Towards unobtrusive patient‐centric access‐control for Health Information System

Author(s):  
Marcelo Antonio Carvalho Junior ◽  
Paulo Bandiera‐Paiva
2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Marcelo Antonio de Carvalho Junior ◽  
Paulo Bandiera-Paiva

Objective. This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. Method. We have selected articles related to our investigation theme “RBAC trends and limitations” in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: “Role-Based Access Control” OR “RBAC” AND “Health information System” OR “EHR” AND “Trends” OR “Challenges” OR “Security” OR “Authorization” OR “Attacks” OR “Permission Assignment” OR “Permission Relation” OR “Permission Mapping” OR “Constraint”. We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. Results. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Conclusion. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.


2018 ◽  
Vol 8 (10) ◽  
Author(s):  
Keith Horvath ◽  
◽  
Patricia Sengstack ◽  
Frank Opelka ◽  
Andrea Borondy Kitts ◽  
...  

Cardiology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Aziez Ahmed ◽  
Parthak Prodhan ◽  
Beverly J. Spray ◽  
Elijah H. Bolin

Introduction: Tachydysrhythmias (TDS) frequently occur after complete repair of tetralogy of Fallot (TOF). However, not much is known about the effect of TDS on morbidity and mortality after TOF repair. We sought to assess the associations between TDS and mortality and morbidity after repair of TOF using a multicentre database. Materials and Methods: We identified all children aged 0–5 years in the Pediatric Health Information System who underwent TOF repair between 2004 and 2015. Codes for TDS were used to identify cases. Outcome variables were inpatient mortality and total length of stay (LOS). Univariate and multiple logistic and linear regression analyses were used to identify the effects of multiple risk factors, including TDS, on mortality and LOS. Results: A total of 7,749 patients met inclusion criteria, of which 1,493 (19%) had codes for TDS. There was no association between TDS and inpatient mortality. However, TDS were associated with 1.1 days longer LOS and accounted for 2% of the variation observed in LOS. Conclusion: After complete repair of TOF, TDS were not associated with mortality and appeared to have only a modest effect on LOS.


2021 ◽  
pp. 019459982110298
Author(s):  
Chengetai Mahomva ◽  
Yi-Chun Carol Liu ◽  
Nikhila Raol ◽  
Samantha Anne

Objective To determine the incidence of auditory neuropathy spectrum disorder (ANSD) and its risk factors among the neonatal intensive care unit (NICU) population from 2009 to 2018 in the Pediatric Health Information System database. Study Design Retrospective national database review. Setting Population-based study. Methods The Pediatric Health Information System database was queried to identify patients ≤18 years old with NICU admission and ANSD diagnosis. Patient demographics, jaundice diagnosis, use of mechanical ventilation, extracorporeal membrane oxygenation, furosemide, and/or aminoglycosides were extracted. Multivariable linear regression was used to assess trends in incidence. Chi-square analysis was used to assess differences between patients with and without ANSD. Logistic regression was used to assess factors associated with ANSD. Results From 2009 to 2018, there was an increase in (1) NICU admissions from 14,079 to 24,851 ( P < .001), (2) total ANSD diagnoses from 92 to 1847 ( P = .001), and (3) annual total number of patients with ANSD and NICU admission increased from 4 to 16 ( P = .005). There was strong correlation between the increases in total number of NICU admissions and total ANSD diagnoses over time ( R = 0.76). The average ANSD incidence was 0.052% with no statistically significant change over 10 years. When compared with all NICU admissions, children with ANSD had a higher association with use of furosemide ( P < .001) and ventilator ( P < .001). Conclusion Despite a statistically significant increase in NICU admissions and total ANSD diagnosis, the incidence of ANSD in the NICU population has not increased from 2009 to 2018. Furosemide and mechanical ventilator use were associated with increased likelihood of ANSD.


Author(s):  
Anuchit Nirapai ◽  
Jittarporn Somchue ◽  
Pongsiri Chaikot ◽  
Nipa Kimsungnoen ◽  
Manas Sangworasil ◽  
...  

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