Huckvale Kit, Prieto José Tomás, Tilney Myra, Benghozi Pierre-Jean, Car Josip
Global eHealth Unit, Imperial College London, Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
CRG, Ecole polytechnique CNRS, Bâtiment Ensta, 828 boulevard des Maréchaux, Palaiseau, Cedex, 91762, France.
BMC Med. 2015 Sep 7;13:214. doi: 10.1186/s12916-015-0444-y.
Poor information privacy practices have been identified in health apps. Medical app accreditation programs offer a mechanism for assuring the quality of apps; however, little is known about their ability to control information privacy risks. We aimed to assess the extent to which already-certified apps complied with data protection principles mandated by the largest national accreditation program.
Cross-sectional, systematic, 6-month assessment of 79 apps certified as clinically safe and trustworthy by the UK NHS Health Apps Library. Protocol-based testing was used to characterize personal information collection, local-device storage and information transmission. Observed information handling practices were compared against privacy policy commitments.
The study revealed that 89% (n = 70/79) of apps transmitted information to online services. No app encrypted personal information stored locally. Furthermore, 66% (23/35) of apps sending identifying information over the Internet did not use encryption and 20% (7/35) did not have a privacy policy. Overall, 67% (53/79) of apps had some form of privacy policy. No app collected or transmitted information that a policy explicitly stated it would not; however, 78% (38/49) of information-transmitting apps with a policy did not describe the nature of personal information included in transmissions. Four apps sent both identifying and health information without encryption. Although the study was not designed to examine data handling after transmission to online services, security problems appeared to place users at risk of data theft in two cases.
Systematic gaps in compliance with data protection principles in accredited health apps question whether certification programs relying substantially on developer disclosures can provide a trusted resource for patients and clinicians. Accreditation programs should, as a minimum, provide consistent and reliable warnings about possible threats and, ideally, require publishers to rectify vulnerabilities before apps are released.
健康应用程序中存在信息隐私保护不力的问题。医疗应用程序认证计划为确保应用程序质量提供了一种机制；然而，对于它们控制信息隐私风险的能力却知之甚少。我们旨在评估已获认证的应用程序在多大程度上符合由最大的国家认证计划所规定的数据保护原则。
对英国国民健康服务体系（NHS）健康应用程序库认证为临床安全可靠的79款应用程序进行为期6个月的横断面系统评估。基于协议的测试用于描述个人信息收集、本地设备存储和信息传输情况。将观察到的信息处理做法与隐私政策承诺进行比较。
研究显示，89%（n = 70/79）的应用程序将信息传输到在线服务。没有应用程序对本地存储的个人信息进行加密。此外，66%（23/35）通过互联网发送识别信息的应用程序未使用加密，20%（7/35）没有隐私政策。总体而言，67%（53/79）的应用程序有某种形式的隐私政策。没有应用程序收集或传输政策明确表示不会收集或传输的信息；然而，78%（38/49）有政策的信息传输应用程序没有描述传输中包含的个人信息的性质。四款应用程序在未加密的情况下同时发送识别信息和健康信息。尽管该研究并非旨在检查传输到在线服务后的数据处理情况，但在两起案例中，安全问题似乎使用户面临数据被盗的风险。
经认证的健康应用程序在遵守数据保护原则方面存在系统性差距，这让人质疑主要依赖开发者披露的认证计划是否能为患者和临床医生提供可信赖的资源。认证计划至少应就可能的威胁提供一致且可靠的警告，理想情况下，要求发布者在应用程序发布前修复漏洞。
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