Yesmin Tahera, Carter Michael W
Center for Healthcare Engineering, Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada.
Int J Med Inform. 2020 Jun;138:104123. doi: 10.1016/j.ijmedinf.2020.104123. Epub 2020 Mar 24.
We aim to 1) design an evaluation framework to examine the accuracy of automatic privacy auditing tools, 2) apply the evaluation method at a hospital to validate the performance of an auditing tool that uses a machine learning algorithm to automate user access auditing, and 3) recommend further improvements in auditing for the hospital.
Using the black box method of user acceptance testing, we have designed an evaluation framework consisting of appropriate and inappropriate behaviour scenarios to examine the privacy auditing tools. The scenarios were designed from clinical and non-clinical hospital staff perspective, taking expert opinions from the privacy officers and considering examples from the Information and Privacy Commission (IPC) and were tested using Mackenzie Richmond Hill Hospital's data.
The case study using this evaluation framework found that on average 98.09 % of total accesses of the hospital were identified as appropriate and the tool was unable to explain the remaining 1.91 % of accesses. In addition, a statistically significant (P < 0.05) increasing trend on categorizing appropriate accesses by the tool have been observed. Furthermore, an analysis of unexplained accesses revealed the contributing factors and found issues related to hospital workflows and data quality (information was missing about staff roles and departments).
Given that adoption of these machine learning tools is increasing in hospitals, this research provides an evaluation framework and an empirical evidence on the effectiveness of automated privacy auditing and detecting anomalies for dynamic hospital workflows.
我们旨在1)设计一个评估框架,以检验自动隐私审计工具的准确性;2)在一家医院应用该评估方法,以验证一种使用机器学习算法实现用户访问审计自动化的审计工具的性能;3)为该医院的审计工作提出进一步改进建议。
我们采用用户接受度测试的黑盒方法,设计了一个由适当和不适当行为场景组成的评估框架,用于检验隐私审计工具。这些场景是从医院临床和非临床工作人员的角度设计的,征求了隐私专员的专家意见,并参考了信息与隐私委员会(IPC)的示例,使用麦肯齐列治文山医院的数据进行了测试。
使用该评估框架的案例研究发现,该医院平均98.09%的访问被判定为适当,而该工具无法解释其余1.91%的访问。此外,观察到该工具在对适当访问进行分类方面存在统计学上显著的(P<0.05)上升趋势。此外,对无法解释的访问进行的分析揭示了促成因素,并发现了与医院工作流程和数据质量相关的问题(缺少有关员工角色和部门的信息)。
鉴于医院中这些机器学习工具的采用率不断提高,本研究提供了一个评估框架以及关于自动化隐私审计和检测动态医院工作流程异常情况有效性的实证证据。