Privacy and Security of Personal Information in a New Health Care System

Gostin, Lawrence O.; Turek-Brezina, Joan; Powers, Madison; Kozloff, Rene; Faden, Ruth R.; Steinauer, Dennis D.

doi:10.1001/jama.1993.03510200093038

Cited by 77 publications

(14 citation statements)

References 21 publications

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“…An alternative to computing average co-ordinates for non-overlapping groups is to form moving averages from a sliding interval of fixed length or containing a fixed number of records. Microaggregation and other types of point aggregation can be represented as isomasks satisfying equation (2). For example, blurring as described in the previous paragraph is a case of equation (2) with…”

Section: Point Aggregationmentioning

confidence: 99%

Geographically masking health data to preserve confidentiality

1999

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The conventional approach to preserving the confidentiality of health records aggregates all records within a geographical area that has a population large enough to ensure prevention of disclosure. Though this approach normally protects the privacy of individuals, the use of such aggregated data limits the types of research one can conduct and makes it impossible to address many important health problems. In this paper we discuss the design and implementation of geographical masks that not only preserve the security of individual health records, but also support the investigation of questions that can be answered only with some knowledge about the location of health events. We describe several alternative methods of masking individual-level data, evaluate their performance, and discuss both the degree to which we can analyse masked data validly as well as the relative security of each approach, should anyone attempt to recover the identity of an individual from the masked data. We conclude that the geographical masks we describe, when appropriately used, protect the confidentiality of health records while permitting many important geographically-based analyses, but that further research is needed to determine how the power of tests for clustering or the strength of other associative relationships are adversely affected by the characteristics of different masks.

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Section: Point Aggregationmentioning

confidence: 99%

Geographically masking health data to preserve confidentiality

1999

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“…A less ambitious computerized database linking hospitals and the police department has been tried in New York City (James 1994). The central issue, however, is not our ability to integrate administrative databases, but the confidentiality protections that limit disclosure (Woodward 1995;Gostin et al 1996Gostin et al , 1993). An integrated law enforcement and mental health system database that is openly accessible to mental health providers and police officers raises important issues regarding the individual's right to privacy.…”

Section: Absence Of Integrated Client Databasesmentioning

confidence: 99%

“…Because no federal law protects mental health care information, each state has its own set of protections that may only pertain to physicians and hospitals (Gellman 1995;Gostin et al 1993Gostin et al , 1996. Likewise, there are no consistent protections for law enforcement information.…”

Section: Absence Of Integrated Client Databasesmentioning

confidence: 99%

Interactions between Mental Health and Law Enforcement Systems: Problems and Prospects for Cooperation

Wolff

1998

Journal of Health Politics, Policy and Law

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This article examines the challenges posed by system specialization, as illustrated by the difficulties of coordinating the roles of the mental health and law enforcement agencies working with people with severe mental illness. Dealing with the needs of clients in one system when they are most appropriately served by the other may make both law enforcement and mental health systems appear ineffective and inefficient. This could increase the incidence of disorderly or violent behavior, which forments the myth that the seriously mentally ill are inherently dangerous. Despite the evident need to manage these issues, conventional methods of coordinating services have failed. This article concludes by developing a contracting model that creates more appropriate incentives for the two systems and bridges the gap between them.

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“…Confidentiality is a form of informational privacy characteristic of certain relationships, such as the physician-patient relationship. Personal information obtained in the course of that relationship should not be revealed to others unless the patient is made aware of this intention and consents to disclosure (Gostin et al 1993). Integrity of EHRs is important, as any changes or inaccuracy in data can have an impact on the healthcare process.…”

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confidence: 99%

A Review of Security of Electronic Health Records

Win

2005

Health Information Management

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The objective of this study is to answer the research question, "Are current information security technologies adequate for electronic health records (EHRs)?" In order to achieve this, the following matters have been addressed in this article: (i) What is information security in the context of EHRs? (ii) Why is information security important for EHRs? and (iii) What are the current technologies for information security available to EHRs? It is concluded that current EHR security technologies are inadequate and urgently require improvement. Further study regarding information security of EHRs is indicated.

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Privacy and Security of Personal Information in a New Health Care System

Cited by 77 publications

References 21 publications

Geographically masking health data to preserve confidentiality

Geographically masking health data to preserve confidentiality

Interactions between Mental Health and Law Enforcement Systems: Problems and Prospects for Cooperation

A Review of Security of Electronic Health Records

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