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Determinants of RFID adoption in Malaysia's healthcare industry: occupational level as a moderator

Zailani S, Iranmanesh M, Nikbin D, Beng JK

J Med Syst, 2015 Jan;39(1):172.
PMID: 25503418 DOI: 10.1007/s10916-014-0172-4

With today's highly competitive market in the healthcare industry, Radio Frequency Identification (RFID) is a technology that can be applied by hospitals to improve operational efficiency and to gain a competitive advantage over their competitors. The purpose of this study is to investigate the factors that may effect RFID adoption in Malaysia's healthcare industry. In addition, the moderating role of occupational level was tested. Data was collected from 223 managers as well as healthcare and supporting staffs. This data was analyzed using the partial least squares technique. The results show that perceived ease of use and usefulness, government policy, top management support, and security and privacy concerns have an effect on the intent to adopt RFID in hospitals. There is a wide gap between managers and healthcare staff in terms of the factors that influence RFID adoption. The results of this study will help decision makers as well as managers in the healthcare industry to better understand the determinants of RFID adoption. Additionally, it will assist in the process of RFID adoption, and therefore, spread the usage of RFID technology in more hospitals.

Matched MeSH terms: Confidentiality
A security framework for nationwide health information exchange based on telehealth strategy

Zaidan BB, Haiqi A, Zaidan AA, Abdulnabi M, Kiah ML, Muzamel H

J Med Syst, 2015 May;39(5):51.
PMID: 25732083 DOI: 10.1007/s10916-015-0235-1

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

Matched MeSH terms: Confidentiality
A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction

Hussien HM, Yasin SM, Udzir SNI, Zaidan AA, Zaidan BB

J Med Syst, 2019 Sep 14;43(10):320.
PMID: 31522262 DOI: 10.1007/s10916-019-1445-8

Blockchain in healthcare applications requires robust security and privacy mechanism for high-level authentication, interoperability and medical records sharing to comply with the strict legal requirements of the Health Insurance Portability and Accountability Act of 1996. Blockchain technology in the healthcare industry has received considerable research attention in recent years. This study conducts a review to substantially analyse and map the research landscape of current technologies, mainly the use of blockchain in healthcare applications, into a coherent taxonomy. The present study systematically searches all relevant research articles on blockchain in healthcare applications in three accessible databases, namely, ScienceDirect, IEEE and Web of Science, by using the defined keywords 'blockchain', 'healthcare' and 'electronic health records' and their variations. The final set of collected articles related to the use of blockchain in healthcare application is divided into three categories. The first category includes articles (i.e. 43/58 scientific articles) that attempted to develop and design healthcare applications integrating blockchain, particularly those on new architecture, system designs, framework, scheme, model, platform, approach, protocol and algorithm. The second category includes studies (i.e., 6/58 scientific articles) that attempted to evaluate and analyse the adoption of blockchain in the healthcare system. Finally, the third category comprises review and survey articles (i.e., 6/58 scientific articles) related to the integration of blockchain into healthcare applications. The final articles for review are discussed on the basis of five aspects: (1) year of publication, (2) nationality of authors, (3) publishing house or journal, (4) purpose of using blockchain in health applications and the corresponding contributions and (5) problem types and proposed solutions. Additionally, this study provides identified motivations, open challenges and recommendations on the use of blockchain in healthcare applications. The current research contributes to the literature by providing a detailed review of feasible alternatives and identifying the research gaps. Accordingly, researchers and developers are provided with appealing opportunities to further develop decentralised healthcare applications through a comprehensive discussion of about the importance of blockchain and its integration into various healthcare applications.

Matched MeSH terms: Confidentiality
Sensor-Based mHealth Authentication for Real-Time Remote Healthcare Monitoring System: A Multilayer Systematic Review

