Security and privacy of electronic health records: Concerns and challenges

Keshta, Ismail; Odeh, Ammar

doi:10.1016/j.eij.2020.07.003

Cited by 238 publications

(123 citation statements)

References 45 publications

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“…Also, in accordance with our findings, Fernández-Alemán et al raised a concern regarding the confidentiality and security of EMR's in their study [36]. Additionally, some authors reported the accidental loss of sensitive information from electronic records and even security breaches in healthcare data from both insider and external threats [37,38]. Contrary to this, in a study carried out in Taif, Saudi Arabia, the majority of physicians showed their trust in the confidentiality and security of EMR's [20].…”

Section: Discussionsupporting

confidence: 90%

Performance, Barriers, and Satisfaction of Healthcare Workers Toward Electronic Medical Records in Saudi Arabia: A National Multicenter Study

Otaybi¹,

Al‐Raddadi²,

Bakhamees³

2022

Cureus

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BackgroundElectronic medical record (EMR) systems are nowadays available internationally, including in Saudi Arabia. Nevertheless, there are still many obstacles to overcome before their effective implementation. This crossnational study aimed to investigate the perceptions and practices of healthcare workers toward implemented EMR systems. MethodsA cross-sectional study was conducted across selected hospitals in the four cities of Al-Ahsa, Dammam, Medina, and Riyadh in Saudi Arabia. Healthcare workers of all specialties were invited to participate in the study during the six-month study period from August 2019 to February 2020. The questionnaire was submitted online through institutional e-mails. ResultsThe study included a total of 2684 healthcare providers. Almost half of the respondents (47.1%) were aged between 35 and 50 years. High experience with computer use was observed among 38.3% of them, while 54.3% attended EMR training activities. The performance scores of EMR's compared to previous routines had a median of 24 (interquartile range {IQR} = 0-38). The satisfaction scores with EMR's ranged between 16 and 80 with a median of 53 (IQR = 48-61). Older participants (>50 years), non-Saudis, and those who attended EMR training had statistically significant higher scores of both EMR performance and EMR satisfaction, (p<0.001). Those working in other medical specialties (not major) had statistically significant higher scores of EMR performance alone (p<0.001), while general practitioners (p<0.001) and females (p = 0.001) had statistically significant higher scores of EMR satisfaction alone. EMR systems' positive impact on quality of care was the highest agreed-upon benefit reported, while the temporary loss of access to patient records if computers crashed or power failed was the highest agreed-upon barrier. ConclusionsThe attitude and satisfaction of healthcare workers in Saudi Arabia towards EMR systems are acceptable particularly among those who are older, non-Saudi, and have attended EMR training. Improved quality of care was the main noted benefit of EMR's, followed by improved productivity. The temporary loss of access to patient records if computers crashed or power failed, followed by privacy and security concerns, was the major EMR barrier mentioned.

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Section: Discussionsupporting

confidence: 90%

Performance, Barriers, and Satisfaction of Healthcare Workers Toward Electronic Medical Records in Saudi Arabia: A National Multicenter Study

Otaybi¹,

Al‐Raddadi²,

Bakhamees³

2022

Cureus

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“…The properties are discussed below: Privacy: Privacy refers to the right that someone can decide when, how and at which levels accessing the personal EHRs, transforming them and sharing them with others are given. [38]. Privacy can be breached in various situations, for example, a healthcare provider may either intentionally or by misktake abuse EHRs [39].…”

Section: Screening the Articlesmentioning

confidence: 99%

Blockchain-Based Electronic Health Records Management: A Comprehensive Review and Future Research Direction

2022

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Blockchain is the revolutionary invention of the twentieth century that offers a distributed and decentralized setting to communicate among nodes in a list of networks without a central authority. On the other hand, an electronic health records (EHRs) is the electronically stored health information in a digital format.EHRs are normally shared among healthcare stakeholders and facing power failure, data misuse, lack of privacy and security, and audit trail. Blockchain is a leading technology among others to address the limitations related to EHRs. It can provide a safer and secured decentralized environment for exchanging EHRs data. There are three categories of blockchain-based potential solutions have been proposed to handle EHRs: conceptual, prototype, and implemented. This study focused on a Systematic Literature Review (SLR) to find and analyze articles proposed either conceptual or implemented to manage EHRs using blockchain. The study analyzed 99 papers that were described from various publication categories. The deep technical analysis focused on evaluating articles based on privacy, security, scalability, accessibility, cost, consensus algorithms, and type of blockchain used. The SLR found that the blockchain technology is promising to provide decentralization, security, and privacy that traditional EHRs often lack. Moreover, results obtained from the detailed studies would provide potential researchers with a reference as to which type of blockchain to choose for future development. Finally, future research directions, in the end, would direct enthusiasm to combine new blockchain-based systems to properly manage EHRs.

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“…Various threats in the level of collecting data (Habib, Torjusen & Leister, 2015;Saleem, Ullah & Kwak, 2011;Chelli, 2015;Kumar & Lee, 2011;Saleem, Ullah & Yoo, 2009;Om & Talib, 2011), transmission (Ismail & Ammar, 2020;Partala et al, 2013;Niksaz, 2015;Bonab & Masdari, 2015), and storage (Santos-Pereira et al, 2013;Zhang & Liu, 2010;Drosatos et al, 2016;Fatema & Brad, 2014;Wellington, 2013) were present in this EHR's. Due to these threats, some of the users are concerned to employ this EHR to save and transmit their health data (Ismail & Ammar, 2020). Hence, a novel methodology for providing privacy and security combining the AI-based intelligent agents and blockchain is proposed in this article.…”

Section: Introductionmentioning

confidence: 97%

Artificial intelligence and multi agent based distributed ledger system for better privacy and security of electronic healthcare records

Alruwaili

2020

PeerJ Computer Science

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Background Application of Artificial Intelligence (AI) and the use of agent-based systems in the healthcare system have attracted various researchers to improve the efficiency and utility in the Electronic Health Records (EHR). Nowadays, one of the most important and creative developments is the integration of AI and Blockchain that is, Distributed Ledger Technology (DLT) to enable better and decentralized governance. Privacy and security is a critical piece in EHR implementation and/or adoption. Health records are updated every time a patient visits a doctor as they contain important information about the health and wellbeing of the patient and describes the history of care received during the past and to date. Therefore, such records are critical to research, hospitals, emergency rooms, healthcare laboratories, and even health insurance providers. Methods In this article, a platform employing the AI and the use of multi-agent based systems along with the DLT technology for privacy preservation is proposed. The emphasis of security and privacy is highlighted during the process of collecting, managing and distributing EHR data. Results This article aims to ensure privacy, integrity and security metrics of the electronic health records are met when such copies are not only immutable but also distributed. The findings of this work will help guide the development of further techniques using the combination of AI and multi-agent based systems backed by DLT technology for secure and effective handling EHR data. This proposed architecture uses various AI-based intelligent based agents and blockchain for providing privacy and security in EHR. Future enhancement in this work can be the addition of the biometric based systems for improved security.

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Security and privacy of electronic health records: Concerns and challenges

Cited by 238 publications

References 45 publications

Performance, Barriers, and Satisfaction of Healthcare Workers Toward Electronic Medical Records in Saudi Arabia: A National Multicenter Study

Performance, Barriers, and Satisfaction of Healthcare Workers Toward Electronic Medical Records in Saudi Arabia: A National Multicenter Study

Blockchain-Based Electronic Health Records Management: A Comprehensive Review and Future Research Direction

Artificial intelligence and multi agent based distributed ledger system for better privacy and security of electronic healthcare records

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