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Design and develop a video conferencing framework for real-time telemedicine applications using secure group-based communication architecture

Mat Kiah ML, Al-Bakri SH, Zaidan AA, Zaidan BB, Hussain M

J Med Syst, 2014 Oct;38(10):133.
PMID: 25199651 DOI: 10.1007/s10916-014-0133-y

One of the applications of modern technology in telemedicine is video conferencing. An alternative to traveling to attend a conference or meeting, video conferencing is becoming increasingly popular among hospitals. By using this technology, doctors can help patients who are unable to physically visit hospitals. Video conferencing particularly benefits patients from rural areas, where good doctors are not always available. Telemedicine has proven to be a blessing to patients who have no access to the best treatment. A telemedicine system consists of customized hardware and software at two locations, namely, at the patient's and the doctor's end. In such cases, the video streams of the conferencing parties may contain highly sensitive information. Thus, real-time data security is one of the most important requirements when designing video conferencing systems. This study proposes a secure framework for video conferencing systems and a complete management solution for secure video conferencing groups. Java Media Framework Application Programming Interface classes are used to design and test the proposed secure framework. Real-time Transport Protocol over User Datagram Protocol is used to transmit the encrypted audio and video streams, and RSA and AES algorithms are used to provide the required security services. Results show that the encryption algorithm insignificantly increases the video conferencing computation time.

Matched MeSH terms: Confidentiality
Fulltext Cross-sectional survey of multi-centre patient registries in malaysia

Sharmini S, Jamaiyah H, Jaya Purany SP

Malays Fam Physician, 2010;5(1):13-8.
PMID: 25606180 MyJurnal

This survey set out to describe patient registries available in the country, to determine their security features, data confidentiality, extent of outputs produced and data quality of the registries.

Matched MeSH terms: Confidentiality
Fulltext Attitudes of rehabilitation medicine doctors toward medical ethics in Malaysia

Mazlina M, Julia PE

Singapore Med J, 2011 Jun;52(6):421-7.
PMID: 21731994

Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care.

Matched MeSH terms: Confidentiality
Fulltext Adolescent health problems and adolescent friendly health clinic from adolescents’ perspective (Besut and Kuala Terengganu): a qualitative research

Hassan N, A. Rahman K, Aris Kasah M, Jusoh M

Malaysian Journal of Public Health Medicine, 2002;2(2):9-14.
MyJurnal

A qualitative research was carried out in Besut and Kuala Terengganu to identyy adolescents’ health problems and needs jiom adolescent perspective, and to establish a priority area in the development of Adolescent Health Clinic in the district. A total of 61 adolescents were selected and divided into four groups and stratified according to age, 13-15 years old and 16 - 17 years old. Generally all participants wished to live in an environment free hom negative health risk factors. The obstacles they perceived were mainly related to lack of care or too much control by their parents. Some of them perceived that their parents in general had inadequate knowledge and skills on parenting. Among local behavioural problems mentioned were loafing, running away from home, vandalism, school absenteeism, aggressive behaviour, substance abuse, pre-marital sexual activities, "bohsia", “bohjan" and even involvement in crimes. More than hah' agreed that counselling service is important for adolescents, and it should be made available in the community preferably outside the schools. They perceived an adolescent friendly health clinic concept as an important concept that should be introduced. To them adolescent friendly health clinic is a clinic run by professionals who are knowledgeable, caring, good listeners, non—judgemental, and who exercise confidentiality. The clinic preferably should be situated in a location which is away from the present health facilities to avoid the image of a place for sick people. Clinic hours preferably during weekends, should provide appropriate technologies and situated in a comfortable ambience. Adolescent participation in the clinic was also mentioned as an important entity for adolescent friendly health services.

Matched MeSH terms: Confidentiality
Fulltext Profiles of men-who-have-sex-with-men seeking anonymous voluntary HIV counseling and testing at a community-based centre in Malaysia

Koh KC, Kamarulzaman A

Med J Malaysia, 2011 Dec;66(5):491-4.
PMID: 22390108 MyJurnal

Community-based HIV voluntary counseling and testing (VCT) services is an effective alternative for mapping the local demographics of at-risk populations for HIV as well as provide an acceptable and reliable means of early detection of HIV. We describe the profiles of men-who-have-sex-with-men (MSM) who sought VCT services in a community based centre in Kuala Lumpur.