Shuwandy ML, Zaidan BB, Zaidan AA, Albahri AS

J Med Syst, 2019 Jan 06;43(2):33.
PMID: 30612191 DOI: 10.1007/s10916-018-1149-5

The new and groundbreaking real-time remote healthcare monitoring system on sensor-based mobile health (mHealth) authentication in telemedicine has considerably bounded and dispersed communication components. mHealth, an attractive part in telemedicine architecture, plays an imperative role in patient security and privacy and adapts different sensing technologies through many built-in sensors. This study aims to improve sensor-based defence and attack mechanisms to ensure patient privacy in client side when using mHealth. Thus, a multilayer taxonomy was conducted to attain the goal of this study. Within the first layer, real-time remote monitoring studies based on sensor technology for telemedicine application were reviewed and analysed to examine these technologies and provide researchers with a clear vision of security- and privacy-based sensors in the telemedicine area. An extensive search was conducted to find articles about security and privacy issues, review related applications comprehensively and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were investigated for articles on mHealth in telemedicine-based sensor. A total of 3064 papers were collected from 2007 to 2017. The retrieved articles were filtered according to the security and privacy of sensor-based telemedicine applications. A total of 19 articles were selected and classified into two categories. The first category, 57.89% (n = 11/19), included survey on telemedicine articles and their applications. The second category, 42.1% (n = 8/19), included articles contributed to the three-tiered architecture of telemedicine. The collected studies improved the essential need to add another taxonomy layer and review the sensor-based smartphone authentication studies. This map matching for both taxonomies was developed for this study to investigate sensor field comprehensively and gain access to novel risks and benefits of the mHealth security in telemedicine application. The literature on sensor-based smartphones in the second layer of our taxonomy was analysed and reviewed. A total of 599 papers were collected from 2007 to 2017. In this layer, we obtained a final set of 81 articles classified into three categories. The first category of the articles [86.41% (n = 70/81)], where sensor-based smartphones were examined by utilising orientation sensors for user authentication, was used. The second category [7.40% (n = 6/81)] included attack articles, which were not intensively included in our literature analysis. The third category [8.64% (n = 7/81)] included 'other' articles. Factors were considered to understand fully the various contextual aspects of the field in published studies. The characteristics included the motivation and challenges related to sensor-based authentication of smartphones encountered by researchers and the recommendations to strengthen this critical area of research. Finally, many studies on the sensor-based smartphone in the second layer have focused on enhancing accurate authentication because sensor-based smartphones require sensors that could authentically secure mHealth.

Matched MeSH terms: Confidentiality
Fulltext Nurses’ perceptions and attitudes towards family presence during resuscitation in adult critical care units

Chung Su Chin, Pauline Stitt

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):61-0.
MyJurnal

Introduction: During resuscitation efforts, patients’ families are routinely barred from the resuscitation area. Even there is an increased in demand from the family members requesting to be present during resuscitation of their loved one, health care providers not always offer the option for family presence. The major concerns of health care providers who are opposed to family presence during resuscitation (FPDR) were fear of psychological trauma to family members who witnessed the resuscitation. This study aimed to examine the critical care nurses’ perception and attitudes towards the presence of patients’ family members during resuscitation in adult critical care units. Methods: Study papers included were narrowed to primary study, published within 2003-2014, describing nurses’ perceptions and attitudes on an adult inpatient family witnessed resuscitation in critical care units. Results: Seven studies included, and four main themes emerged mainly samples population, nurses’ experiences of FPDR, nurses’ responses toward FPDR and factor predicting nurses’ attitudes toward FPDR. 20% - 42.2% of nurses had experienced FPDR. Only 4% - 6% of study participants working in hospital with established policy and 95% - 100% had not invited family members to witnessed resuscitation. Nurses would consider the option if family members are accompanied by trained staff. Nurses concern included difficult to concentrate, negatively affecting their per- formance, increased rate of legal action, inadequate staff and limited space. Concerns on family members included too distressing event, negative psychological impact argue and interfere with staff. Concerns on patient would be breach of confidentiality. Conclusion: Adult critical care nurses demonstrated negative perceptions and attitudes towards FPDR. Study participants in this review are not familiar with the concept of FPDR. There is a need for policy development and education on FPDR.

Matched MeSH terms: Confidentiality
Fulltext Trust and Other Factors that Drive Students’ Self-Disclosure on Social Networking Sites (SNSs)

LIM SOK FERN, SITI ZANARIAH AHMAD ISHAK

Trends in Undergraduate Research, 2018;1(1):0-0.
MyJurnal

The aim of this study is to examine the factors that drive students’ self-disclosure on Social Networking Sites (SNSs). A total of 215 undergraduates from two public universities in East Malaysia were recruited as respondents. This study adapts self-disclosure model by Elmi, A.Iahad and Ahmed (2012), where the model proposed trust as one of the factors that complementing other existing factors in online self-disclosure. This study proved that privacy concerns (r = -.212, p < .01), perceived trust (r = .22, p < .01), perceived ease of use (r = .213, p < .01), and perceived enjoyment (r = .28, p < .01) are significantly related to students’ online self-disclosure on SNSs. In addition, as trust plays a vital role in moderating the users’ online self-disclosure behavior, this study formulated students’ trusts on SNSs based on three dimensions which are individual, institutional and online trust. Findings of study suggested that there is a significant difference between online trust based on male and female respondents.

