23-06-2014, 03:23 PM
ICT in Telemedicine: Conquering Privacy and Security Issues In Health Care
Services
ICT in Telemedicine.pdf (Size: 434.95 KB / Downloads: 64)
Abstract
– Advancement in telecommunication combined
with improved information technology infrastructures has
opened up new dimensions in e-health environment. Such
technologies make readily available to access, store,
manipulate and replicate medical information and images.
These technologies help reduced the time and effort in
diagnoses and treatment at lower cost. However, protection
and authentication of such medical information and images
are now becoming increasingly important in telemedicine
environment, where images are readily distributed over
electronic networks. Intruders/hackers may gain access to
confidential information and possible alter or even delete
such vital records. The ultimate success of telemedicine
demands an effective technology as well as privacy and
security of records should be main concern. This paper
explores recent identified privacy and security issues that
affect telemedicine. Featuring threats on security and
authentication of medical records, and proposing digital
watermarking as a technology to curb authentication issues
in telemedicine is highlighted.
INTRODUCTION
Protection of personally identifiable information whether
health information, banking records, employment history
or credit score, must be ensured. With the advent of
telehealth, e-health and/or telemedicine; a system were
application of wireless communications is used in
connecting healthcare professionals and patients through
ubiquitous and cloud computing over the electronic
networks, authentication, integrity and confidentiality of
patient's data are often pointed out as key factors to be
considered in medical information system.
Newer information technology and telecommunication
products offered to patients and healthcare professionals
alike are capable of transmitting vital signals. Such as key
blood test results for diabetics and blood pressure data.
The technology has grown to advanced imaging
technologies and gamma cameras with higher data
requirements that can be used to transfer data and images
such as CT Scanners, MRIs, PET-CT, C-Arms,
Mammography, X-Rays, Bone Densitometers,
Radiographic and urology system e.t.c. [1].
Telecommunication technologies and information systems
are being integrated and adopted in medical field to store
patient information in digital format that allows adequate
medical assistance delivered to the patient in distinct
places and scenarios, called Electronic Patient Records
(EPR) [2]. Such records are used in conjunction with
sensor networks for remote patient monitoring,
consulting, training and diagnoses to form a telemedicine
system.
OVERVIEW OF TELEMEDICINE
More than 52 million deaths in 1996 worldwide, about
40 million occurred in the developing world due to lack of
medical facilities. More than 600 million people
worldwide have chronic diseases with treatments costing
$500 billion per year in 2010 and these costs will
increase by 37% until 2020 [15]. Poor countries had four
times more deaths than rich countries. One of the ways to
curb this problem is by relevant development and
implementation of telehealth services supported by ICT.
Telemedicine is the use of modern telecommunications
and information technologies for the provision of clinical
care to individuals at a distance and the transmission of
information to provide that care [16]. While, ehealth/
telehealth is an emerging field in the intersection of
medical informatics, public health and business, enhanced
through the Internet and related technologies, to improve
health care locally, regionally, and worldwide by using
information and communication technology [17].
SECURITY AND PRIVACY ISSUES IN TELEMEDICINE
As an individual, he/she have right to privacy, that is,
having control over personal information such as name,
social security number, medical diagnoses, shopping
habits, work history and credit score. Therefore the right
to privacy is the ability to limit who has this information,
how the information is kept and what can be done with it.
For this reason, Electronic Patient Record (EPR), EPR on
network requires a systematic content validation to
provide quality control such as correctness and reliability
of the source. In telemedicine, file sharing may create new
security and customer privacy issues. There are numerous
potential risks to privacy in any health care activity that
requires the exchange of patient information between
organizations or individuals. The potential for protected
health information to be exposed when organizations or
individual cooperate in a telehealth/telemedicine
interaction may be greater than face-to-face interactions,
particularly when telehealth activities are not integrated
into an organization’s usual practice patterns [26]. The
security of medical images, derived from strict ethics and
legislative rules, gives rights to the patient and duties to
the health professionals. This imposes three mandatory
characteristics: confidentiality, reliability and availability
[27]. Table 1 shows the security services and their
application in telemedicine.
Table 1: Security and their applications to telemedicine
Security and their applications to telemedicine
Security Services Description
Availability It is a timely access to data. Patient
information and images needed
should be readily available even
when there are unpredicted power
outages or hardware/software
failure [8]. Availability also
involves ensuring that data are
prevented from disasters such as
natural disaster, machine faults, etc.
which may cause unavailability of
data.
Confidentiality Prevention of medical data and
images from disclosure, that is,
information is only accessed by
authorized individuals.
Integrity It is the ability of an image and
information of patient to be use by
authorized personnel in correctness
condition of access.
Other security issues include data access, and storage; this
is because eavesdropping and skimming are possible
when the sensor data is transmitted wirelessly. Yet
another issue is the data mining. When mining on human
data, there are unique privacy and security constraints that
limit what collection, distribution, and analysis can be
done, in which some of this large amounts of medical data
is not stored electronically and cannot be mined. While
the type of data mining done on this information has
security and privacy concerns, the heterogeneity of the
databases and the scattering of the data throughout the
medical care facilities also contributed to the security
issue [28]. Furthermore, the lack of standardized
regulatory framework, that is, different state has different
law, each state has specialized rules for how health care is
handled.
CONCLUSION
Telemedicine is an enabling technology that provides
cheap and effective healthcare with interconnected sensor
networks making it an ideal for remote patient monitoring
a reality. Currently, telemedicine is becoming a viable
alternative that supplements conventional face-to-face
health care service because of availability of ICT. The
number of unnecessary admission and emergency visits to
the hospital is reduced; at the same time, early
intervention is facilitated. However, privacy and security
issues continue to plague telemedicine projects, especially
due to the extensive use of information and
communication technologies like wireless network. While
the Health Insurance Portability and Accountability Act of
1996 (HIPAA) addresses health information security and
privacy issues. Digital Watermarking has the potential to
redress privacy-security problems that have plagued
telemedicine.
In this paper we discussed the privacy and security
issues that arise when using telemedicine. We explored
some of the existing solutions and found that Digital
Watermarking is a means of data protection with minimal
security and privacy risks.