Identity Concealment When Uploading Pictures of Patients in a Tele-Medicine System

Identity Concealment When Uploading Pictures of Patients in a Tele-Medicine System

Judith Jumig Azcarraga (De La Salle University, Manila, Philippines), John Zachary Raduban (National Telehealth Center, University of the Philippines, Manila, Philippines), Ma. Christine Gendrano (De La Salle University, Manila, Philippines) and Arnulfo P. Azcarraga (De La Salle University, Manila, Philippines)
Copyright: © 2019 |Pages: 19
DOI: 10.4018/IJEHMC.2019040103

Abstract

Tele-medicine systems run the risk of unauthorized access to medical records, and there is greater possibility for the unlawful sharing of sensitive patient information, including children, and possibly showing their private parts. Aside from violating their right to privacy, such practices discourage patients from subjecting themselves to tele-medicine. The authors thus present an automatic identity concealment system for pictures, the way it is designed in the GetBetter tele-medicine system developed under a WHO/TDR grant. Based on open-source face- and eye-detection algorithms, identity concealment is executed by blurring the eye region of a detected face using pixel shuffling. This method is shown to be not only effective in concealing the identity of the patient, but also in preserving the exact distribution of pixel values in the image. This is useful when subsequent image processing techniques are employed, such as when identifying the type of lesions based on images of the skin.
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Introduction

Technology has not only significantly influenced the discovery of new drugs and medicines, but has also altered the way patients are cared for. Indeed, the use of information and communications technology (ICT) in the various aspects of healthcare delivery has spawned a range of services and possibilities, under what is generally known as e-health (Rifat, 2004; Wootton et al., 2009).

E-health services are often classified into three broad areas, namely a) healthcare administration; b) training and education; and c) delivery of clinical care. Each of these areas of e-health is of a considerable range of sophistication, from those that involve very little ICT and automation, to those that are heavily dependent on the most advanced features and services that ICT can possibly deploy.

Healthcare administration involves the management of health-related information and resources, including logistics issues dealing with the deployment of doctors, monitoring of public health metrics, as well as automated systems and decision-support systems for hospitals, clinics, and other health institutions. At its core is the management of patient records (Geissbuhler, Bagayoko, & Ly, 2007; Marcelo, 2009). Indeed, central to all e-health services, even in education and training, and especially in the delivery of clinical care, is the use and the management of patient records. Education and training for doctors, nurses, midwives, as well as for health workers of varied levels of competencies, also deal with patient data. Patient cases are either used as actual test cases for training (as medical cases in lecture slides, for example), or may be used in the course of an actual on-the-job training where patient records are used as basis for assessment and management of live patients (Oliveira et al, 2002; Geissbuhler, Bagayoko, & Ly, 2007; Bediang, et al., 2015).

The increasing use of electronic information systems in healthcare provides a new set of challenges to the maintenance of patient confidentiality. Picture Archiving and Communication Systems (PACS) provide a centralized repository for all imaging data (Faggioni, 2011) and deliver diagnostic images (e.g., x-rays, CT scans, MRI scans) and radiology reports electronically to clinicians at the point-of-care. Confidentiality in PACS and associated Radiology Information Systems (RIS) must be maintained on the same basis as any other aspect of the practice of medicine. Standards for patient confidentiality in RIS and PACS aim to clearly define how patient confidentiality should be maintained with specific regard to the use of PACS. Readers may refer to the following URL for the standards of the Royal College of Radiologists for the standards on the confidentiality of patient records in the United Kingdom: http://www.hhs.gov/ocr/hipaa).

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