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International Journal of... 2017The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth... (Review)
Review
The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). PubMed, CINAHL and INSPEC from 2003 - 2016 were searched and returned 25,404 papers (after duplications were removed). Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth. Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen's kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions.
PubMed: 29238448
DOI: 10.5195/ijt.2017.6231 -
JMIR MHealth and UHealth Jul 2022COVID-19 digital contact-tracing apps were created to assist public health authorities in curbing the pandemic. These apps require users' permission to access specific...
BACKGROUND
COVID-19 digital contact-tracing apps were created to assist public health authorities in curbing the pandemic. These apps require users' permission to access specific functions on their mobile phones, such as geolocation, Bluetooth or Wi-Fi connections, or personal data, to work correctly. As these functions have privacy repercussions, it is essential to establish how contact-tracing apps respect users' privacy.
OBJECTIVE
This study aimed to systematically map existing contact-tracing apps and evaluate the permissions required and their privacy policies. Specifically, we evaluated the type of permissions, the privacy policies' readability, and the information included in them.
METHODS
We used custom Google searches and existing lists of contact-tracing apps to identify potentially eligible apps between May 2020 and November 2021. We included contact-tracing or exposure notification apps with a Google Play webpage from which we extracted app characteristics (eg, sponsor, number of installs, and ratings). We used Exodus Privacy to systematically extract the number of permissions and classify them as dangerous or normal. We computed a Permission Accumulated Risk Score representing the threat level to the user's privacy. We assessed the privacy policies' readability and evaluated their content using a 13-item checklist, which generated a Privacy Transparency Index. We explored the relationships between app characteristics, Permission Accumulated Risk Score, and Privacy Transparency Index using correlations, chi-square tests, or ANOVAs.
RESULTS
We identified 180 contact-tracing apps across 152 countries, states, or territories. We included 85.6% (154/180) of apps with a working Google Play page, most of which (132/154, 85.7%) had a privacy policy document. Most apps were developed by governments (116/154, 75.3%) and totaled 264.5 million installs. The average rating on Google Play was 3.5 (SD 0.7). Across the 154 apps, we identified 94 unique permissions, 18% (17/94) of which were dangerous, and 30 trackers. The average Permission Accumulated Risk Score was 22.7 (SD 17.7; range 4-74, median 16) and the average Privacy Transparency Index was 55.8 (SD 21.7; range 5-95, median 55). Overall, the privacy documents were difficult to read (median grade level 12, range 7-23); 67% (88/132) of these mentioned that the apps collected personal identifiers. The Permission Accumulated Risk Score was negatively associated with the average App Store ratings (r=-0.20; P=.03; 120/154, 77.9%) and Privacy Transparency Index (r=-0.25; P<.001; 132/154, 85.7%), suggesting that the higher the risk to one's data, the lower the apps' ratings and transparency index.
CONCLUSIONS
Many contact-tracing apps were developed covering most of the planet but with a relatively low number of installs. Privacy-preserving apps scored high in transparency and App Store ratings, suggesting that some users appreciate these apps. Nevertheless, privacy policy documents were difficult to read for an average audience. Therefore, we recommend following privacy-preserving and transparency principles to improve contact-tracing uptake while making privacy documents more readable for a wider public.
Topics: COVID-19; Contact Tracing; Data Management; Humans; Mobile Applications; Policy; Privacy
PubMed: 35709334
DOI: 10.2196/35195 -
Interactive Journal of Medical Research Nov 2022Inpatient portals are online platforms that allow patients to access their personal health information and monitor their health while in the acute care setting. Despite... (Review)
Review
BACKGROUND
Inpatient portals are online platforms that allow patients to access their personal health information and monitor their health while in the acute care setting. Despite their potential to improve quality of care and empower patients and families to participate in their treatment, adoption remains low. Outpatient portal studies have shown that physician endorsement can drive patients' adoption of these systems. Insights on physicians' perspectives on use of these platforms can help improve patient and physician satisfaction and inpatient portal uptake.
OBJECTIVE
The purpose of this systematic review is to better understand physicians' perspectives toward inpatient portals.
