Biomedical Engineering Reference
In-Depth Information
mechanisms for message priorities and message expiration. The sender should
be able to mark the message urgent or high priority not only for a prompt
attention from the recipient but also to expedite delivery of a message by the
network transport and routing protocols. On the fl ip side, undelivered mes-
sages must expire and need to be discarded after a certain period. We do not
want a diagnostic report for a person to be queued in a mail server in the
network for several years and then delivered to their children. E-mail mes-
sages cannot be stuck for several years in a mail server but could be queued
for delivery when there is a message routing error, as in the case of the domain
server omega.univ.edu, which was briefl y described by Greenberg et al. [7].
According to the story, a computer assigned to the domain name omega.univ.
edu was decommissioned and was turned off. After a few years, upon purchase
of a new computer, the network domain name was reassigned to the new
computer and activated to receive the e-mails, many of which were over three
years old. The e-mail messages had been stored “pending delivery” in mail
relays on the Internet.
The key properties of a clinical e-mail system, such as message validity and
integrity, are provided by encrypting the e-mail messages and attachments and
digitally signing them to protect personal privacy and to ensure data confi den-
tiality and integrity. Maintaining e-mail logs will provide nonrepudiation and
security audit trails.
In order to comply with the statutory requirements for protection of privacy,
an individual must be notifi ed about the purpose of collecting the personal
information as well as the legal authority for doing so. The HIPAA defi nes
personal information as “any recorded information about an identifi able indi-
vidual. Institutions must protect that personal information by appropriate
security. All the demographic and other information associated with registra-
tion must be consolidated and securely managed in one logical location for
confi dentiality and integrity of personal information and for accurate eligibility
assessment. Access to a personal health record may be granted at the following
levels: role based (access privileges will be assigned to a set of users based on
the role they perform), group based (access privileges will be assigned to a set
of users that are members of a defi ned group), and individual based (access
privileges will be assigned to individual health care providers). Access privi-
leges to a personal health record should be constrained for delegation, referral,
or escalation based on the role, purpose, and logical location, and all transac-
tions should be logged. The transactions in this context are any activities involv-
ing the patient data, such as creation, viewing, sharing with others, updating,
correcting, archiving, or deleting a health record or related information.
18.9
GREEN HEALTH CARE
Green health care is an emerging discipline of sustainable health care to keep
people healthy and to protect the environmental and medical resources
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