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- Fagerlund, A. J., et al.
(författare)
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Experiences from patients in mental healthcare accessing their electronic health records : Results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
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Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. Conclusions: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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- Holm, J., et al.
(författare)
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Optical arrangement
- 2000
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Patent (populärvet., debatt m.m.)abstract
- A solid-state laser or arrangement for wavelength conversion is disclosed, which in its simplest embodiment is comprised of a light-generating body (102) arranged in a supporting means (103), the light-generating body (102) having a shape which is substantially complementary to a guiding structure (104) which is formed in the supporting means (103). The guiding structure (104) is formed with a high degree of accuracy, for instance, by etching the supporting means (103) or by replicating an original. Between the light-generating body (102) and the guiding structure (104) of the supporting means a thin contact layer (105) is arranged, the purpose of which is to increase the adherence to and/or the heat transfer to the supporting means (103). Due to the fact that the contact layer (105) is a deformable material, possible discrepancies as regards complementarity between the guiding structure (104) and the light-generating body (102) will be filled by the contact layer (105), whereby a close fit is obtained between the complementary structures.
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- Holm, J., et al.
(författare)
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Optical arrangement
- 1999
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Patent (populärvet., debatt m.m.)abstract
- A solid-state laser or arrangement for wavelength conversion is disclosed, which in its simplest embodiment is comprised of a light-generating body (102) arranged in a supporting means (103), the light-generating body (102) having a shape which is substantially complementary to a guiding structure (104) which is formed in the supporting means (103). The guiding structure (104) is formed with a high degree of accuracy, for instance, by etching the supporting means (103) or by replicating an original. Between the light-generating body (102) and the guiding structure (104) of the supporting means a thin contact layer (105) is arranged, the purpose of which is to increase the adherence to and/or the heat transfer to the supporting means (103). Due to the fact that the contact layer (105) is a deformable material, possible discrepancies as regards complementarity between the guiding structure (104) and the light-generating body (102) will be filled by the contact layer (105), whereby a close fit is obtained between the complementary structures.
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- Iwaya, Leonardo H, et al.
(författare)
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E-Consent for Data Privacy : Consent Management for Mobile Health Technologies in Public Health Surveys and Disease Surveillance
- 2019
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Ingår i: MEDINFO 2019. - : IOS Press. - 9781643680026 - 9781643680033 ; , s. 1223-1227
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Konferensbidrag (refereegranskat)abstract
- Community health workers in primary care programs increasingly use Mobile Health Data Collection Systems (MDCSs) to report their activities and conduct health surveys, replacing paper-based approaches. The mHealth systems are inherently privacy invasive, thus informing individuals and obtaining their consent is important to protect their rights to privacy. In this paper, we introduce an e-Consent tool tailored for MDCSs. It is developed based on the requirement analysis of consent management for data privacy and built upon the solutions of Participant-Centered Consent toolkit and Consent Receipt specification. The e-Consent solution has been evaluated in a usability study. The study results show that the design is useful for informing individuals on the nature of data processing, allowing them to make informed decisions.
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- Iwaya, Leonardo H
(författare)
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Engineering Privacy for Mobile Health Data Collection Systems in the Primary Care
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mobile health (mHealth) systems empower Community Health Workers (CHWs) around the world, by supporting the provisioning of Community-Based Primary Health Care (CBPHC) – primary care outside the health facility into people’s homes. In particular, Mobile Health Data Collection Systems (MDCSs) are used by CHWs to collect health-related data about the families that they treat, replacing paper-based approaches for health surveys. Although MDCSs significantly improve the overall efficiency of CBPHC, existing and proposed solutions lack adequate privacy and security safeguards. In order to bridge this knowledge gap between the research areas of mHealth and privacy, the main research question of this thesis is: How to design secure and privacy-preserving systems for Mobile Health Data Collection Systems? To answer this question, the Design Method is chosen as an engineering approach to analyse and design privacy and security mechanisms for MDCSs. Among the main contributions, a comprehensive literature review of the Brazilian mHealth ecosystem is presented. This review led us to focus on MDCSs due to their impact on Brazil’s CBPHC, the Family Health Strategy programme. On the privacy engineering side, the contributions are a Privacy Impact Assessment (PIA) for the GeoHealth MDCS and three mechanisms: (a) SecourHealth, a security framework for data encryption and user authentication; (b) an Ontology-based Data Sharing System (O-DSS) that provides obfuscation and anonymisation functions; and, (c) an electronic consent (e-Consent) tool for obtaining and handling informed consent. Additionally, practical experience is shared about designing a MDCS, GeoHealth, and deploying it in a large-scale experimental study. In conclusion, the contributions of this thesis offer guidance to mHealth practitioners, encouraging them to adopt the principles of privacy by design and by default in their projects.
