Information Technology Reference
In-Depth Information
6.2.4 Securing Medical Safety
To ensure medical safety, BCMA helps practitioners to ensure the five “rights” of
medication administration (Koppel et al.
2008
): “right patient,” “right drug,” “right
dose,” “right route,” and “right time.” On the other hand, there is a report pointing
out that the effect of BCMA is limited and may even be one of the causes of medical
accidents (Koppel et al.
2008
). The controversy over the usefulness of BCMA
stems from a lack of standardized definitions relating to the information and the
workflow that BCMA should handle (Akiyama and Atsushi
2009
; Henneman et al.
2007
). In that sense, BCMA is not a mature system. There have also been few
discussions about the absolute merit of the five “rights” (Shane
2009
); the informa-
tion for analysis and authentication is still not fully elucidated.
Akiyama et al. suggested that authentication of the “right drug” not only implies
authentication of the right kind of drug, which is exactly what the physician has
prescribed, but also implies checking whether a drug to be co-infused is co-infused
correctly, as well as accessing a drug adverse reaction database to ensure that these
drugs have no side effects related the medical administration (Akiyama et al.
2008a
). After drugs are co-infused, there is a decrease in drug efficacy and bacterial
growth as time goes on; mixing drugs more than 1 h from the prescribed time is
inappropriate (Schneider et al.
1998
). “Right route” is commonly focused on
confirming the intravenous injection route. Additionally, improper treatments that
deviate from the scheduled time should be suppressed. Checking whether additional
treatments are medically appropriate is also required; this is conducted by calculat-
ing the daily dose (Akiyama and Atsushi
2009
). In other words, securing medical
safety does not involve merely authenticating items and times; it also requires that
treatments are performed appropriately, using the right medications, at the
prescribed time and place, and properly conducted using the correct workflow. To
that end, we have to develop a system that accesses an adverse event database and
queries the clinical decision support system instantly, via an authentication process,
to judge whether the request is correct according to the “five rights”.
6.2.5
Information Security
In healthcare, the sharing of patient information between practitioners, as well as
immediate access to the information, should be guaranteed. Without this guarantee,
patients' lives may be endangered. Efficient medical treatment may be hampered if
access control with regard to medical records is inappropriate. The healthcare
domain should establish an original security policy that balances the protection of
information, considering fundamental patients' rights, and the disclosure of patient
information to practitioners to ensure medical safety (Tsukuma et al.
2001
).
Some paper suggested that instead of managing access control strictly, we
should add audit functions to the medical information system. We may enhance
