Advertisement

Security, Legal and Ethical Aspects of Computerised Health Data in Europe

  • C. Quantin
  • F.-A. Allaert
  • C. Daniel
  • E. Lamas
  • V. Rialle
Chapter
Part of the Health Informatics book series (HI)

Abstract

The European directive 95/46/CE has defined the legal framework of all personal data collection and treatment and the right of patients about the processing of their personal medical information. The development of telemedicine and domotics are real services provided to the patients but the raising new questions about the share of liability in case of medical litigation and the protection of patients’ privacy when a camera is permanently at home. Solutions protecting privacy may be found by using security tools based on cryptography and therefore then main technical principles must be known.

Keywords

Liability Data protection Security Personal data Telemedicine Patient’s right Cryptography 

References

  1. Allaert FA, Le Teuff G, Quantin C et al (2004) The legal acknowledgement of the electronic signature: a key for a secure direct access of patients to their computerised medical record. Int J Med Inform 73(3):239–242PubMedCrossRefGoogle Scholar
  2. Anonymous ‘Convention n°108 (28 January 1981) for the Protection of Individuals with regard to Automatic Processing of Personal Data’Google Scholar
  3. Anonymous ‘French law “Loi informatique et libertés”, Act n°78-17 of 6 January 1978, on information technology, data files and civil liberties’Google Scholar
  4. Anonymous ‘Post i-2010 priorities for new strategy for European information society (2010–2015).’ http://ec.europa.eu/information_society/eeurope/i2010/docs/post_i2010/090804_ipm_content.pdf
  5. Anonymous ‘Since EHR systems may contain a large amount of data over a long period of time, the new European legal framework should also foresee, among other things, the need for a comprehensive logging and documentation of all processing steps that have taken place within the system, combined with regular internal checks and follow-up on correct authorization, and regular internal and external data protection auditing. See also European Commission Commission Recommendation of 2 July 2008 on cross-border interoperability of electronic health records’, C (2008) 3282 final, 2 July 2008, Point 14(k). It will also be an important challenge for legislators to guarantee that all groups in society (including single parents, homeless persons, the elderly and disabled, isolated communities, etc.) have equal access to electronic health records. See also European Commission, ‘e-Health – making healthcare better for European citizens: an action plan for a European e-Health Area’, COM (2004) 356 final, 30 April 2004, 15’Google Scholar
  6. Anonymous ‘Directive 95/46/EC on the protection of individuals with regard to the processing of personal data and on the free movement of such data’Google Scholar
  7. Armstrong BK, Kricker A (1999) Record linkage – a vision renewed. Aust N Z J Public Health 23(5):451–452PubMedCrossRefGoogle Scholar
  8. Arney D, Venkatasubramanian KK, Sokolsky O et al (2011) Biomedical devices and systems security. Conf Proc IEEE Eng Med Biol Soc 2011:2376–2379PubMedGoogle Scholar
  9. Bellare M, Canetti R, Krawczyck H (1996) ‘Message authentication using hash functions’, the HMAC construction. RSA Laboratories’CryptoBytes 2:1–5. http://www.cs.ucsd.edu/users/mihir/papers/hmac.html/
  10. Blakely T, Woodward A, Salmond C (2000) Anonymous linkage of New Zealand mortality and census data. Aust N Z J Public Health 24(1):92–95PubMedCrossRefGoogle Scholar
  11. Borst F, Allaert FA, Quantin C (2001) The Swiss solution for anonymously chaining patient files. Stud Health Technol Inform 84(Pt 2):1239–1241PubMedGoogle Scholar