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- Iwaya, Leonardo H, et al.
(författare)
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mHealth : A Privacy Threat Analysis for Public Health Surveillance Systems
- 2018
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Ingår i: 2018 IEEE 31st International Symposium on Computer-Based Medical Systems. - : IEEE. - 9781538660607 - 9781538660614 ; , s. 42-47
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Konferensbidrag (refereegranskat)abstract
- Community Health Workers (CHWs) have been using Mobile Health Data Collection Systems (MDCSs) for supporting the delivery of primary healthcare and carrying out public health surveys, feeding national-level databases with families’ personal data. Such systems are used for public surveillance and to manage sensitive data (i.e., health data), so addressing the privacy issues is crucial for successfully deploying MDCSs. In this paper we present a comprehensive privacy threat analysis for MDCSs, discuss the privacy challenges and provide recommendations that are specially useful to health managers and developers. We ground our analysis on a large-scale MDCS used for primary care (GeoHealth) and a well-known Privacy Impact Assessment (PIA) methodology. The threat analysis is based on a compilation of relevant privacy threats from the literature as well as brain-storming sessions with privacy and security experts. Among the main findings, we observe that existing MDCSs do not employ adequate controls for achieving transparency and interveinability. Thus, threatening fundamental privacy principles regarded as data quality, right to access and right to object. Furthermore, it is noticeable that although there has been significant research to deal with data security issues, the attention with privacy in its multiple dimensions is prominently lacking.
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| 9. |
- Iwaya, Leonardo H, et al.
(författare)
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Mobile Health Systems for Community-Based Primary Care : Identifying Controls and Mitigating Privacy Threats
- 2019
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Ingår i: JMIR mhealth and uhealth. - CANADA : JMIR Publications. - 2291-5222. ; 7:3, s. 1-16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Community-based primary care focuses on health promotion, awareness raising, and illnesses treatment and prevention in individuals, groups, and communities. Community Health Workers (CHWs) are the leading actors in such programs, helping to bridge the gap between the population and the health system. Many mobile health (mHealth) initiatives have been undertaken to empower CHWs and improve the data collection process in the primary care, replacing archaic paper-based approaches. A special category of mHealth apps, known as mHealth Data Collection Systems (MDCSs), is often used for such tasks. These systems process highly sensitive personal health data of entire communities so that a careful consideration about privacy is paramount for any successful deployment. However, the mHealth literature still lacks methodologically rigorous analyses for privacy and data protection.Objective: In this paper, a Privacy Impact Assessment (PIA) for MDCSs is presented, providing a systematic identification and evaluation of potential privacy risks, particularly emphasizing controls and mitigation strategies to handle negative privacy impacts.Methods: The privacy analysis follows a systematic methodology for PIAs. As a case study, we adopt the GeoHealth system, a large-scale MDCS used by CHWs in the Family Health Strategy, the Brazilian program for delivering community-based primary care. All the PIA steps were taken on the basis of discussions among the researchers (privacy and security experts). The identification of threats and controls was decided particularly on the basis of literature reviews and working group meetings among the group. Moreover, we also received feedback from specialists in primary care and software developers of other similar MDCSs in Brazil.Results: The GeoHealth PIA is based on 8 Privacy Principles and 26 Privacy Targets derived from the European General Data Protection Regulation. Associated with that, 22 threat groups with a total of 97 subthreats and 41 recommended controls were identified. Among the main findings, we observed that privacy principles can be enhanced on existing MDCSs with controls for managing consent, transparency, intervenability, and data minimization.Conclusions: Although there has been significant research that deals with data security issues, attention to privacy in its multiple dimensions is still lacking for MDCSs in general. New systems have the opportunity to incorporate privacy and data protection by design. Existing systems will have to address their privacy issues to comply with new and upcoming data protection regulations. However, further research is still needed to identify feasible and cost-effective solutions.
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| 10. |
- Iwaya, Leonardo H., 1988-, et al.
(författare)
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Overview of Privacy Challenges in Mobile Health Data Collection Systems
- 2018
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Konferensbidrag (refereegranskat)abstract
- Community Health Workers (CHWs) have been using Mobile HealthData Collection Systems (MDCSs) for public health surveys, feeding the national-level databases with the families’ personal data. Since such systems are inherentlyused for public surveillance and manage sensitive data (i.e., health data), deal-ing with the privacy issues is crucial to successful deployments. In this poster wepresent the privacy challenges related to MDCSs, providing a summary speciallyimportant to health managers and developers.
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