Matched MeSH terms: Confidentiality
Confidentiality and death

Ong BB, Kaur S

Malays J Pathol, 1997 Dec;19(2):111-4.
PMID: 10879250

The duty of confidentiality in the normal doctor-patient relationship is well recognized. However, the duty of confidentiality between the pathologist who performs the autopsy and the requesting authorities and the next-of-kin is not as clearly spelt out. This article discusses the problems faced by the pathologist with regards to hospital and medico-legal autopsies in Malaysia. A proposed ethical guideline is included on how to deal with peculiar issues regarding confidentiality and the pathologist.

Matched MeSH terms: Confidentiality*
Fulltext Beliefs and attitudes of medical students from public and private universities in Malaysia towards individuals with HIV/AIDS

Koh KC, Teh JR, Khan SA

ScientificWorldJournal, 2013;2013:462826.
PMID: 24285935 DOI: 10.1155/2013/462826

We describe the findings from a survey assessing the beliefs regarding testing, confidentiality, disclosure, and environment of care and attitudes towards care of people with HIV/AIDS (PLHWA), in 1020, 4th and 5th year medical students, from public and private medical universities in Malaysia. A self-administered validated questionnaire based on the UNAIDS Model Questionnaire with a 5-point Likert scale (5, strongly disagree; 4, disagree; 3, neutral; 2, agree; 1, strongly agree) was used as a survey tool. The survey included demographic data and data on undergraduate training received on HIV/AIDS. Statistical significance in the demographic data and training received by respondents was evaluated using the chi-square test while the independent Student's t-test was used for comparison of means between public and private universities. A P value of <0.05 was considered statistically significant with 95% confidence interval. Our study revealed less than 20% of medical students received adequate training to care for PLHWA. They had prevalent negative beliefs regarding testing, confidentiality, disclosure and environment of care towards PLHWA although in giving care to PLHWA, their attitudes were largely positive and nondiscriminatory.
Study site: 7 public and private universities in Malaysia

Matched MeSH terms: Confidentiality/psychology
Fulltext Examining Consumers' Adoption of Wearable Healthcare Technology: The Role of Health Attributes

Cheung ML, Chau KY, Lam MHS, Tse G, Ho KY, Flint SW, et al.

Int J Environ Res Public Health, 2019 Jun 26;16(13).
PMID: 31247962 DOI: 10.3390/ijerph16132257

With the advancement of information technology, wearable healthcare technology has emerged as one of the promising technologies to improve the wellbeing of individuals. However, the adoption of wearable healthcare technology has lagged when compared to other well-established durable technology products, such as smartphones and tablets, because of the inadequate knowledge of the antecedents of adoption intention. The aim of this paper is to address an identified gap in the literature by empirically testing a theoretical model for examining the impact of consumers' health beliefs, health information accuracy, and the privacy protection of wearable healthcare technology on perceived usefulness. Importantly, this study also examines the influences of perceived usefulness, consumer innovativeness, and reference group influence on the adoption intention of wearable healthcare technology. The model seeks to enhance understanding of the influential factors in adopting wearable healthcare technology. Finally, suggestions for future research for the empirical investigation of the model are provided.

Matched MeSH terms: Confidentiality
Licence to commence clinical day: the L-Plate test

Sim JH, Vadivelu J, Lee SS

Med Educ, 2016 Nov;50(11):1145.
PMID: 27762037 DOI: 10.1111/medu.13188
Matched MeSH terms: Confidentiality/legislation & jurisprudence
Fulltext Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients' perspectives

Lee JY, Chan CKY, Chua SS, Paraidathathu T, Lee KK, Tan CSS, et al.

BMJ Open, 2019 Oct 22;9(10):e026575.
PMID: 31640990 DOI: 10.1136/bmjopen-2018-026575

OBJECTIVE: Telemedicine has been promoted as an economical and effective way to enhance patient care, but its acceptance among patients in low-income and middle-income countries is poorly understood. This study is aimed to explore the experiences and perspectives of people with type 2 diabetes mellitus that used telemedicine to manage their condition.
DESIGN: In-depth and focus group interviews were conducted with participants who have engaged in telemedicine. Questions included were participants' perception on the programme being used, satisfaction as well as engagement with the telemedicine programme. All interviews and focus groups were audio-recorded and transcribed verbatim. Data were analysed using a thematic approach.
PARTICIPANTS AND SETTING: People with type 2 diabetes (n=48) who participated in a randomised controlled study which examined the use of telemedicine for diabetes management were recruited from 11 primary care clinics located within the Klang Valley.
RESULTS: Twelve focus groups and two in-depth interviews were conducted. Four themes emerged from the analysis: (1) generational difference; (2) independence and convenience, (3) sharing of health data and privacy and (4) concerns and challenges. The main obstacles found in patients using the telemedicine systems were related to internet connectivity and difficulties experienced with system interface. Cost was also another significant concern raised by participants. Participants in this study were primarily positive about the benefits of telemedicine, including its ability to provide real-time data and disease monitoring and the reduction in clinic visits.
CONCLUSION: Despite the potential benefits of telemedicine in the long-term care of diabetes, there are several perceived barriers that may limit the effectiveness of this technology. As such, collaboration between educators, healthcare providers, telecommunication service providers and patients are required to stimulate the adoption and the use of telemedicine.NCT0246680.

