Gestión del control de acceso en historiales clínicos electrónicos: revisión sistemática de la literatura

Señor, Inmaculada Carrión; Fernández-Alemán, José Luis; Toval, Ambrosio

doi:10.1016/j.gaceta.2011.11.019

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…34 The authors note that implementation of new projects is linked to the likelihood of return on investment. 35,36 Based on the study findings, the main obstacles to implementing eHealth 37 are insufficient economic resources, 5 technical challenges arising from the difficulty of accessing confidential data, insufficient interoperability, 38 a weak culture of consumer empowerment, and lack of equity for groups at risk of exclusion. To overcome the current barriers, 39 it is important to create a favorable context for the development of eHealth.…”

Section: Discussionmentioning

confidence: 99%

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The Present and Future of eHealth in Spain From a Health Management Perspective

et al. 2020

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eHealth has grown significantly over the last decade. The aim of this study was to determine the level of use of information and communication technologies for health care in Spain and identify the main barriers to development. We used a qualitative study based on data obtained from 8 Spanish autonomous communities through semi-structured, in-depth interviews with key informants in eHealth management and planning. Programs present varying degrees of implementation. Services such as electronic prescriptions, digital medical records, and appointment requests via the Internet are advanced and widespread; others, such as digital imaging, are advanced but not fully deployed; and some, such as telecare programs, are experimental. The study also revealed diverse levels of interoperability and barriers to the expansion of these technologies, which can be classified into 4 fields: technological, organizational, human, and economic. eHealth might evolve more slowly in the coming years. Unless the payoff is clearly seen, major budget cuts in the current economic climate will prevent the implementation of new projects. Programs that help reduce health spending are more likely to be implemented, to the detriment of projects involving simple techniques or even clear health care improvements.

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Section: Discussionmentioning

confidence: 99%

“…However, the Internet is still not the most prevalent way of scheduling an appointment, as security of access remains a handicap (Table 1, INTERVENTIONS 3,37,38,42,and 43). Users still prefer to make appointments in person at the medical center or by telephone.…”

Section: Levels Of Ehealth Development In Spain: Programs With Advanc...mentioning

confidence: 99%

The Present and Future of eHealth in Spain From a Health Management Perspective

et al. 2020

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“…Due to the above and given that privacy for electronic medical records is regulated by government laws [ 6 , 36 ], a review of the literature on this topic was carried out. In this review, it was found that a very important aspect is the type of access control to be used for the confidentiality of clinical information, mainly highlighting the role-based access control (RBAC) access control [ 51 , 52 , 53 , 54 ]. In this type of control, each user who accesses the system is assigned a role, which, in turn, has a defined series of permissions and restrictions.…”

Section: Literature Reviewmentioning

confidence: 99%

HealthyBlock: Blockchain-Based IT Architecture for Electronic Medical Records Resilient to Connectivity Failures

Gutiérrez

Romero²,

Perez³

et al. 2020

IJERPH

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The current information systems for the registration and control of electronic medical records (EMR) present a series of problems in terms of the fragmentation, security, and privacy of medical information, since each health institution, laboratory, doctor, etc. has its own database and manages its own information, without the intervention of patients. This situation does not favor effective treatment and prevention of diseases for the population, due to potential information loss, misinformation, or data leaks related to a patient, which in turn may imply a direct risk for the individual and high public health costs for governments. One of the proposed solutions to this problem has been the creation of electronic medical record (EMR) systems using blockchain networks; however, most of them do not take into account the occurrence of connectivity failures, such as those found in various developing countries, which can lead to failures in the integrity of the system data. To address these problems, HealthyBlock is presented in this paper as an architecture based on blockchain networks, which proposes a unified electronic medical record system that considers different clinical providers, with resilience in data integrity during connectivity failure and with usability, security, and privacy characteristics. On the basis of the HealthyBlock architecture, a prototype was implemented for the care of patients in a network of hospitals. The results of the evaluation showed high efficiency in keeping the EMRs of patients unified, updated, and secure, regardless of the network clinical provider they consult.

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“…The reason behind that is that RBAC is really popular and widely used within HIS scope. In two recent literature reviews aiming for a wider health informatics scope, Señor et al [ 12 ] published that the most preferred access control is the RBAC. This first publication was made after assessing 21 articles out of 1208 initially selected while searching for access control management in EHR.…”

Section: Literature Review Classificationmentioning

confidence: 99%

Health Information System Role-Based Access Control Current Security Trends and Challenges

Carvalho

Bandiera-Paiva

2018

Journal of Healthcare Engineering

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Objective This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. Method We have selected articles related to our investigation theme “RBAC trends and limitations” in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: “Role-Based Access Control” OR “RBAC” AND “Health information System” OR “EHR” AND “Trends” OR “Challenges” OR “Security” OR “Authorization” OR “Attacks” OR “Permission Assignment” OR “Permission Relation” OR “Permission Mapping” OR “Constraint”. We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. Results 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Conclusion Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

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Gestión del control de acceso en historiales clínicos electrónicos: revisión sistemática de la literatura

Cited by 8 publications

References 16 publications

The Present and Future of eHealth in Spain From a Health Management Perspective

The Present and Future of eHealth in Spain From a Health Management Perspective

HealthyBlock: Blockchain-Based IT Architecture for Electronic Medical Records Resilient to Connectivity Failures

Health Information System Role-Based Access Control Current Security Trends and Challenges

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