambiguation and filtering, we selected 30 articles for analysis. The result of such an analysis provides a comprehensive view of current research.

Conclusions

We can highlight some relevant research possibilities. First, we noticed a growing interest in privacy in EHR research in the last 6 years. Second, blockchain has been used in many EHR systems as a solution to achieve data privacy. However, it is a challenge to maintain traceability by recording metadata that can be mapped to private data of the users applying a particular mapping function that can be hosted outside the blockchain. Finally, the lack of a systematic approach between EHR solutions and existing laws or policies leads to better strategies for developing a certification process for EHR systems.

Patient Expectations: Searching Websites on How to Apply to Access Medical Records

Patients who want to know how to access their medical records from a health organization’s website have certain expectations about what must be included to assist in this process. The purpose of this article is to detail patient expectations of a health care organization website when searching for information on how to apply for access to their medical records. Using expectation confirmation theory, a survey was developed to ask patients, as consumers of health care, about their expectations when accessing websites. The results revealed that patients want websites to be safe and secure and have help available if there are questions about the website or search functionality. In order to improve the patient experience, health care providers need to understand these expectations from the patient perspective about this information-seeking exercise.

PRISED tangle: a privacy-aware framework for smart healthcare data sharing using IOTA tangle

Healthcare has evolved significantly in recent years primarily due to the advancements in and increasing adoption of technology in healthcare processes such as data collection, storage, diagnostics, and treatment. The emergence of the industrial internet of things (IIoT) has further evolved e-Health by facilitating the development of connected healthcare systems which can significantly improve data connectivity, visibility, and interoperability leading to improved quality of service delivered to patients. However, such technological advancements come with their perils—there are growing concerns with regards to the security and privacy of healthcare data especially when collected, shared, and processed using cutting-edge connected sensor devices affecting the adoption of next-generation e-healthcare systems. In particular, during the front-end and back-end data transfer in health information exchange (HIE) there exist a security risk in term of confidentiality, integrity, authentication and access control of the data due to the limited capabilities of IoT devices involved. In this paper, we investigate the use of distributed ledger technologies (DLT) to address such security concerns for emerging healthcare systems. In particular, we use masked authenticated messaging (MAM) over the Tangle to achieve secure data sharing within a healthcare system and provide a proof-of-concept of applying the proposed approach for securing healthcare data in a connected IIoT environment. Further, we have performed the evaluation and analysis of data communication against the metrics of encryption and efficiency in transaction time.

A Model for Examining Challenges and Opportunities in Use of Cloud Computing for Health Information Systems

Health Information Systems (HIS) are becoming crucial for health providers, not only for keeping Electronic Health Records (EHR) but also because of the features they provide that can be lifesaving, thanks to the advances in Information Technology (IT). These advancements have led to increasing demands for additional features to these systems to improve their intelligence, reliability, and availability. All these features may be provisioned through the use of cloud computing in HIS. This study arrives at three dimensions pertinent to adoption of cloud computing in HIS through extensive interviews with experts, professional expertise and knowledge of one of the authors working in this area, and review of academic and practitioner literature. These dimensions are financial performance and cost; IT operational excellence and DevOps; and security, governance, and compliance. Challenges and drivers in each of these dimensions are detailed and operationalized to arrive at a model for HIS adoption. This proposed model detailed in this study can be employed by executive management of health organizations, especially senior clinical management positions like Chief Technology Officers (CTOs), Chief Information Officers (CIOs), and IT managers to make an informed decision on adoption of cloud computing for HIS. Use of cloud computing to support operational and financial excellence of healthcare organizations has already made some headway in the industry, and its use in HIS would be a natural next step. However, due to the mission′s critical nature and sensitivity of information stored in HIS, the move may need to be evaluated in a holistic fashion that can be aided by the proposed dimensions and the model. The study also identifies some issues and directions for future research for cloud computing adoption in the context of HIS.

An efficient and secure data sharing scheme for mobile devices in cloud computing

With the development of big data and cloud computing, more and more enterprises prefer to store their data in cloud and share the data among their authorized employees efficiently and securely. So far, many different data sharing schemes in different fields have been proposed. However, sharing sensitive data in cloud still faces some challenges such as achieving data privacy and lightweight operations at resource constrained mobile terminals. Furthermore, most data sharing schemes have no integrity verification mechanism, which would result in wrong computation results for users. To solve the problems, we propose an efficient and secure data sharing scheme for mobile devices in cloud computing. Firstly, the scheme guarantees security and authorized access of shared sensitive data. Secondly, the scheme realizes efficient integrity verification before users share the data to avoid incorrect computation. Finally, the scheme achieves lightweight operations of mobile terminals on both data owner and data requester sides.

Taxonomic framework for factors influencing ERMS adoption in organisations of higher professional education

An electronic records management system (ERMS) is tightly linked with most of the daily activities of educational organisations and leads to enhance their performance and decision-making. The aim of this article is to identify the significant factors that could influence the ERMS adoption in higher professional education (HPE). The methodology of this article started with identifying the factors through theory analysis and literature and also recommended by experts. Technology–organisation–environment (TOE) theory was used for factor classification. Qualitative approach was used through the interview with experts to validate and verify the proposed framework. This article presents the results of a study which identifies the issues involved in the utilisation and adoption of ERMS. More than 100 previous works and six well-known theories were critically reviewed to identify the main factors for successful ERMS adoption in different areas with the aim of proposing a taxonomic framework that can depict and identify the main factors that have an impact on the success of ERMS adoption. The proposed framework includes 11 factors categorised into three dimensions. The framework is validated and verified by experts. The adoption factors identified here provide a sound theoretical basis for research to understand, support and facilitate the adoption of ERMS to HPE benefit. The proposed framework could help to improve educational outcomes and the successful implementation of ERMS.

The Performance of Educational Institutions Through the Electronic Records Management Systems

This article discusses the relationship between educational institutes that use ERMS and the performance of those institutions. This article uses a mixed explanatory method that incorporated quantitative and qualitative approaches. The quantitative method collected the responses from 364 participants. This was followed by a qualitative approach where experts were interviewed to verify the model. The results generated using the quantitative approach demonstrated that the quality of the system, information, and service as well as the security provided by the system had a significant positive relationship with the successful adoption of ERMS, which in turn improved performance. Moreover, the qualitative results that gathered through the experts confirmed the findings and contributed to enriching the understanding of the adoption of ERMS in educational institutions.