METHODS
A systematic literature review was conducted for studies published between 1994 and November 2021 using keywords for physicians' perspectives toward patient portals and personal health records. Databases included PubMed, MEDLINE, Web of Science, and Scopus. Articles solely focused on nonphysician clinicians or addressing only outpatient settings or shared notes were excluded from this review. Two reviewers performed title, abstract, and full-text screening independently. Bias assessment was performed using the JBI SUMARI Critical Appraisal Tool (Joanna Briggs Institute). Inductive thematic analysis was done based on themes reported by original authors. Data were synthesized using narrative synthesis and reported according to overarching themes.
RESULTS
In all, 4199 articles were collected and 9 included. All but 2 of the studies were conducted in the United States. Common themes identified were communication and privacy, portal functionality and patient use, and workflow. In studies where physicians had no prior patient portal experience, concerns were expressed about communication issues created by patients' access to laboratory results and potential impact on existing workflow. Concerns about negative communication impacts were not borne out in postimplementation studies.
CONCLUSIONS
Physicians perceived inpatient portals to be beneficial to patients and saw improvement in communication as a result. This is consistent with outpatient studies and highlights the need to improve training on portal use and include physicians during the design process. Health care organizations and information technology entities can take steps to increasing clinician comfort. Physician concerns involving patient portal usage and managing patient expectations also need to be addressed. With improved clinician support, initial pessimism about communication and workload issues can be overcome. Limitations of this review include the small number of pre- and postimplementation studies found. This is also not a review of perspectives on open notes, which merits separate discussion.
PubMed: 36378521
DOI: 10.2196/39542 -
Journal of Housing and the Built... 2022Grounded in psychological and social constructs, the need for privacy is reflected in human socio-spatial behaviour and in our own home. To discuss housing privacy, this...
Grounded in psychological and social constructs, the need for privacy is reflected in human socio-spatial behaviour and in our own home. To discuss housing privacy, this article presents a systematic literature review (SLR) that identified theoretical and methodological aspects relevant to the topic. The research was based on consolidated protocols to identify, select and evaluate articles published between 2000 and 2021 in three databases (Web of Science, Google Scholar and Scielo), with 71 eligible articles identified for synthesis. The results showed a concentration of studies in the American, European and Islamic context, and the increase in this production since 2018. This was guided by the inadequacy of architectural and urban planning projects, by new forms of social interaction and, recently, by the COVID-19 pandemic. From a theoretical point of view, the SLR demonstrated the importance of investigating privacy in housing from a comprehensive perspective, observing its different dimensions (physical, social and psychological) and characterizing the issues involved and the context under analysis. Methodologically, the main instruments identified were: (i) to behavioural analysis, questionnaires, interviews and observations; (ii) to built environment evaluation, in addition to the previous ones, space syntax analysis, architectural design and photographs analysis; (iii) for the general characterization of users, the data collection regarding the socio-demographic and cultural context and the meanings attributed to spatial organizations; (iv) to characterize the participants of the investigations, the analysis of personality traits, the ways to personalize the space, user satisfaction/preferences and the influence of social interactions on these perceptions.
PubMed: 35317451
DOI: 10.1007/s10901-022-09939-z -
Journal of Medical Systems Feb 2024This systematic review examines the recent use of artificial intelligence, particularly machine learning, in the management of operating rooms. A total of 22 selected... (Review)
Review
This systematic review examines the recent use of artificial intelligence, particularly machine learning, in the management of operating rooms. A total of 22 selected studies from February 2019 to September 2023 are analyzed. The review emphasizes the significant impact of AI on predicting surgical case durations, optimizing post-anesthesia care unit resource allocation, and detecting surgical case cancellations. Machine learning algorithms such as XGBoost, random forest, and neural networks have demonstrated their effectiveness in improving prediction accuracy and resource utilization. However, challenges such as data access and privacy concerns are acknowledged. The review highlights the evolving nature of artificial intelligence in perioperative medicine research and the need for continued innovation to harness artificial intelligence's transformative potential for healthcare administrators, practitioners, and patients. Ultimately, artificial intelligence integration in operative room management promises to enhance healthcare efficiency and patient outcomes.
