Security Engineering of Patient-Centered Health Care Information Systems in Peer-to-Peer Environments: Systematic Review

Background Patient-centered health care information systems (PHSs) enable patients to take control and become knowledgeable about their own health, preferably in a secure environment. Current and emerging PHSs use either a centralized database, peer-to-peer (P2P) technology, or distributed ledger technology for PHS deployment. The evolving COVID-19 decentralized Bluetooth-based tracing systems are examples of disease-centric P2P PHSs. Although using P2P technology for the provision of PHSs can be flexible, scalable, resilient to a single point of failure, and inexpensive for patients, the use of health information on P2P networks poses major security issues as users must manage information security largely by themselves. Objective This study aims to identify the inherent security issues for PHS deployment in P2P networks and how they can be overcome. In addition, this study reviews different P2P architectures and proposes a suitable architecture for P2P PHS deployment. Methods A systematic literature review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. Thematic analysis was used for data analysis. We searched the following databases: IEEE Digital Library, PubMed, Science Direct, ACM Digital Library, Scopus, and Semantic Scholar. The search was conducted on articles published between 2008 and 2020. The Common Vulnerability Scoring System was used as a guide for rating security issues. Results Our findings are consolidated into 8 key security issues associated with PHS implementation and deployment on P2P networks and 7 factors promoting them. Moreover, we propose a suitable architecture for P2P PHSs and guidelines for the provision of PHSs while maintaining information security. Conclusions Despite the clear advantages of P2P PHSs, the absence of centralized controls and inconsistent views of the network on some P2P systems have profound adverse impacts in terms of security. The security issues identified in this study need to be addressed to increase patients’ intention to use PHSs on P2P networks by making them safe to use.

ContSOnto: A Formal Ontology for Continuity of Care

The global pandemic over the past two years has reset societal agendas by identifying both strengths and weaknesses across all sectors. Focusing in particular on global health delivery, the ability of health care facilities to scale requirements and to meet service demands has detected the need for some national services and organisations to modernise their organisational processes and infrastructures. Core to requirements for modernisation is infrastructure to share information, specifically structural standardised approaches for both operational procedures and terminology services. Problems of data sharing (aka interoperability) is a main obstacle when patients are moving across healthcare facilities or travelling across border countries in cases where emergency treatment is needed. Experts in healthcare service delivery suggest that the best possible way to manage individual care is at home, using remote patient monitoring which ultimately reduces cost burden both for the citizen and service provider. Core to this practice will be advancing digitalisation of health care underpinned with safe integration and access to relevant and timely information. To tackle the data interoperability issue and provide a quality driven continuous flow of information from different health care information systems semantic terminology needs to be provided intact. In this paper we propose and present ContSonto a formal ontology for continuity of care based on ISO 13940:2015 ContSy and W3C Semantic Web Standards Language OWL (Web Ontology Language). ContSonto has several benefits including semantic interoperability, data harmonization and data linking. It can be use as a base model for data integration for different healthcare information models to generate knowledge graph to support shared care and decision making.

Security Engineering of Patient-Centered Health Care Information Systems in Peer-to-Peer Environments: Systematic Review (Preprint)

BACKGROUND Patient-centered health care information systems (PHSs) enable patients to take control and become knowledgeable about their own health, preferably in a secure environment. Current and emerging PHSs use either a centralized database, peer-to-peer (P2P) technology, or distributed ledger technology for PHS deployment. The evolving COVID-19 decentralized Bluetooth-based tracing systems are examples of disease-centric P2P PHSs. Although using P2P technology for the provision of PHSs can be flexible, scalable, resilient to a single point of failure, and inexpensive for patients, the use of health information on P2P networks poses major security issues as users must manage information security largely by themselves. OBJECTIVE This study aims to identify the inherent security issues for PHS deployment in P2P networks and how they can be overcome. In addition, this study reviews different P2P architectures and proposes a suitable architecture for P2P PHS deployment. METHODS A systematic literature review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. Thematic analysis was used for data analysis. We searched the following databases: IEEE Digital Library, PubMed, Science Direct, ACM Digital Library, Scopus, and Semantic Scholar. The search was conducted on articles published between 2008 and 2020. The Common Vulnerability Scoring System was used as a guide for rating security issues. RESULTS Our findings are consolidated into 8 key security issues associated with PHS implementation and deployment on P2P networks and 7 factors promoting them. Moreover, we propose a suitable architecture for P2P PHSs and guidelines for the provision of PHSs while maintaining information security. CONCLUSIONS Despite the clear advantages of P2P PHSs, the absence of centralized controls and inconsistent views of the network on some P2P systems have profound adverse impacts in terms of security. The security issues identified in this study need to be addressed to increase patients’ intention to use PHSs on P2P networks by making them safe to use.

Smart healthcare

Purpose The aim of this paper is to identify some of the challenges that need to be addressed to accelerate the deployment and adoption of smart health technologies for ubiquitous healthcare access. The paper also explores how internet of things (IoT) and big data technologies can be combined with smart health to provide better healthcare solutions. Design/methodology/approach The authors reviewed the literature to identify the challenges which have slowed down the deployment and adoption of smart health. Findings The authors discussed how IoT and big data technologies can be integrated with smart health to address some of the challenges to improve health-care availability, access and costs. Originality/value The results of this paper will help health-care designers, professionals and researchers design better health-care information systems.