Matched MeSH terms: Confidentiality
Access control and privilege management in electronic health record: a systematic literature review

Jayabalan M, O'Daniel T

J Med Syst, 2016 Dec;40(12):261.
PMID: 27722981

This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

Matched MeSH terms: Confidentiality
Real-Time Medical Systems Based on Human Biometric Steganography: a Systematic Review

Mohsin AH, Zaidan AA, Zaidan BB, Ariffin SAB, Albahri OS, Albahri AS, et al.

J Med Syst, 2018 Oct 29;42(12):245.
PMID: 30374820 DOI: 10.1007/s10916-018-1103-6

In real-time medical systems, the role of biometric technology is significant in authentication systems because it is used in verifying the identity of people through their biometric features. The biometric technology provides crucial properties for biometric features that can support the process of personal identification. The storage of biometric template within a central database makes it vulnerable to attack which can also occur during data transmission. Therefore, an alternative mechanism of protection becomes important to develop. On this basis, this study focuses on providing a detailed analysis of the extant literature (2013-2018) to identify the taxonomy and research distribution. Furthermore, this study also seeks to ascertain the challenges and motivations associated with biometric steganography in real-time medical systems to provide recommendations that can enhance the efficient use of real-time medical systems in biometric steganography and its applications. A review of articles on human biometric steganography in real-time medical systems obtained from three main databases (IEEE Xplore, ScienceDirect and Web of Science) is conducted according to an appropriate review protocol. Then, 41 related articles are selected by using exclusion and inclusion criteria. Majority of the studies reviewed had been conducted in the field of data-hiding (particularly steganography) technologies. In this review, various steganographic methods that have been applied in different human biometrics are investigated. Thereafter, these methods are categorised according to taxonomy, and the results are presented on the basis of human steganography biometric real-time medical systems, testing and evaluation methods, significance of use and applications and techniques. Finally, recommendations on how the challenges associated with data hiding can be addressed are provided to enhance the efficiency of using biometric information processed in any authentication real-time medical system. These recommendations are expected to be immensely helpful to developers, company users and researchers.

Matched MeSH terms: Confidentiality
Educating school students and gauging their perception about the harmful effects of smoking using a "Facial-Ageing App (mobile application):" An experience from Malaysia

Marzo RR, Bhattacharya S, Ravichandran S, Lakshmanan P, Jeffery VR, Moralitheran P, et al.

J Educ Health Promot, 2019;8:250.
PMID: 32002422 DOI: 10.4103/jehp.jehp_192_19

INTRODUCTION: Smoking is one of the leading factors of mortality in Malaysia. Most youngsters start at adolescence, fascinated by the concept of smoking. Interventions that harness the broad availability of mobile phones, as well as adolescents' interest in their appearance, may be an innovative way to advance school-based prevention. This study aims to determine the perceptions of facial-aging apps among secondary school students.
METHODOLOGY: For this research, descriptive cross-sectional study using simple random sampling method was used. Population sampling was targeted toward three government schools. The total number of respondents is 383, with all of them aged between 13 and- 16 years of age. Legal considerations were taken to maintain the confidentiality of respondents. The specific objectives are: 1. To determine the level of change of intention on smoking, 2. To know the perceived reactions of the peer groups on the appearances of students as nonsmokers, 3. To determine whether the students learned new benefits of nonsmokingand, 4. To measure the impact of a facial-aging app among students.
RESULTS: The number of respondents who smoke was 40 (10.4%), while the number of respondents who do not smoke was 343 (89.6%). About 89% of the respondents agree that their three-dimensional selfie image motivates them not to smoke. In addition, 87.8% of respondents admit that the perceived reactions of their classmates make them think that they look better as nonsmokers. After learning the effects of smoking, about 86.4% of the respondents acknowledged that they would educate their peer groups. Furthermore, 85.9% of the respondents found this "Smokerface" app enjoyable.
CONCLUSION: The facial-aging intervention was effective in motivating Malaysian pupils to stay away from tobacco use. Thus, the analysis on the study of facial app usage in smoking prevention among youngsters concludes that most of the adolescents concur that the "Smokerface" app helps in the prevention of smoking among youths.

Matched MeSH terms: Confidentiality
Fulltext Hospitalised patients' awareness of their rights: a cross-sectional survey from a tertiary care hospital on the east coast of Peninsular Malaysia

Yousuf RM, Fauzi AR, How SH, Akter SF, Shah A

Singapore Med J, 2009 May;50(5):494-9.
PMID: 19495519

Optimal patient care varies considerably from place to place and is influenced by scientific as well as social developments. The purpose of this study was to investigate awareness and pertinent issues regarding informed consent among hospitalised patients and to determine lapses, in order to improve the standard of care.

