EHR - Revision history

Tom: /* Errors and Omissions with EHR */

2023-11-21T04:28:39Z

‎Errors and Omissions with EHR

Tom: /* Solutions */

2021-12-23T00:07:57Z

‎Solutions

Tom: /* References */

2021-12-22T23:55:24Z

‎References

Tom: /* References */

2021-12-22T18:45:17Z

‎References

Tom: /* Sloppy Security */

2021-12-21T20:13:17Z

‎Sloppy Security

Tom: /* Sloppy Security */

2021-12-21T20:11:23Z

‎Sloppy Security

Tom: /* Sloppy Security */

2021-12-21T20:09:43Z

‎Sloppy Security

Tom: /* Conduct Risk with EHR */

2021-12-21T20:08:55Z

‎Conduct Risk with EHR

Tom: /* Conduct Risk with EHR */

2021-02-16T22:52:05Z

‎Conduct Risk with EHR

Tom: /* Conduct Risk with EHR */

2019-10-08T00:26:51Z

‎Conduct Risk with EHR

@@ Line 12: / Line 12: @@
 ===Errors and Omissions with EHR===
-The advent of [[EHR]] has introduced new problems that create new risd of legal liability for the holders of the data.
+The advent of [[EHR]] has introduced new problems that create new risk of legal liability for the holders of the data.
 * Not all information in the record is valid but entered just to assure that the payment for services will be rendered, or because it is easier to cut and paste or blindly click "OK".<ref>Fred N. Pelzman, ''Just because EMRs can document everything doesn’t mean they should'' (2019-08-29) https://www.kevinmd.com/blog/2019/08/just-because-emrs-can-document-everything-doesnt-mean-they-should.html</ref>
 * Information that is entered by the Physician may not make it to the correct service to assure action. This type of failure has already resulted in patient deaths.<ref>Kaiser Health News Summary, ''Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.'' https://khn.org/news/death-by-a-thousand-clicks/</ref> The U.S. government claimed that turning American medical charts into electronic records would make health care better, safer and cheaper. Ten years and $36 billion later, the system is an unholy mess. <ref>Fred Schulte and Erika Fry, ''Inside a digital revolution that took a bad turn.'' Fortune (2019-03-18)</ref>

@@ Line 46: / Line 46: @@
 ==Solutions==
 # Follow the wiki page on [[HIPAA Compliance Checklist]]
-# Try to fallow the US Government Regulations
+# Try to fallow the US Government Regulations on a Standardized API for patient and population services
+  '''Table for Privacy and Security'''
 * If choosing Approach 1:
 ** Authentication, access control, and authorization (§ 170.315(d)(1))
@@ Line 60: / Line 58: @@
 https://www.healthit.gov/test-method/standardized-api-patient-and-population-services#ccg
 ==References==

← Older revision		Revision as of 23:55, 22 December 2021
Line 43:		Line 43:

	Tapio says that Finland’s “supervisory authorities” then signed off on the system “numerous times” in the years ahead. Härkönen, who is one of those authorities, says that to monitor all the Class B systems carefully would be “mission impossible” for him. He adds, however, that there should be more “proactive inspections.”</blockquote>		Tapio says that Finland’s “supervisory authorities” then signed off on the system “numerous times” in the years ahead. Härkönen, who is one of those authorities, says that to monitor all the Class B systems carefully would be “mission impossible” for him. He adds, however, that there should be more “proactive inspections.”</blockquote>
		+
		+	==Solutions==
		+	# Follow the wiki page on [[HIPAA Compliance Checklist]]
		+	# Try to fallow the US Government Regulations
		+
		+	Standardized API for patient and population services
		+	Table for Privacy and Security
		+	* If choosing Approach 1:
		+	** Authentication, access control, and authorization (§ 170.315(d)(1))
		+	** Trusted connection (§ 170.315(d)(9))
		+	** Either Auditable events and tamper-resistance (§ 170.315(d)(2)) or [https://www.healthit.gov/test-method/auditing-actions-health-information Auditing actions on health information (§ 170.315(d)(10))].
		+	** Encrypt authentication credentials (§ 170.315(d)(12))
		+	**Multi-factor authentication (MFA) (§ 170.315(d)(13))
		+	* If choosing Approach 2:
		+	** For each applicable privacy and security certification criterion not certified for Approach 1, the health IT developer may certify using system documentation which is sufficiently detailed to enable integration such that the Health IT Module has implemented service interfaces to access external services necessary to meet the requirements of the privacy and security certification criterion. Please see the ONC Cures Act Final Rule at 85 FR 25710 for additional clarification
		+
		+	https://www.healthit.gov/test-method/standardized-api-patient-and-population-services#ccg
		+

	==References==		==References==

@@ Line 46: / Line 46: @@
 ==References==
 <references />
 *See the wiki page on [[Medical Records Identifier]].
 [[Category:Glossary]]
 [[Category:Health]]

