Background: Information and communication technology (ICT) has transformed the health care field worldwide. One of the main drivers of this change is the electronic health record (EHR). However, there are still open issues and challenges because the EHR usually reflects the partial view of a health care provider without the ability for patients to control or interact with their data. Furthermore, with the growth of mobile and ubiquitous computing, the number of records regarding personal health is increasing exponentially. This movement has been characterized as the Internet of Things (IoT), including the widespread development of wearable computing technology and assorted types of health-related sensors. This leads to the need for an integrated method of storing health-related data, defined as the personal health record (PHR), which could be used by health care providers and patients. This approach could combine EHRs with data gathered from sensors or other wearable computing devices. This unified view of patients’ health could be shared with providers, who may not only use previous health-related records but also expand them with data resulting from their interactions. Another PHR advantage is that patients can interact with their health data, making decisions that may positively affect their health. Objective: This work aimed to explore the recent literature related to PHRs by defining the taxonomy and identifying challenges and open questions. In addition, this study specifically sought to identify data types, standards, profiles, goals, methods, functions, and architecture with regard to PHRs. Methods: The method to achieve these objectives consists of using the systematic literature review approach, which is guided by research questions using the population, intervention, comparison, outcome, and context (PICOC) criteria. Results: As a result, we reviewed more than 5000 scientific studies published in the last 10 years, selected the most significant approaches, and thoroughly surveyed the health care field related to PHRs. We developed an updated taxonomy and identified challenges, open questions, and current data types, related standards, main profiles, input strategies, goals, functions, and architectures of the PHR. Conclusions: All of these results contribute to the achievement of a significant degree of coverage regarding the technology related to PHRs. [J Med Internet Res 2017;19(1):e13]

Personal Health Records: A Systematic Literature Review

https://epub.uni-regensburg.de/21886/1/computer_sec.pdf

Roles in information security - A survey and classification of the research area

The existing literature in relation to electronic personal health records (PHRs) has typically focused on the discussion of several key issues—namely, their design, functional evaluation, privacy, security and architecture The benefits of PHRs and barriers preventing their adoption are also widely discussed These issues are affected by technology infrastructure, and current and planned technology infrastructure deployment will be key determinants in the selection and design of PHR architectures Assumptions about the community-wide deployment of required technologies such as hardware and internet accessibility are implicit in the architectural selection of PHRs and these dependencies have not been fully appreciated or addressed in the existing literature This review article introduces and describes two infrastructural drivers—ubiquitous technology baseline for PHRs and connectivity coverage—and examines their inter-relationships with the selected PHR architectures Eleven functional capabilities are also described, providing a basis for the analysis of the relationships between the two infrastructural drivers and architectural selection © 2012 Wiley Periodicals, Inc

https://onlinelibrary.wiley.com/doi/pdf/10.1002/asi.22635

Personal health record architectures: Technology infrastructure implications and dependencies

Significant benefits arise from being able to capture dietary or nutritional intake information automatically or semi-automatically. These include the ability for individuals to know and understand their nutritional intake and hence improve their diet and health. To date, only highly manual processes such as 24-hour recall, food diaries, and food journals have been utilized which have been overly cumbersome for widespread adoption. Emerging informatics, computer vision, mobile computing, and sensor-based approaches are likely to play a role in further automating the capture of dietary intake information and these are becoming increasingly utilizable through such advents as the rapid and ubiquitous uptake of smartphones with built-in digital cameras and other sensors. In this paper, we review the state of the art of technologies for automatic capture of dietary intake information and identify significant outstanding research problems and promising directions.

An overview of the state of the art of automated capture of dietary intake information.

The information and communication technology infrastructure available in rural and remote areas may often not have the bandwidth to support all types of telehealth applications; therefore, for example, some traditionally envisaged videoconferencing-based telehealth applications may not be able to be used or not used in their anticipated form at this time. While the level of broadband services available may impose limitations on these types of telehealth applications, in this review article, we identify applications that allow the maximizing of telehealth benefits in the presence of low-bandwidth connectivity and have potential benefits well-matched to rural and remote area healthcare challenges. In particular, we include consideration of how ubiquitous computing might potentially bring non-traditional approaches to telehealth that can also come into usage more immediately in bandwidth-constrained rural and regional areas. In this article, we review the benefits of ubiquitous computing for rural and remote telehealth including social media-based preventative, peer support and public health communication, mobile phone platforms for the detection and notification of emergencies, wearable and ambient biosensors, the utilization of personal health records including in conjunction with mobile and sensor platforms, chronic condition care and management information systems, and mobile device---enabled video consultation.

Telehealth and ubiquitous computing for bandwidth-constrained rural and remote areas

At present, emerging possibilities for patients to access their health records or health information may potentially lead to changes within the current health care delivery system from an institution-centered to a patient-centered model and an electronic personal health record (PHR) may greatly influence such a shift. However, the use of PHRs does introduce specific challenges in terms of accidental disclosure of or malicious access to an individual’s health data. Hence a high level of security for data access is required due to the sensitivity and confidentiality of the health data in PHRs. In this paper, we present extensible models for defining and configuring fine-grained, role-based access control policies for XML-based portable personal health records using an extended digital certificate approach, called HealthPass which enables flexible and dynamic interactions without using a classical authorization and authentication approach like username and password.

HealthPass: Fine-Grained Access Control to Portable Personal Health Records

Electronic health information systems (e.g. health record systems, clinical information systems) can assist in the provision of better health care services for patients and help doctors and other health care workers treat and diagnose patients more effectively and efficiently. One of the most important issues in health-related information systems is high information security and stringent access control for patient's health data to protect the patient's privacy and to prevent the use of data harmfully or illegally. Carrying health records with a patient, for example in a personal digital assistant (PDA) or a mobile phone, could provide greater control of the patient's health data and privacy. It can also facilitate exchanging this health data with health care workers at the point of care and only to the level desired. In this paper, we propose a portable personal electronic health record architecture which natively supports a greater level of privacy using an extended digital certificate- based approach. Other challenges to security accompanying a portable device-based approach are also considered.

Role-Based Access To Portable Personal Health Records

A common use of micro-blogging systems, such as Twitter, is to ‘tweet’ or ‘re-tweet’ URLs of the latest news articles. The challenge is that with the large number of such micro-blog posts, it is difficult to find and filter to just the most relevant news for an individual. In this paper, we propose and detail the health news feed system which utilises a three-stage filtering and categorisation process with three types of knowledge resources using natural language processing (NLP) technologies for filtering and extracting personally-relevant health-related news articles referred to in tweets. The three stages are term-based filtering, content filtering, and categorization.

Health news feed: Identifying personally relevant health-related URLs in tweets

Members of the health care workforce and health care practitioner organizations are amongst those who make use of micro-blogging services such as Twitter, to share news and updates. In this paper we propose a system to gauge across the health system and in particular in relation to the practitioners whom make use of this media system, based upon URLs tweeted and shared, what are the current topics of interest and perspectives. In this way, the proposed system enables new abilities for gathering insights into the real-time, system-wide status of a health industry, for example, the most frequently occurring themes or the most frequently health-related URLs shared by the health systems workforce.

Kyongho Min

Papers

Personal health record architectures: Technology infrastructure implications and dependencies

HealthPass: Fine-Grained Access Control to Portable Personal Health Records

Role-Based Access To Portable Personal Health Records

Health news feed: Identifying personally relevant health-related URLs in tweets

Health system zeitgeist: How tweets can provide real-time insight into the health system