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PubMed2005

Incremental adoption of information security in health-care organizations: implications for document management.

The incremental adoption of electronic media in U.S. health care has created increased risk of security and privacy violations in provider organizations. Protective regulatory efforts have been proposed to address ineffective security of patient information, with severe noncompliance penalties. Using data from a nationwide survey of health information managers, this study examines how industry-wide knowledge management trends may influence the degree of security program adoption in health-care organizations. Results suggest that significant nonadoption of mandated security measures continues to occur across the health-care industry. Paper-based systems still prevail, and computerized settings tend to have less security measures. Implications for document management and knowledge policy are discussed.

Computer Security↗
PubMed2005

Toward secure distribution of electronic health records: quantitative feasibility study on secure E-mail systems for sharing patient records.

If the quality and efficiency of medical services are to be ensured, electronic health records (EHR) and EHR-supporting infrastructure must be prevalent. Many hospitals, however, have EHR systems for their internal use only, and the standardization process for the exchange of medical information is still in process. This standardization process addresses information security and is considering public key infrastructure (PKI) as one security measure, but PKI is rarely used by medical practioners because of its poor user-friendliness. Here we propose an effective use of the identity-based encryption (IBE) system as a security measure. This system enables us to send encrypted and signed messages without requiring the receiver to get a public key, and it enables us to deliver secured messages to ambiguous receivers like those to whom letters of reference are sent. We evaluated the feasibility of this technology by using the analytic hierarchy process, which is an effective analysis tool when selection and judgment depend on nonquantitative psychological factors, to analyze the results of an experiment in which medical workers used E-mail agents with and without PKI and IBE. We found that medical practioners and researchers avoid using PKI because of its poor user-friendliness and instead use IBE even though it is harder to install. We therefore think IBE would encourage medical institutions to share patient records.

Algorithms↗
PubMed2002

Gross anatomy of network security.

Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

Computer Communication Networks↗
PubMed1988

Immunologic transfusion reactions.

ABO blood group incompatibility is of major concern because the antibodies frequently cause intravascular destruction leading to the most clinically severe complications. Irregular erythrocyte antibodies seldom cause intravascular destruction. However, when the antibodies bind complement and are present in high concentration the extravascular destruction occurs predominantly in the liver and may cause a clinically severe reaction with hemoglobinemia, shock and DIC. Those IgG class antibodies which do not bind complement cause a spleen-mediated, more or less drastically shortened life span of the red cells with unpleasant but usually not life threatening consequences for the patient. The transfusion reaction may occur with a delay of several days. Compatibility testing may consist of either a cross-match performed in such a way that both ABO incompatibility and irregular antibodies are detected, or a type-and-screen procedure. In the latter a computerized delivery control checking the patient's previous serological history and the donor/recipient compatibility is a recent improvement and rationalization. In an acute situation a reduction of the normal security measures may be necessary. The clinician responsible for the patient must know the time needed for carrying out an acute blood group determination and compatibility test in the hospital and must give instructions about what normal security measures that should be refrained from. Blood group incompatible transfusions have nowadays a much better prognosis than earlier, provided a rapid diagnosis can be made and appropriate treatment can be started promptly. Formation of antibodies against leukocyte/thrombocyte antigens is a frequent consequence of transfusion which, however, can be prevented by modern blood component therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

ABO Blood-Group System↗
PubMed2000

The utilization of a Midwifery Obstetrical Unit (MOU) in a Metropolitan area.

In this study an explorative, descriptive design which is contextual in nature, is utilized. The objective of the study is three-fold: Firstly, to describe the opinions of members of the community about the reasons for the under-utilization of the Midwifery Obstetrical Unit (MOU); secondly, to describe the suggestions of the community for improving the utilization of the MOU and thirdly, to describe intervention strategies for community nurses to improve the utilization of the MOU. Data was collected by means of focus group interviews, and was analysed using Tesch's (in Cresswell, 1994: 154-155) method of data analysis. Trustworthiness was ensured by using the method of Guba and Lincoln (1985). The respondents were mothers who delivered their babies at the hospital, mothers who delivered their babies at the MOU, members of the Community Health Committee and MOU nurses. Data was collected in two phases. Phase I dealt with the first question: What is your opinion about the reasons for the under-utilization of the MOU? Phase II dealt with the second question: What are your suggestions for improving the utilization of the MOU? The four groups participated in Phase I as well as in Phase II, the reason being to involve the groups in identifying problems and finding solutions with which they would be comfortable, since it would be their ideas. This whole exercise was, however, carried out in line with the RDP principle of people driven approach or community involvement. The investigation revealed that the community was not utilizing the MOU because of the following reasons: Negative attitudes of nurses. Lack of material and human resources. Poor safety and security measures. Lack of community involvement/participation. The focus groups then identified the following suggestions for improving the utilization of the MOU: Change of attitudes by nurses towards the patients. Availability of material and human resources. Proper safety and security measures in the MOU. Community involvement/participation. Integration of health services. Intervention strategies for community nurses to improve the utilization of the MOU were based on the literature as well as the suggestions made by the focus group respondents because the researcher found the suggestions to be realistic.

Attitude of Health Personnel↗
PubMed2003

Transmission security for single kinesthetic afferent fibers of joint origin and their target cuneate neurons in the cat.

