论文标题

电子健康记录的次要使用:机会和挑战

Secondary Use of Electronic Health Record: Opportunities and Challenges

论文作者

Shah, Shahid Munir, Khan, Rizwan Ahmed

论文摘要

在目前的技术时代,医疗保健提供者每天都会产生大量的临床数据。生成的临床数据以电子健康记录(EHR)的形式以数字形式存储,作为医院的中央数据存储库。 EHR中包含的数据不仅用于患者的初级保健,还用于各种次要目的,例如临床研究,自动疾病监测和临床审核以提高质量。在未经同意的情况下或在某些情况下,将EHR数据用于次要目的,即使同意也会为个人造成隐私问题。其次,通过有线或无线网络,包括不同地理位置的不同政府机构,包括不同的政府机构,包括不同的政府机构,还可以访问EHR数据。跨多个机构共享EHR使其容易受到网络攻击的攻击,并且很难实施严格的隐私法律,因为在某些情况下,数据与受特定区域法律管辖的组织共享。当一个人在EHR中包含的敏感私人信息被泄露或暴露于公众时,可能会严重影响其隐私。数据泄漏会导致财务损失,或者如果个人的医疗状况暴露在公共场合,则可能会遭受社交抵制。为了保护患者个人数据免受此类威胁的影响,存在不同的隐私法规,例如GDPR,HIPAA和MHR。但是,在机器学习,数据分析和黑客攻击中不断发展的最新技术使完全保护个人 /患者的隐私变得更加困难。在本文中,我们系统地检查了EHR的各种次要用途,目的是突出这些二次使用如何影响患者的隐私。其次,考虑到技术的使用和EHR的不同次要用途,我们对GDPR进行了严格的分析,并强调了可能的改进领域。

In present technological era, healthcare providers generate huge amount of clinical data on daily basis. Generated clinical data is stored digitally in the form of Electronic Health Records (EHR) as a central data repository of hospitals. Data contained in EHR is not only used for the patients' primary care but also for various secondary purposes such as clinical research, automated disease surveillance and clinical audits for quality enhancement. Using EHR data for secondary purposes without consent or in some cases even with consent creates privacy issues for individuals. Secondly, EHR data is also made accessible to various stake holders including different government agencies at various geographical sites through wired or wireless networks. Sharing of EHR across multiples agencies makes it vulnerable to cyber attacks and also makes it difficult to implement strict privacy laws as in some cases data is shared with organization that is governed by specific regional law. Privacy of an individual could be severely affected when their sensitive private information contained in EHR is leaked or exposed to public. Data leak can cause financial losses or an individuals may encounter social boycott if their medical condition is exposed in public. To protect patients personal data from such threats, there exists different privacy regulations such as GDPR, HIPAA and MHR. However, continually evolving state-of-the-art techniques in machine learning, data analytics and hacking are making it even more difficult to completely protect individual's / patient's privacy. In this article, we have systematically examined various secondary uses of EHR with the aim to highlight how these secondary uses effect patients' privacy. Secondly, we have critically analyzed GDPR and highlighted possible areas of improvement, considering escalating use of technology and different secondary uses of EHR.

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