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Healthcare Data Breaches: Implications for Digital Forensic Readiness
While the healthcare industry is undergoing disruptive digital transformation, data breaches involving health information are not usually the result of integration of new technologies. Based on published industry reports, fundamental security safeguards are still considered to be lacking with many documented data breaches occurring as the result of device and equipment theft, human error, hacking, ransomware attacks and misuse. Health information is considered to be one of the most attractive targets for cybercriminals due to its inherent sensitivity, but digital investigations of incidents involving health information are often constrained by the lack of the necessary infrastructure forensic readiness. Following the analysis of healthcare data breach causes and threats, we describe the associated digital forensic readiness challenges in the context of the most significant incident causes. With specific focus on privilege misuse, we present a conceptual architecture for forensic audit logging to assist with capture of the relevant digital artefacts in support of possible future digital investigations.
Journal Article
Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review
The digitalization of medicine has led to a considerable growth of heterogeneous health datasets, which could improve healthcare research if integrated into the clinical life cycle. This process requires, amongst other things, the harmonization of these datasets, which is a prerequisite to improve their quality, re-usability and interoperability. However, there is a wide range of factors that either hinder or favor the harmonized collection, sharing and linkage of health data.
This systematic review aims to identify barriers and facilitators to health data harmonization-including data sharing and linkage-by a comparative analysis of studies from Denmark and Switzerland.
Publications from PubMed, Web of Science, EMBASE and CINAHL involving cross-institutional or cross-border collection, sharing or linkage of health data from Denmark or Switzerland were searched to identify the reported barriers and facilitators to data harmonization.
Of the 345 projects included, 240 were single-country and 105 were multinational studies. Regarding national projects, a Swiss study reported on average more barriers and facilitators than a Danish study. Barriers and facilitators of a technical nature were most frequently reported.
This systematic review gathered evidence from Denmark and Switzerland on barriers and facilitators concerning data harmonization, sharing and linkage. Barriers and facilitators were strictly interrelated with the national context where projects were carried out. Structural changes, such as legislation implemented at the national level, were mirrored in the projects. This underlines the impact of national strategies in the field of health data. Our findings also suggest that more openness and clarity in the reporting of both barriers and facilitators to data harmonization constitute a key element to promote the successful management of new projects using health data and the implementation of proper policies in this field. Our study findings are thus meaningful beyond these two countries.
Journal Article
Operational Health Information Exchanges Show Substantial Growth, But Long-Term Funding Remains A Concern
Policy makers are actively promoting the electronic exchange of health information to improve the quality and efficiency of health care. We conducted a national survey of organizations facilitating health information exchange, to assess national progress. We found that 30 percent of hospitals and 10 percent of ambulatory practices now participate in one of the 119 operational health information exchange efforts across the United States, substantial growth from prior surveys. However, we also found that 74 percent of health information exchange efforts report struggling to develop a sustainable business model. Our findings suggest that despite progress, there is a substantial risk that many current efforts to promote health information exchange will fail when public funds supporting these initiatives are depleted. [PUBLICATION ABSTRACT]
Journal Article
Healthcare information management and operational cost performance: empirical evidence
Healthcare knowledge management systems can mitigate hospitals’ operational inefficiency. As a healthcare information technology, the electronic health record (EHR) receives much attention from medical institutions due to its considerable impact on operational cost performance. This paper focuses on EHR systems to address operational inefficiency by which patients pay more for health care services, and many U.S. hospitals are filing for bankruptcy. From the theoretical perspective of the practice-based view, this paper introduces a path to implement EHR systems for improving cost performance. The empirical investigation is archival data of 200 hospitals collected from the U.S. healthcare agencies. Findings contribute to prior work by hypothesizing moderating and mediating roles in EHR systems implementation. This paper introduces absorptive capacity and monitoring mechanisms as enablers of implementing EHR systems. The results showed that hospital monitoring strengthens the relationship between absorptive capacity and electronic health record systems implementation, which results in better operational cost performance. Theoretically, this study supports the long-term potential benefits of EHR adoption, and its findings are consistent with optimizing efficiency through data standardization and interoperability. From a practical perspective, this study supports hospitals' investments in evolving healthcare information technology systems through the development of a knowledge-based system employing EHR, particularly when hospitals are merging or need a financial strategic plan to control expenses.
Journal Article
Transforming Biomedical Informatics and Health Information Access
During his 31-year tenure as director of the U.S.National Library of Medicine (NLM), Donald A.B.Lindberg M.D.dramatically increased access to knowledge about health issues, medicine, medical care, the health professions, and health literacy.
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