Transmission between single identified, kinesthetic afferent fibers of joint origin and their central target neurons of the cuneate nucleus was examined in anesthetized cats by means of paired electrophysiological recording. Fifty-three wrist joint afferent-cuneate neuron pairs were isolated in which the single joint afferent fiber exerted suprathreshold excitatory actions on the target cuneate neuron. For each pair, the minimum kinesthetic input, a single spike, was sufficient to generate cuneate spike output, often amplified as a pair or burst of spikes, particularly at input rates up to 50-100 impulses per second. The high security was confirmed quantitatively by construction of stimulus-response relationships and calculation of transmission security measures in response to both static and dynamic vibrokinesthetic disturbances applied to the joint capsule. Graded stimulus-response relationships demonstrated that the output for this synaptic connection between single joint afferents and cuneate neurons could provide a sensitive indicator of the strength of joint capsule stimuli. The transmission security measures, calculated as the proportion of joint afferent spikes that generated cuneate spike output, were high (>85-90%) even at afferent fiber discharge rates up to 100-200 impulses per second. Furthermore, tight phase locking in the cuneate responses to vibratory stimulation of the joint capsule demonstrated that the synaptic linkage preserved, with a high level of fidelity, the temporal information about dynamic kinesthetic perturbations that affected the joint. The present study establishes that single kinesthetic afferents of joint origin display a capacity similar to that of tactile afferent fibers for exerting potent synaptic actions on central target neurons of the major ascending kinesthetic sensory pathway.

Afferent Pathways↗
PubMedDate not supplied

[Legal status of persons with mental illness in Serbia].

In this study, legal status of the mentally ill has been discussed in the context of Serbian legislation. The topics covered are the following: 1) the admission of persons with mental illness to psychiatric institution, 2) general (legal) competence, 3) marital relations of persons with mental illness, 4) legal definitions of sanity and security measures of medical character. Serbia still has no general law on mental health which would be in accordance with European standards, and the existing legislation which deals with the rights of persons with mental illness is, to a large extent, incomplete and obsolete. The author appeals for passing the law on mental health which should: a) follow modern trends in psychiatry concerning the protection of human rights with the basic goal to protect society and mentally ill persons, b) to protect the professional and moral integrity of psychiatrists, c) to provide ethically and professionally acceptable authorization for the use of force, if necessary, in order to prevent criminal acts and/or self-injuries in patients suffering from severe psychical disorders, d) to conceptualize forensic psychiatric treatment (the security measures, corrective psychiatry) and the programs of rehabilitation as an integral part of the community mental health protection system.

Commitment of Persons with Psychiatric Disorders↗
PubMed1986

A case for system security.

Mainframe security measures provided by the manufacturer, are adequate for normal security needs. However, a truly competent MIS security and/or hospital administration strategy must try to take advantage of the latest technological advancements as they become available. The integration of intelligent "dial-back" modems that "hang up" and then re-establish their communications link with a CRT terminal is now a requirement. However, finding a terminal with adequate stand-alone security devices is a different matter.

Computers↗
PubMed1995

[Transformations in the transition between work activity and retirement in Europe: new stakes for social security].

"The tendency towards early retreat from the work force observed in Europe over the past years can be attributed to social security measures other than old age security, and is not simply due to an advancing retirement age. Two programmes have been especially favoured for protecting ageing workers: disability insurance and unemployment insurance. Preretirement compensation packages have also facilitated the early departure of these workers from the labour force, whether employed or not. Such emerging models in the transition from work activity to retirement are revealing, both in terms of the social restructuring of the life cycle, and the overhaul of the social safety net. These transformations are analyzed in conclusion in relation with their potential role in new stakes for social security." (SUMMARY IN ENG AND SPA)

Developed Countries↗
PubMed2002

Security planning for the hospital library: protecting your information assets.

The hospital library has become a multi-service information center with a variety of costly resources. This article presents an overview of two important areas of hospital library security: access control and premises protection. It discusses access control policies, auditing of premises security, and implementing premises security measures.

Libraries, Hospital↗
PubMed1994

ED security: a national telephone survey.

To determine current practices regarding security measures in the emergency department (ED), a random sample of 250 hospitals with EDs was surveyed by telephone. Security issues addressed included personnel (in-house security, contract guards, or police), hours of staffing in the ED, how security is armed, whether ED doors are locked at off-hours, and whether alarm buttons, direct phone lines, a paging code, closed circuit surveillance, metal detectors, and seclusion rooms are used. This information was stratified according to hospital size, ED census, rural/suburban/urban setting, teaching/nonteaching status, and region. Generally, on-site security presence increases with increasing hospital size and ED census, suburban and urban locations, and teaching status. Small, rural hospitals are more likely to lock the ED doors at off-hours, whereas the use of security codes does not clearly follow demographic trends. Larger hospitals in suburban and urban settings and having a teaching status are more likely to have secure/detention rooms and closed circuit surveillance. The use of alarm buttons and/or direct telephone lines varies widely, but is generally more common in larger, teaching hospitals, located in urban and suburban settings.

Bed Occupancy↗
PubMed1987

From tangled webs to network integrity: computer security in hospital management. Part II.

This article is the second of two on the subject of computer security in hospital management in the first part, the authors dramatized the need for not only information security awareness but also the need for implementation of security measures to protect valuable information. This second article provides an overview of the components of a good computer security plan, contains a brief explanation of some of the new network security technology available today, and gives the reader several sources that can provide further information on information security.

Computer Communication Networks↗