Privacy and Security in e-Health Applications

Digital Health Records: Current Situation And Trends

To reduce cost and improve accuracy there is a pressure on healthcare providers to start managing and sharing patient information in digital form. This implies a revolution in the way health information is managed. Paper-based records are becoming obsolete as with the increasing complexity of the healthcare system the paper systems cannot fulfill the complicated requirements and ensure that the right information is available at the point of care when needed. Therefore, digital records are increasingly used within hospitals in departmental information systems (DIS) as well as at the hospital level in hospital information systems (HIS). However, the use of digital records will go beyond the walls of the hospital. General practitioners (GP), pharmacies, remote patient monitoring systems and other home e-Health services are increasingly using them.

In this section, we give an overview of digital health records and describe two main purposes they have: (i) to serve healthcare providers and (ii) to empower the patient/consumer. To make the differences clear, we describe the architecture of a national/regional EHR system, as well as an example of a PHR system. However, there are a number of dedicated services such as remote patient monitoring systems that collect and use some types of health data, such as blood pressure, pulse, weight, etc. These systems share a number of security and privacy concerns with EHR and PHR systems, but we do not describe them in this chapter as their architectures are in most cases related to the EHR and PHR architectures. For a good example, the interested reader can check the architecture of the Philips Motiva system (Simons, 2006).