Topics: Humans; Artificial Intelligence; Operating Rooms; Neural Networks, Computer; Algorithms; Machine Learning
PubMed: 38353755
DOI: 10.1007/s10916-024-02038-2 -
PeerJ. Computer Science 2021The Internet of Medical Things (IoMTs) is gradually replacing the traditional healthcare system. However, little attention has been paid to their security requirements...
BACKGROUND
The Internet of Medical Things (IoMTs) is gradually replacing the traditional healthcare system. However, little attention has been paid to their security requirements in the development of the IoMT devices and systems. One of the main reasons can be the difficulty of tuning conventional security solutions to the IoMT system. Machine Learning (ML) has been successfully employed in the attack detection and mitigation process. Advanced ML technique can also be a promising approach to address the existing and anticipated IoMT security and privacy issues. However, because of the existing challenges of IoMT system, it is imperative to know how these techniques can be effectively utilized to meet the security and privacy requirements without affecting the IoMT systems quality, services, and device's lifespan.
METHODOLOGY
This article is devoted to perform a Systematic Literature Review (SLR) on the security and privacy issues of IoMT and their solutions by ML techniques. The recent research papers disseminated between 2010 and 2020 are selected from multiple databases and a standardized SLR method is conducted. A total of 153 papers were reviewed and a critical analysis was conducted on the selected papers. Furthermore, this review study attempts to highlight the limitation of the current methods and aims to find possible solutions to them. Thus, a detailed analysis was carried out on the selected papers through focusing on their methods, advantages, limitations, the utilized tools, and data.
RESULTS
It was observed that ML techniques have been significantly deployed for device and network layer security. Most of the current studies improved traditional metrics while ignored performance complexity metrics in their evaluations. Their studies environments and utilized data barely represent IoMT system. Therefore, conventional ML techniques may fail if metrics such as resource complexity and power usage are not considered.
PubMed: 33834100
DOI: 10.7717/peerj-cs.414 -
PloS One 2021Digital nudging has been mooted as a tool to alter user privacy behavior. However, empirical studies on digital nudging have yielded divergent results: while some... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Digital nudging has been mooted as a tool to alter user privacy behavior. However, empirical studies on digital nudging have yielded divergent results: while some studies found nudging to be highly effective, other studies found no such effects. Furthermore, previous studies employed a wide range of digital nudges, making it difficult to discern the effectiveness of digital nudging. To address these issues, we performed a systematic review of empirical studies on digital nudging and information disclosure as a specific privacy behavior.
METHOD
The search was conducted in five digital libraries and databases: Scopus, Google Scholar, ACM Digital Library, Web of Science, and Science Direct for peer-reviewed papers published in English after 2006, examining the effects of various nudging strategies on disclosure of personal information online.
RESULTS
The review unveiled 78 papers that employed four categories of nudge interventions: presentation, information, defaults, and incentives, either individually or in combination. A meta-analysis on a subset of papers with available data (n = 54) revealed a significant small-to-medium sized effect of the nudge interventions on disclosure (Hedges' g = 0.32). There was significant variation in the effectiveness of nudging (I2 = 89%), which was partially accounted for by interventions to increase disclosure being more effective than interventions to reduce disclosure. No evidence was found for differences in the effectiveness of nudging with presentation, information, defaults, and incentives interventions.
CONCLUSION
Identifying ways to nudge users into making more informed and desirable privacy decisions is of significant practical and policy value. There is a growing interest in digital privacy nudges for disclosure of personal information, with most empirical papers focusing on nudging with presentation. Further research is needed to elucidate the relative effectiveness of different intervention strategies and how nudges can confound one another.
Topics: Disclosure; Health Records, Personal; Humans; Personally Identifiable Information; Privacy
PubMed: 34449821
DOI: 10.1371/journal.pone.0256822 -
Sensors (Basel, Switzerland) Dec 2020The research presented aims to investigate the relationship between privacy and anonymisation in blockchain technologies on different fields of application. The study is...
