Privacy, Security and Ethics

From Capsil Wiki

Jump to: navigation, search

Contents

Overview

Home healthcare monitoring poses the fundamental problems of security and privacy balanced with safe and effective healthcare. In reality these can be two opposing ideas as the more effective the home healthcare package, the more threat to privacy that exists. A major issue that comes up in this context is that of trust. “How do I know that others are not viewing my healthcare data without my explicit permission?” The Office for the Advancement of Telemedicine (OAT) (1), identified consumer fears such as, “the presence of outsiders or non-clinical persons in teleconsultations, such as non-clinical technicians, camera people and schedulers located on either side of a telemedicine consultation or at the site of a service provider, either physically or via the technology they support. Clinical personnel who may not be visible or observable by the patient may also be involved in a teleconsultation. Patient information routinely stored electronically and/or physically at each site may not be protected by policies or procedures as effectively as information used in on-site encounters.”

The use of the internet as a means of accessing and communicating has its problems and security is a very real concern. The Civic Research report on Home Health Care Technology states, “Currently, there are no standard protocols for protecting the security of email, telemetry, or electronic health records. Further, firewalls and encryption, while they may slow down the process, are unlikely to deter someone motivated to access personal health records. Wireless transmissions pose even greater concerns. Concerns regarding privacy, confidentiality, and security of health information have always existed; however, the ease with which, the extent to which, and the context within which they may be breached are intensified with the electronic exchange of information.” Patients must feel protected from “nightmare scenarios,” which include accidentally transmitting medical information to the wrong address or to someone masquerading (as a physician for example) and allowing hackers to break into medical information that they then broadcast over the Internet.

Privacy concerns are more accentuated in the older people group as evidenced by a 2005 Pew Internet survey (2) which shows that, “sixty-one percent of those 65 and older say they are ‘very concerned’ about businesses and people they don’t know getting personal information about them or their families, compared to forty-six percent of Americans between ages 18 and 29”.

Situation in Europe

In Europe there are a number of policies that deal with privacy and security. The particular ones relevant to telemedicine are as follows;

  • Directive 95/46/EC – “On the protection of individuals with regard to the processing of personal data and on the free movement of such data"
  • Directive 2000/31/EC (The “e-Commerce Directive”) - The e-Commerce Directive defines rules for the provision of Information Society Services both within and between member states.
  • Directive 2002/58/EC – “Concerning the processing of personal data and the protection of privacy in the electronic communications sector”.
  • Directive 2005/36/EC - Establishes the criteria for a set of regulated professions according to which qualifications obtained in one member state are recognised by another.

Situation in the USA

In the USA the applicable law regarding healthcare privacy is called The Health Insurance Portability and Accountability Act (HIPAA). The act is roughly broken in to two sections one of which protects health insurance coverage for workers and their families when they change or lose their jobs. The second, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. The Administration Simplification provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the US health care system

An extensive treatment of the issues around Privacy, Security and Ethics are given in the Privacy & Security CAPSIL.

References



Retrieved from "http://www.capsil.org/capsilwiki/index.php/Privacy,_Security_and_Ethics"
Personal tools