  12. Carretero S, et al (2012) Can technology-based services support long-term care challenges in home care?: analysis of evidence from social innovation good practices across the EU, in European Commission – Joint Research Centre. (http://www.epractice.eu/files/Can%20Technology-based%20Services%20support%20Long-term%20Care%20Challenges%20in%20Home%20Care_%20Analysis%20of%20Evidence%20from%20Social%20Innovation%20Good%20Practices%20across%20the%20EU_%20CARICT%20Project%20Summary%20Report_0.pdf)
  13. Chen YY, Lu JC, Jan JK (2012) A secure EHR system based on hybrid clouds. J Med Syst 36(5):3375–3384Google Scholar
  14. Chryssanthou A, Varlamis I, Latsiou C (2011) A risk management model for securing virtual healthcare communities. Int J Electron Healthc 6(2–4):95–116PubMedGoogle Scholar
  15. Churches T, Christen P (2004) Some methods for blindfolded record linkage. BMC Med Inform Decis Mak 4:9PubMedCrossRefGoogle Scholar
  16. Coatrieux G, Quantin C, Allaert FA et al (2011a) Lossless watermarking of categorical attributes for verifying medical data base integrity. Conf Proc IEEE Eng Med Biol Soc 2011:8195–8198PubMedGoogle Scholar
  17. Coatrieux G, Auverlot B, Roux C (2011b) Watermarking – a new way to bring evidence in case of telemedicine litigation. Stud Health Technol Inform 169:611–615PubMedGoogle Scholar
  18. Cormen TH, Leiserson CE, Rivest RL, Stein C. Introduction to algorithms, 3rd edn. Edition Dunod. Collection: Sciences SupGoogle Scholar
  19. Couris CM, Gutknecht C, Ecochard R et al (2006) Estimates of the number of cancer patients hospitalized in a geographic area using claims data without a unique personal identifier. Methods Inf Med 45(5):515–522PubMedGoogle Scholar
  20. Das S, Kundu MK (2012) Effective management of medical information through a novel blind watermarking technique. J Med Syst 36(5):3339–3351Google Scholar
  21. Engelbrecht R, Hildebrand C, Jung E (1995) The smart card: an ideal tool for a computer-based patient record. Medinfo 8(Pt 1):344–348PubMedGoogle Scholar
  22. Hsu CL, Lu CF (2012) A security and privacy preserving e-prescription system based on smart cards. J Med Syst 36(6):3637–3647Google Scholar
  23. Hustinx P (2009) Data protection in the light of the Lisbon Treaty and the consequences for present regulations. In: 11th conference on data protection and data security – DuD 2009, BerlinGoogle Scholar
  24. Jones PS, Meleis AI (1993) Health is empowerment. ANS Adv Nurs Sci 15(3):1–14PubMedGoogle Scholar
  25. King T, Brankovic L, Gillard P (2012) Perspectives of Australian adults about protecting the privacy of their health information in statistical databases. Int J Med Inform 81(4):279–289PubMedCrossRefGoogle Scholar
  26. Kun L et al (2007) Improving outcomes with interoperable EHRs and secure global health information infrastructure. Conf Proc IEEE Eng Med Biol Soc 2007:6159–6160PubMedGoogle Scholar
  27. Laske C (1996) Legal liability issues in health care telematics. Med Inform Europe 34:942–945Google Scholar
  28. Lau DH (2002) Patient empowerment – a patient-centred approach to improve care. Hong Kong Med J 8(5):372–374PubMedGoogle Scholar
  29. Mandl KD, Szolovits P, Kohane IS (2001) Public standards and patients’ control: how to keep electronic medical records accessible but private. BMJ 322(7281):283–287PubMedCrossRefGoogle Scholar
  30. Morin E (2004) La méthode, tome 6: Ethique, ed. Le Seuil, ParisGoogle Scholar
  31. Quantin C, Benhamiche AM, Faivre J et al (1998a) How to ensure data security of an epidemiological follow-up: quality assessment of an anonymous record linkage procedure. Int J Med Inform 49(1):117–122PubMedCrossRefGoogle Scholar
  32. Quantin C, Bouzelat H, Allaert FA et al (1998b) Automatic record hash coding and linkage for epidemiological follow-up data confidentiality. Methods Inf Med 37(3):271–277PubMedGoogle Scholar
