Biomedical Engineering Reference
In-Depth Information
pilot settings and at best become available in regional settings. In this sense,
access to mobile health services might remain limited to certain regions.
Unequal access is an issue that is difficult to avoid, but if not anticipated on,
can have negative impacts. Our interviewees from health care and health-
care insurance background anticipated that BAN might remain limited to
niches because not enough patients can subscribe to ensure profitability in
the long run. The problem of scale of implementation is difficult to deal with
and will remain an issue so long as monitoring equipment is not widely
used and is not eligible for reimbursement. The majority of the stakeholders
we have interviewed mentioned that patient organizations can play a vital
role in the development processes and active cooperation with the medical
device industries. The arguments that were put forward were twofold. First,
it was argued that patient organizations have access to incredible amount of
knowledge and experience with regard to patient needs in specific contexts.
This in turn can contribute to the design process. Second, it was argued that
patient organizations have the power to promote proven medical applica-
tions via their channels to patients.
12.3.3.7 Privacy and Security Aspects of Medical Data
Various publications have appeared that warn about security and privacy
aspects related to the vision of ambient intelligence, the most prominent of
which is the series of publications by the IST advisory group (ISTAG) on safe-
guards that needs to be considered in the design of different technological
applications in a world of ambient intelligence (ISTAG 2001). This has caused
privacy issues to appear seriously on research agendas to deploy various
safeguards and privacy-enhancing mechanisms in the development of vari-
ous applications, including those of BAN. Thus, privacy is certainly an issue
that needs further elaboration with regard to applications of BAN, especially
in health-care settings. The question of access to medical data by different
stakeholders is important to consider. The first consideration is that for pri-
vacy reasons, it is generally required that medical data of patients be trans-
ferred in a secure manner. Furthermore, the transfer of data needs to take
place reliably to enable correct interpretation by health-care professionals.
Our interviews with different experts involved in the MobiHealth project
(see Jones et al. 2007) in the Netherlands suggest that there are still some
technical challenges involved in developing such a secure infrastructure (cf.
energy consumption and availability of reliable bandwidth resources). For
a subject like privacy protection, cooperation and involvement of all stake-
holders is considered significant. However, it is the large number of involved
stakeholders that makes the process of coordination complex to manage.
Access to medical records by unauthorized parties can have serious conse-
quences for individuals; however, as more responsibilities are allocated along
the health-care chain, it becomes more difficult to restrict access by different
parties. Serious impacts like theft of identity information and utilizing it for
