Electrical Engineering Department, National Taiwan University, Taipei, Taiwan.
J Med Syst. 2012 Jun;36(3):1009-20. doi: 10.1007/s10916-010-9563-3. Epub 2010 Jul 29.
Electronic anamnesis is to transform ordinary paper trails to digitally formatted health records, which include the patient's general information, health status, and follow-ups on chronic diseases. Its main purpose is to let the records could be stored for a longer period of time and could be shared easily across departments and hospitals. Which means hospital management could use less resource on maintaining ever-growing database and reduce redundancy, so less money would be spent for managing the health records. In the foreseeable future, building up a comprehensive and integrated medical information system is a must, because it is critical to hospital resource integration and quality improvement. If mobile agent technology is adopted in the electronic anamnesis system, it would help the hospitals to make the medical practices more efficiently and conveniently. Nonetheless, most of the hospitals today are still using paper-based health records to manage the medical information. The reason why the institutions continue using traditional practices to manage the records is because there is no well-trusted and reliable electronic anamnesis system existing and accepted by both institutions and patients. The threat of privacy invasion is one of the biggest concerns when the topic of electronic anamnesis is brought up, because the security threats drag us back from using such a system. So, the medical service quality is difficult to be improved substantially. In this case, we have come up a theory to remove such security threats and make electronic anamnesis more appealing for use. Our theory is to integrate the mobile agent technology with the backbone of electronic anamnesis to construct a hierarchical access control system to retrieve the corresponding information based upon the permission classes. The system would create a classification for permission among the users inside the medical institution. Under this framework, permission control center would distribute an access key to each user, so they would only allow using the key to access information correspondingly. In order to verify the reliability of the proposed system framework, we have also conducted a security analysis to list all the possible security threats that may harm the system and to prove the system is reliable and safe. If the system is adopted, the doctors would be able to quickly access the information while performing medical examinations. Hence, the efficiency and quality of healthcare service would be greatly improved.
电子病历是将普通纸质病历转化为数字化的健康记录,其中包括患者的一般信息、健康状况和慢性病随访。其主要目的是让记录能够保存更长时间,并能够在部门和医院之间轻松共享。这意味着医院管理可以减少维护不断增长的数据库的资源,并减少冗余,从而减少管理健康记录的费用。在可预见的未来,建立一个全面和综合的医疗信息系统是必要的,因为这对医院资源整合和质量改进至关重要。如果在电子病历系统中采用移动代理技术,将有助于医院更高效、更便捷地开展医疗实践。然而,当今大多数医院仍在使用纸质健康记录来管理医疗信息。医疗机构继续使用传统方法来管理记录的原因是,没有一个值得信赖和可靠的电子病历系统被机构和患者所接受。隐私侵犯的威胁是引入电子病历时最大的关注点之一,因为安全威胁阻碍了我们使用这样的系统。因此,医疗服务质量很难得到实质性的提高。在这种情况下,我们提出了一种理论来消除这种安全威胁,使电子病历更具吸引力。我们的理论是将移动代理技术与电子病历的骨干结合起来,构建一个分层访问控制系统,根据权限级别检索相应的信息。该系统将在医疗机构内部的用户之间创建权限分类。在这个框架下,权限控制中心将为每个用户分配一个访问密钥,以便他们只能使用密钥相应地访问信息。为了验证所提出的系统框架的可靠性,我们还进行了安全分析,列出了可能危害系统的所有安全威胁,并证明了系统是可靠和安全的。如果系统被采用,医生在进行医疗检查时将能够快速访问信息。因此,医疗服务的效率和质量将得到极大提高。