“…[14][15][16] In addition, numerous technical approaches have been developed to enhance privacy and security across medical records; examples include integrating disparate approaches to privacy, improving access audits, performing in-depth analyses of privacy breaches, and improving models for access controls. [17][18][19][20][21][22][23] At Vanderbilt Medical Center (VMC), an EHR system was developed for outpatient psychiatric records and deployed in 2003. Reasons given for the switch from paper charts included patient safety, with improved access to records in emergencies, lower costs of maintaining records, improved legibility and general convenience, and lower costs of providing responses to increasingly frequent and detailed requirements for copies of records for third-party payers.…”
In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems.
“…[14][15][16] In addition, numerous technical approaches have been developed to enhance privacy and security across medical records; examples include integrating disparate approaches to privacy, improving access audits, performing in-depth analyses of privacy breaches, and improving models for access controls. [17][18][19][20][21][22][23] At Vanderbilt Medical Center (VMC), an EHR system was developed for outpatient psychiatric records and deployed in 2003. Reasons given for the switch from paper charts included patient safety, with improved access to records in emergencies, lower costs of maintaining records, improved legibility and general convenience, and lower costs of providing responses to increasingly frequent and detailed requirements for copies of records for third-party payers.…”
In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems.
“…There is an assurance of openness and portability through standards, flexibility and scalability, semantic interoperability and acceptance from the domain experts. In Blobel et al, the authors discuss the fundamentals of future-proof health systems describing an “atomic component” [44]. We apply this notion by creating an “atomic component” that must be guaranteed utilizing the eHB to associate the subject on the study (as the atomic component) with their biospecimens, phenotypic and genomic data.Fig.…”
BackgroundHigh throughput molecular sequencing and increased biospecimen variety have introduced significant informatics challenges for research biorepository infrastructures. We applied a modular system integration approach to develop an operational biorepository management system. This method enables aggregation of the clinical, specimen and genomic data collected for biorepository resources.MethodsWe introduce an electronic Honest Broker (eHB) and Biorepository Portal (BRP) open source project that, in tandem, allow for data integration while protecting patient privacy. This modular approach allows data and specimens to be associated with a biorepository subject at any time point asynchronously. This lowers the bar to develop new research projects based on scientific merit without institutional review for a proposal.ResultsBy facilitating the automated de-identification of specimen and associated clinical and genomic data we create a future proofed specimen set that can withstand new workflows and be connected to new associated information over time. Thus facilitating collaborative advanced genomic and tissue research.ConclusionsAs of Janurary of 2016 there are 23 unique protocols/patient cohorts being managed in the Biorepository Portal (BRP). There are over 4000 unique subject records in the electronic honest broker (eHB), over 30,000 specimens accessioned and 8 institutions participating in various biobanking activities using this tool kit. We specifically set out to build rich annotation of biospecimens with longitudinal clinical data; BRP/REDCap integration for multi-institutional repositories; EMR integration; further annotated specimens with genomic data specific to a domain; build application hooks for experiments at the specimen level integrated with analytic software; while protecting privacy per the Office of Civil Rights (OCR) and HIPAA.
“…The privilege management viewpoint is used by ISO PMAC specification and it allows the system authority to assign the privilege to individual actors or to groups of individual actors which can be a human user, a system or application etc., and playing the closed role to role viewpoint [14].…”
Section: Multiple Views On Access Controlmentioning
This paper considers the use of part four of the EHRcom standard in the context of the availability (or lack thereof) of national identification systems for patients and for users of an integrated care EHR-S. This work begins with a brief summary of the state-of-the-art in identity management and access control in the health domain and a description of approaches that could lead to a secure and interoperable identification mechanism. To address the identification problem, the authors describe well known EHR access control viewpoints that are compatible with the CEN standard for EHR communication, EN13606 and describe how an identification service can support this functionality.
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