@@ Line 26: / Line 26: @@
 In the US health records are protected by HIPAA. Some other countries have special protection for health records, but not all. Even the countries where laws exist, security can be suboptimal. The consequences of Sloppy Security in Healthcare can be catastrophic for the patients.
-Consider this exploit of [https://www.wired.com/story/vastaamo-psychotherapy-patients-hack-data-breach/ Mental Health Records in Finland.] <blockquote>Rather than use an existing system, the company designed its own. It launched in late 2012, around the same time Vastaamo’s first in-person clinic opened, in the Malmi district of Helsinki. Tapio wouldn’t go into technical detail about the system, but in court documents he suggests it was browser-based and stored patients’ records on a MySQL server. More important for Vastaamo’s purposes, the interface was easy to use. When therapists applied for a job at the company, they heard all about how much it would quicken their work.
+Consider this exploit of [https://www.wired.com/story/vastaamo-psychotherapy-patients-hack-data-breach/ Mental Health Records in Finland.] (Wired 2021-05-04)<blockquote>Rather than use an existing system, the company designed its own. It launched in late 2012, around the same time Vastaamo’s first in-person clinic opened, in the Malmi district of Helsinki. Tapio wouldn’t go into technical detail about the system, but in court documents he suggests it was browser-based and stored patients’ records on a MySQL server. More important for Vastaamo’s purposes, the interface was easy to use. When therapists applied for a job at the company, they heard all about how much it would quicken their work.
 But the slick exterior concealed deep vulnerabilities. Mikael Koivukangas, head of R&D at a Finnish medtech firm called Onesys Medical, points out that Vastaamo’s system violated one of the “first principles of cybersecurity”: It didn’t anonymize the records. It didn’t even encrypt them. The only thing protecting patients’ confessions and confidences were a couple of firewalls and a server login screen. Anyone with experience in the field, Koivukangas says, could’ve helped Vastaamo design a safer system.

← Older revision		Revision as of 20:09, 21 December 2021
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	Consider this exploit of [https://www.wired.com/story/vastaamo-psychotherapy-patients-hack-data-breach/ Mental Health Records in Finland. <blockquote>Rather than use an existing system, the company designed its own. It launched in late 2012, around the same time Vastaamo’s first in-person clinic opened, in the Malmi district of Helsinki. Tapio wouldn’t go into technical detail about the system, but in court documents he suggests it was browser-based and stored patients’ records on a MySQL server. More important for Vastaamo’s purposes, the interface was easy to use. When therapists applied for a job at the company, they heard all about how much it would quicken their work.		Consider this exploit of [https://www.wired.com/story/vastaamo-psychotherapy-patients-hack-data-breach/ Mental Health Records in Finland. <blockquote>Rather than use an existing system, the company designed its own. It launched in late 2012, around the same time Vastaamo’s first in-person clinic opened, in the Malmi district of Helsinki. Tapio wouldn’t go into technical detail about the system, but in court documents he suggests it was browser-based and stored patients’ records on a MySQL server. More important for Vastaamo’s purposes, the interface was easy to use. When therapists applied for a job at the company, they heard all about how much it would quicken their work.
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	But the slick exterior concealed deep vulnerabilities. Mikael Koivukangas, head of R&D at a Finnish medtech firm called Onesys Medical, points out that Vastaamo’s system violated one of the “first principles of cybersecurity”: It didn’t anonymize the records. It didn’t even encrypt them. The only thing protecting patients’ confessions and confidences were a couple of firewalls and a server login screen. Anyone with experience in the field, Koivukangas says, could’ve helped Vastaamo design a safer system.		But the slick exterior concealed deep vulnerabilities. Mikael Koivukangas, head of R&D at a Finnish medtech firm called Onesys Medical, points out that Vastaamo’s system violated one of the “first principles of cybersecurity”: It didn’t anonymize the records. It didn’t even encrypt them. The only thing protecting patients’ confessions and confidences were a couple of firewalls and a server login screen. Anyone with experience in the field, Koivukangas says, could’ve helped Vastaamo design a safer system.

@@ Line 23: / Line 23: @@
 * Sharing information that the patient did not want to share.
 * Avoiding sharing information because of bad choices by the Patient.
 ==References==

@@ Line 17: / Line 17: @@
 ===Conduct Risk with EHR===
-The push by the US government Health and Human Services(HHS), Office of the National Coordinator (ONC)<ref>The Sequoia Project Is ONC’s
+The push by the US government Health and Human Services([[HHS]]), Office of the National Coordinator (ONC)<ref>The Sequoia Project Is ONC’s
 Recognized Coordinating Entity (RCE) https://rce.sequoiaproject.org/</ref>  for [[Health Information Exchange]] has created an infrastructure that could disappoint the patients in many new ways.
 * The HIE looks like just another instance of the credit bureaus, and we all know how well that worked out.