  33. Quantin C, Allaert FA, Gouyon B et al (2005a) Proposal for the creation of a European healthcare identifier. Stud Health Technol Inform 116:949–954PubMedGoogle Scholar
  34. Quantin C, Binquet C, Allaert FA et al (2005b) Decision analysis for the assessment of a record linkage procedure: application to a perinatal network. Methods Inf Med 44(1):72–79PubMedGoogle Scholar
  35. Quantin C, Allaert FA, Fassa M et al (2007a) How to manage secure direct access of European patients to their computerized medical record and personal medical record. Stud Health Technol Inform 127:246–255PubMedGoogle Scholar
  36. Quantin C et al (2007b) Interoperability issues regarding patient identification in Europe. Conf Proc IEEE Eng Med Biol Soc 2007:6161PubMedGoogle Scholar
  37. Quantin C, Trouessin G, Allaert FA et al (2008) Combining hashing and enciphering algorithms for epidemiological analysis of gathered data. Methods Inf Med 47(5):454–458PubMedGoogle Scholar
  38. Quantin C, Coatrieux G, Allaert FA et al (2009) New advanced technologies to provide decentralised and secure access to medical records: case studies in oncology. Cancer Inform 7:217–229PubMedGoogle Scholar
  39. Quantin C, Benzenine E, Allaert FA et al (2011a) Medical record search engines, using pseudonymised patient identity: an alternative to centralised medical records. Int J Med Inform 80(2):e6–e11PubMedCrossRefGoogle Scholar
  40. Quantin C, Benzenine E, Auverlot B et al (2011b) Empowerment of patients over their personal health record implies sharing responsibility with the physician. Stud Health Technol Inform 165:68–73PubMedGoogle Scholar
  41. Quantin C, Jaquet-Chiffelle DO, Coatrieux G et al (2011c) Medical record: systematic centralization versus secure on demand aggregation. BMC Med Inform Decis Mak 11:18PubMedCrossRefGoogle Scholar
  42. Rey J, Douglass K (2012) Keys to securing data as a practitioner. J Med Pract Manage 27(4):203–205PubMedGoogle Scholar
  43. Rialle V (2009) Quelques enjeux de l’éthique évaluative en gérontologie. Revue Francophone de Gériatrie et de Gérontologie 16(156):262–266Google Scholar
  44. Ricoeur P (1992) Oneself as another (trans. Blamey K), ed. University of Chicago Press, ChicagoGoogle Scholar
  45. Rivest RL, Shamir A, Adleman L (1978) A method for obtaining digital signatures and public key cryptosystems. Commun ACM 2:10Google Scholar
  46. Ross SE, Lin CT (2003) The effects of promoting patient access to medical records: a review. J Am Med Inform Assoc 10(2):129–138PubMedCrossRefGoogle Scholar
  47. Rostad L (2008) An initial model and a discussion of access control in patient controlled health records. Proceedings of the 2008 Third International Conference on Availability, Reliability and Security. IEEE Computer Society, Washington, DC, USA, pp 935–942Google Scholar
  48. Turchin MC, Hirschhorn JN (2012) Gencrypt: one-way cryptographic hashes to detect overlapping individuals across samples. Bioinformatics 28(6):886–888PubMedCrossRefGoogle Scholar
  49. Vulliet-Tavernier S (2000) Discussion about anonymity in health data processing. Médecine et droit 40:1–4CrossRefGoogle Scholar
  50. Wei J, Hu X, Liu W (2012) An improved authentication scheme for telecare medicine information systems. J Med Syst 36(6):3597–3604PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • C. Quantin
    • 1
  • F.-A. Allaert
    • 2
  • C. Daniel
    • 3
  • E. Lamas
    • 4
  • V. Rialle
    • 5
  1. 1.Bourgogne UniversityDijonFrance
  2. 2.Health Claim Medical Chair ESCDIJON CedexFrance
  3. 3.CCS Domaine Patient AP-HPParisFrance
  4. 4.National Institute for Medical Research (INSERM)Paris, Cedex 13France
  5. 5.CHU de Grenoble / Pôle de Santé Publique – Responsable de l’UF ATMISS & Laboratoire AGIM (AGe, Imagerie, Modélisation)FRE 3405 CNRS-UJF-EPHE-UPMF/équipe AFIRMLa TroncheFrance

Personalised recommendations