Matched MeSH terms: Confidentiality
A Qualitative Study of Young Men Who Have Sex With Men and Multilevel Factors Related to HIV Risks in Malaysia

Burch WJ, Hart GJ, Lim SH

AIDS Educ Prev, 2018 04;30(2):85-95.
PMID: 29688771 DOI: 10.1521/aeap.2018.30.2.85

Young men who have sex with men (YMSM) are a group at high risk for HIV infection, yet no research has been conducted to understand this population in Malaysia. Semistructured interviews from a combination of YMSM aged 18-25 (n = 20) and local service providers of sexual health services (n = 4) were conducted from May to June 2015. Thematic analysis was used to identify common themes in participant responses from transcripts. Participants reported societal and internalized homophobia, an absence of sex education and difficulty accessing confidential HIV testing. This study provides insights into how homophobia in Malaysian society influences individual risk behavior for HIV in Malaysian YMSM, and makes practical suggestions for more effective HIV prevention in this population.

Matched MeSH terms: Confidentiality
Patient confidentiality, ethics and licensing in telemedicine

Yadav H, Lin WY

Asia Pac J Public Health, 2001;13 Suppl:S36-8.
PMID: 12109246

Telemedicine is fast becoming popular in many countries in the world. It has several advantages such as being cost saving and providing better access to health care in the remote areas in many parts of the world. However, it has some disadvantages as well. One of the major problems is the problem of patients' rights and confidentiality in the use of telemedicine. There are no standard guidelines and procedures in the practice of telemedicine as yet. Both the patient and the physician are unsure of the standard of practice and how to maintain confidentiality. The patient is uncertain as to how to protect her/his rights in the use of telemedicine. The issue of litigation is also unclear as to where the physician is practicing when he/she uses telemedicine. Is she/he practicing in the country where the patient is or is the physician practicing in the country of her/his origin? These issues need to be addressed urgently so that telemedicine will have standards of ethical practice and the patient's rights and confidentiality will be protected.

Matched MeSH terms: Confidentiality*
Fulltext RULA mobile android application software

Yusof Kadikon, Imran Mohd Shafek, M. Maarof Bahurdin

Journal of Occupational Safety and Health, 2015;12(1):121-124.
MyJurnal

In Malaysia, the number of Musculoskeletal Disorder (MSD) cases is increasing . Rapid Upper Limb Assessment
(RULA) is carried out in a physical paper form which is cumbersome and based on the complex nature and it should
consider human error. This project aims to create the RULA application for mobile devices featuring the android system
for this move will cut down the process time by more than half, create a more structured system and eliminate human
error wholly. The application will be designed on the App Inventor website which features a lot of handy tutorials
and takes the initiative to create a RULA mobile app for Android phones. The RULA mobile app for Android phones
is intended to make it easier and much more efficient to conduct a RULA analysis. Additionally, the analyses can be
conducted by minimally trained users, eliminating the need for highly trained technicians. RULA test is performed to
achieve accurate results and the mathematical processes will be programmed into the app so that the user will have a
friendly interface and will only be asked to tick boxes.

Matched MeSH terms: Confidentiality
Fulltext SenseCrypt: A Security Framework for Mobile Crowd Sensing Applications

Pius Owoh N, Mahinderjit Singh M

Sensors (Basel), 2020 Jun 09;20(11).
PMID: 32526843 DOI: 10.3390/s20113280

The proliferation of mobile devices such as smartphones and tablets with embedded sensors and communication features has led to the introduction of a novel sensing paradigm called mobile crowd sensing. Despite its opportunities and advantages over traditional wireless sensor networks, mobile crowd sensing still faces security and privacy issues, among other challenges. Specifically, the security and privacy of sensitive location information of users remain lingering issues, considering the "on" and "off" state of global positioning system sensor in smartphones. To address this problem, this paper proposes "SenseCrypt", a framework that automatically annotates and signcrypts sensitive location information of mobile crowd sensing users. The framework relies on K-means algorithm and a certificateless aggregate signcryption scheme (CLASC). It incorporates spatial coding as the data compression technique and message query telemetry transport as the messaging protocol. Results presented in this paper show that the proposed framework incurs low computational cost and communication overhead. Also, the framework is robust against privileged insider attack, replay and forgery attacks. Confidentiality, integrity and non-repudiation are security services offered by the proposed framework.