Matched MeSH terms: Confidentiality/legislation & jurisprudence*
Challenges, alternatives, and paths to sustainability: better public health promotion using social networking pages as key tools

Zaidan AA, Zaidan BB, Kadhem Z, Larbani M, Lakulu MB, Hashim M

J Med Syst, 2015 Feb;39(2):7.
PMID: 25631841 DOI: 10.1007/s10916-015-0201-y

This paper discusses the possibility of promoting public health and implementing educational health services using Facebook. We discuss the challenges and strengths of using such a platform as a tool for public health care systems from two different perspectives, namely, the view of IT developers and that of physicians. We present a new way of evaluating user interactivity in health care systems from tools provided by Facebook that measure statistical traffic in the Internet. Findings show that Facebook is a very promising tool in promoting e-health services in Web 2.0. Results from statistical traffic show that a Facebook page is more efficient than other pages in promoting public health.

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
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
Fulltext A staff-initiated quality improvement project: from paper to web report

Daphne Clemente, Nurul Amiella Abdullah, ZurianahJusmin Jasmin, Muhammad Syafiq Abdullah, Helen Benedict Lasimbang, Wendy Diana Shoesmith, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):14-0.
MyJurnal

Introduction: Continuous quality improvement of system is essential to improve efficiency of working environ- ment. Limited financial allocation in low resource setting results in the vicious circle of having inadequate money to purchase a new system and print paper documents that are required for the operation of clinic. A staff-initiated system improvement with the name of “PRW UMS Staff Portal” was attempted to break-free from the vicious cycle. Methods: An online system covering different aspects of routine clinical work of healthcare workers was created in Dec 2019 and implemented in Feb 2020 using Google SiteTM by the nurses of a local university community clinic, which included: submission of daily reports of nurses and assistant medical officers, submission of reports of all programmes conducted by the clinic, surveillance of health status of working staffs, announcement and request of working roster, archiving of documents, and medication inventory. The system could only be accessed using official working email for general documents while accesses to sensitive documents were restricted to relevant staffs to pro- tect privacy and confidentiality of information. Qualitative interviews were performed with all nursing staff involved. Results: Qualitative feeling of improvement in coordination of workflow was reported by all 23 staffs working in the clinic in view of the easy access of system using smartphone and computer at workstation. It also reduced the need to move away from the working station in order to access, replenish, or submit the printed documents and reports. Significant amount of paper and printing were saved monthly. Conclusions: Despite positive feedback from the staffs, the system requires further improvement in terms of function and security. Further evaluation on cost-efficiency of the system can be done to promote the system to other universities.

Matched MeSH terms: Confidentiality
Fulltext Patient’s confidentiality policy breach among nursing students

Patricia Sator

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):58-0.
MyJurnal

Introduction: Nursing is a regulated profession. Hence, the global commitment for nurses to maintain standards of practice is vital to deliver safe and competent care. Written policies will eliminate uncertainty, ambiguity, and legal issues. For this study, it focused on the importance of the nursing students to understand and practice the regulation on patient’s confidentiality in healthcare setting with the usage of technology such as social media. There is a case like nursing student infringe the privacy of patients with the information they posted on social media, such as posting a patient’s photos or videos without valid consent. Methods: This study is a quantitative, cross-sectional survey de- sign. The respondents were selected as convenience sampling of 120 nursing students from the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah (FMHS, UMS). Results: There are 7.4% nursing students intention- ally posted in social media, 18.0% maybe and 73.8% unintentionally. And for their guilty feeling after committing confidentially policy breach on patient, there are 8.2% said NO, 32.8% said MAYBE and 59% said YES. Overall, the nursing students are aware of the patient’s confidentiality but there is still a leakage in practicing full nursing standards and regulation. Further study recommended to explore more on this issue. Conclusion: As a conclusion, this study is relevant to conduct among the nursing students to gain their understanding regarding the responsibilities as a future nurse in maintaining the patient’s confidentiality as one of the most important nursing practices to ensure quality of care and continuation of professional service of nursing profession.