The research presented aims to investigate the relationship between privacy and anonymisation in blockchain technologies on different fields of application. The study is carried out through a systematic literature review in different databases, obtaining in a first phase of selection 199 publications, of which 28 were selected for data extraction. The results obtained provide a strong relationship between privacy and anonymisation in most of the fields of application of blockchain, as well as a description of the techniques used for this purpose, such as Ring Signature, homomorphic encryption, k-anonymity or data obfuscation. Among the literature researched, some limitations and future lines of research on issues close to blockchain technology in the different fields of application can be detected. As conclusion, we extract the different degrees of application of privacy according to the mechanisms used and different techniques for the implementation of anonymisation, being one of the risks for privacy the traceability of the operations.
PubMed: 33327652
DOI: 10.3390/s20247171 -
Sensors (Basel, Switzerland) Apr 2021Owing to progressive population aging, elderly people (aged 65 and above) face challenges in carrying out activities of daily living, while placement of the elderly in a... (Review)
Review
Owing to progressive population aging, elderly people (aged 65 and above) face challenges in carrying out activities of daily living, while placement of the elderly in a care facility is expensive and mentally taxing for them. Thus, there is a need to develop their own homes into smart homes using new technologies. However, this raises concerns of privacy and data security for users since it can be handled remotely. Hence, with advancing technologies it is important to overcome this challenge using privacy-preserving and non-intrusive models. For this review, 235 articles were scanned from databases, out of which 31 articles pertaining to in-home technologies that assist the elderly in living independently were shortlisted for inclusion. They described the adoption of various methodologies like different sensor-based mechanisms, wearables, camera-based techniques, robots, and machine learning strategies to provide a safe and comfortable environment to the elderly. Recent innovations have rendered these technologies more unobtrusive and privacy-preserving with increasing use of environmental sensors and less use of cameras and other devices that may compromise the privacy of individuals. There is a need to develop a comprehensive system for smart homes which ensures patient safety, privacy, and data security; in addition, robots should be integrated with the existing sensor-based platforms to assist in carrying out daily activities and therapies as required.
Topics: Activities of Daily Living; Aged; Aging; Computer Security; Humans; Privacy; Technology
PubMed: 33925161
DOI: 10.3390/s21093082 -
PloS One 2022Mitochondrial diseases are a large group of genetically heterogeneous and clinically diverse disorders. Diagnosis often takes many years for which treatment may not... (Review)
Review
BACKGROUND
Mitochondrial diseases are a large group of genetically heterogeneous and clinically diverse disorders. Diagnosis often takes many years for which treatment may not exist. Registries are often used to conduct research, establish natural disease progression, engage the patient community, and develop best disease management practices. In Canada, there are limited centralized registries for mitochondrial disease patients, presenting a challenge for patients and professionals.
OBJECTIVE
To support the creation of such a registry, a systematic scoping review was conducted to map the landscape of mitochondrial disease patient registries worldwide, with a focus on registry design and challenges. Furthermore, it addresses a knowledge gap by providing a narrative synthesis of published literature that describes these registries.
METHODS
Arksey and O'Malley's methodological framework was followed to systematically search English-language literature in PubMed and CINAHL describing the designs of mitochondrial disease patient registries, supplemented by a grey literature search. Data were extracted in Microsoft Excel. Stakeholder consultations were also performed with patient caregivers, advocates, and researchers to provide perspectives beyond those found in the literature. These data were thematically analyzed and were reported in accordance with the PRISMA-ScR reporting guidelines.
RESULTS
A total of 17 articles were identified describing 13 unique registries located in North America, Europe, Australia, and West Asia. These papers described the registries' designs, their strengths, and weaknesses, as well as their tangible outcomes such as facilitating recruitment for research and supporting epidemiological studies.
CONCLUSION
Based on our findings in this review, recommendations were formulated. These include establishing registry objectives, respecting patients and their roles in the registry, adopting international data standards, data evaluations, and considerations to privacy legislation, among others. These recommendations could be used to support designing a future Canadian mitochondrial disease patient registry, and to further research directly engaging these registries worldwide.
Topics: Humans; Canada; Registries; Research Personnel; Mitochondrial Diseases; Europe
PubMed: 36301904
DOI: 10.1371/journal.pone.0276883