Matched MeSH terms: Confidentiality
Fulltext L-CPPA: Lattice-based conditional privacy-preserving authentication scheme for fog computing with 5G-enabled vehicular system

Almazroi AA, Alqarni MA, Al-Shareeda MA, Manickam S

PLoS One, 2023;18(10):e0292690.
PMID: 37889892 DOI: 10.1371/journal.pone.0292690

The role that vehicular fog computing based on the Fifth Generation (5G) can play in improving traffic management and motorist safety is growing quickly. The use of wireless technology within a vehicle raises issues of confidentiality and safety. Such concerns are optimal targets for conditional privacy-preserving authentication (CPPA) methods. However, current CPPA-based systems face a challenge when subjected to attacks from quantum computers. Because of the need for security and anti-piracy features in fog computing when using a 5G-enabled vehicle system, the L-CPPA scheme is proposed in this article. Using a fog server, secret keys are generated and transmitted to each registered car via a 5G-Base Station (5G-BS) in the proposed L-CPPA system. In the proposed L-CPPA method, the trusted authority, rather than the vehicle's Onboard Unit (OBU), stores the vehicle's master secret data to each fog server. Finally, the computation cost of the suggested L-CPPA system regards message signing, single verification and batch verification is 694.161 ms, 60.118 ms, and 1348.218 ms, respectively. Meanwhile, the communication cost is 7757 bytes.

Matched MeSH terms: Confidentiality
Fulltext ECA-VFog: An efficient certificateless authentication scheme for 5G-assisted vehicular fog computing

Almazroi AA, Aldhahri EA, Al-Shareeda MA, Manickam S

PLoS One, 2023;18(6):e0287291.
PMID: 37352258 DOI: 10.1371/journal.pone.0287291

Fifth-generation (5G)-enabled vehicular fog computing technologies have always been at the forefront of innovation because they support smart transport like the sharing of traffic data and cooperative processing in the urban fabric. Nevertheless, the most important factors limiting progress are concerns over message protection and safety. To cope with these challenges, several scholars have proposed certificateless authentication schemes with pseudonyms and traceability. These schemes avoid complicated management of certificate and escrow of key in the public key infrastructure-based approaches in the identity-based approaches, respectively. Nevertheless, problems such as high communication costs, security holes, and computational complexity still exist. Therefore, this paper proposes an efficient certificateless authentication called the ECA-VFog scheme for fog computing with 5G-assisted vehicular systems. The proposed ECA-VFog scheme applied efficient operations based on elliptic curve cryptography that is supported by a fog server through a 5G-base station. This work conducts a safety analysis of the security designs to analysis the viability and value of the proposed ECA-VFog scheme. In the performance ovulation section, the computation costs for signing and verification process are 2.3539 ms and 1.5752 ms, respectively. While, the communication costs and energy consumption overhead of the ECA-VFog are 124 bytes and 25.610432 mJ, respectively. Moreover, comparing the ECA-VFog scheme to other existing schemes, the performance estimation reveals that it is more cost-effective with regard to computation cost, communication cost, and energy consumption.

Matched MeSH terms: Confidentiality*
Professional Practice and Innovation: The Development and Design of an Electronic Patient Record Using Open Source Web-Based Technology

Syed-Mohamad SM, Ali SH, Mat-Husin MN

Health Inf Manag, 2010 Mar;39(1):30-35.
PMID: 28683624 DOI: 10.1177/183335831003900105

This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open-source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.