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
The Impact of the Security Competency on "Self-Efficacy in Information Security" for Effective Health Information Security in Iran

Shahri AB, Ismail Z, Mohanna S

J Med Syst, 2016 Nov;40(11):241.
PMID: 27681101

The security effectiveness based on users' behaviors is becoming a top priority of Health Information System (HIS). In the first step of this study, through the review of previous studies 'Self-efficacy in Information Security' (SEIS) and 'Security Competency' (SCMP) were identified as the important factors to transforming HIS users to the first line of defense in the security. Subsequently, a conceptual model was proposed taking into mentioned factors for HIS security effectiveness. Then, this quantitative study used the structural equation modeling to examine the proposed model based on survey data collected from a sample of 263 HIS users from eight hospitals in Iran. The result shows that SEIS is one of the important factors to cultivate of good end users' behaviors toward HIS security effectiveness. However SCMP appears a feasible alternative to providing SEIS. This study also confirms the mediation effects of SEIS on the relationship between SCMP and HIS security effectiveness. The results of this research paper can be used by HIS and IT managers to implement their information security process more effectively.

Matched MeSH terms: Confidentiality
Real-Time Remote Health Monitoring Systems Using Body Sensor Information and Finger Vein Biometric Verification: A Multi-Layer Systematic Review

Mohsin AH, Zaidan AA, Zaidan BB, Albahri AS, Albahri OS, Alsalem MA, et al.

J Med Syst, 2018 Oct 16;42(12):238.
PMID: 30327939 DOI: 10.1007/s10916-018-1104-5

The development of wireless body area sensor networks is imperative for modern telemedicine. However, attackers and cybercriminals are gradually becoming aware in attacking telemedicine systems, and the black market value of protected health information has the highest price nowadays. Security remains a formidable challenge to be resolved. Intelligent home environments make up one of the major application areas of pervasive computing. Security and privacy are the two most important issues in the remote monitoring and control of intelligent home environments for clients and servers in telemedicine architecture. The personal authentication approach that uses the finger vein pattern is a newly investigated biometric technique. This type of biometric has many advantages over other types (explained in detail later on) and is suitable for different human categories and ages. This study aims to establish a secure verification method for real-time monitoring systems to be used for the authentication of patients and other members who are working in telemedicine systems. The process begins with the sensor based on Tiers 1 and 2 (client side) in the telemedicine architecture and ends with patient verification in Tier 3 (server side) via finger vein biometric technology to ensure patient security on both sides. Multilayer taxonomy is conducted in this research to attain the study's goal. In the first layer, real-time remote monitoring studies based on the sensor technology used in telemedicine applications are reviewed and analysed to provide researchers a clear vision of security and privacy based on sensors in telemedicine. An extensive search is conducted to identify articles that deal with security and privacy issues, related applications are reviewed comprehensively and a coherent taxonomy of these articles is established. ScienceDirect, IEEE Xplore and Web of Science databases are checked for articles on mHealth in telemedicine based on sensors. A total of 3064 papers are collected from 2007 to 2017. The retrieved articles are filtered according to the security and privacy of telemedicine applications based on sensors. Nineteen articles are selected and classified into two categories. The first category, which accounts for 57.89% (n = 11/19), includes surveys on telemedicine articles and their applications. The second category, accounting for 42.1% (n = 8/19), includes articles on the three-tiered architecture of telemedicine. The collected studies reveal the essential need to construct another taxonomy layer and review studies on finger vein biometric verification systems. This map-matching for both taxonomies is developed for this study to go deeply into the sensor field and determine novel risks and benefits for patient security and privacy on client and server sides in telemedicine applications. In the second layer of our taxonomy, the literature on finger vein biometric verification systems is analysed and reviewed. In this layer, we obtain a final set of 65 articles classified into four categories. In the first category, 80% (n = 52/65) of the articles focus on development and design. In the second category, 12.30% (n = 8/65) includes evaluation and comparative articles. These articles are not intensively included in our literature analysis. In the third category, 4.61% (n = 3/65) includes articles about analytical studies. In the fourth category, 3.07% (n = 2/65) comprises reviews and surveys. This study aims to provide researchers with an up-to-date overview of studies that have been conducted on (user/patient) authentication to enhance the security level in telemedicine or any information system. In the current study, taxonomy is presented by explaining previous studies. Moreover, this review highlights the motivations, challenges and recommendations related to finger vein biometric verification systems and determines the gaps in this research direction (protection of finger vein templates in real time), which represent a new research direction in this area.

Matched MeSH terms: Confidentiality
Fulltext Social Media in the Urology Practice | Opinion: NO

Da Silva RD, Leow JJ, Abidin ZA, Linden-Castro E, Castro EIB, Blanco LT, et al.

Int Braz J Urol, 2019 10 19;45(5):882-888.
PMID: 31626517 DOI: 10.1590/S1677-5538.IBJU.2019.05.04
Matched MeSH terms: Confidentiality
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

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