Matched MeSH terms: Confidentiality
Law on consent and confidentiality in India: a need for clarity

Mathiharan K

Natl Med J India, 2014 Jan-Feb;27(1):39-42.
PMID: 25403126

The concept of informed consent specific to medical research and treatment is still alien to many medical researchers and practitioners and to millions of Indians. The doctor-patient relationship in India is governed more by trust where the doctor is the authoritative person. Therefore, the benefit of informed consent does not reach all patients in day-to-day medical practice. To complicate the issue, the Indian law is not specific about the age at which a person can give valid consent. The Indian Penal Code is silent about the legal validity of consent given by persons between 12 and 18 years of age. Similarly, the age at which the 'Right to Confidentiality' begins is yet to be defined either by the statute or by the courts. Hence, there is a need for a clear statutory provision to remove the anomalies and ambiguities regarding the age of consent to undergo invasive therapeutic or investigative procedures, participate in clinical trials, as well as define the age at which a person's right to medical confidentiality begins.

Matched MeSH terms: Confidentiality/legislation & jurisprudence*
Towards reinforcing telemedicine adoption amongst clinicians in Nigeria

Adenuga KI, Iahad NA, Miskon S

Int J Med Inform, 2017 08;104:84-96.
PMID: 28599820 DOI: 10.1016/j.ijmedinf.2017.05.008

Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (p<0.05), effort expectancy (p<0.05), facilitating condition (p<0.01) and reinforcement factor (p<0.001) have significant effects on clinicians' behavioural intention to use telemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians.

Matched MeSH terms: Confidentiality
Smart Home-based IoT for Real-time and Secure Remote Health Monitoring of Triage and Priority System using Body Sensors: Multi-driven Systematic Review

Talal M, Zaidan AA, Zaidan BB, Albahri AS, Alamoodi AH, Albahri OS, et al.

J Med Syst, 2019 Jan 15;43(3):42.
PMID: 30648217 DOI: 10.1007/s10916-019-1158-z

The Internet of Things (IoT) has been identified in various applications across different domains, such as in the healthcare sector. IoT has also been recognised for its revolution in reshaping modern healthcare with aspiring wide range prospects, including economical, technological and social. This study aims to establish IoT-based smart home security solutions for real-time health monitoring technologies in telemedicine architecture. A multilayer taxonomy is driven and conducted in this study. In the first layer, a comprehensive analysis on telemedicine, which focuses on the client and server sides, shows that other studies associated with IoT-based smart home applications have several limitations that remain unaddressed. Particularly, remote patient monitoring in healthcare applications presents various facilities and benefits by adopting IoT-based smart home technologies without compromising the security requirements and potentially large number of risks. An extensive search is conducted to identify articles that handle these issues, related applications are comprehensively reviewed and a coherent taxonomy for these articles is established. A total number of (n = 3064) are gathered between 2007 and 2017 for most reliable databases, such as ScienceDirect, Web of Science and Institute of Electrical and Electronic Engineer Xplore databases. Then, the articles based on IoT studies that are associated with telemedicine applications are filtered. Nine articles are selected and classified into two categories. The first category, which accounts for 22.22% (n = 2/9), includes surveys on telemedicine articles and their applications. The second category, which accounts for 77.78% (n = 7/9), includes articles on the client and server sides of telemedicine architecture. The collected studies reveal the essential requirement in constructing another taxonomy layer and review IoT-based smart home security studies. Therefore, IoT-based smart home security features are introduced and analysed in the second layer. The security of smart home design based on IoT applications is an aspect that represents a crucial matter for general occupants of smart homes, in which studies are required to provide a better solution with patient security, privacy protection and security of users' entities from being stolen or compromised. Innovative technologies have dispersed limitations related to this matter. The existing gaps and trends in this area should be investigated to provide valuable visions for technical environments and researchers. Thus, 67 articles are obtained in the second layer of our taxonomy and are classified into six categories. In the first category, 25.37% (n = 17/67) of the articles focus on architecture design. In the second category, 17.91% (n = 12/67) includes security analysis articles that investigate the research status in the security area of IoT-based smart home applications. In the third category, 10.44% (n = 7/67) includes articles about security schemes. In the fourth category, 17.91% (n = 12/67) comprises security examination. In the fifth category, 13.43% (n = 9/67) analyses security protocols. In the final category, 14.92% (n = 10/67) analyses the security framework. Then, the identified basic characteristics of this emerging field are presented and provided in the following aspects. Open challenges experienced on the development of IoT-based smart home security are addressed to be adopted fully in telemedicine applications. Then, the requirements are provided to increase researcher's interest in this study area. On this basis, a number of recommendations for different parties are described to provide insights on the next steps that should be considered to enhance the security of smart homes based on IoT. A map matching for both taxonomies is developed in this study to determine the novel risks and benefits of IoT-based smart home security for real-time remote health monitoring within client and server sides in telemedicine applications.

Matched MeSH terms: Confidentiality

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