| Title | REVISITING HEALTH INFORMATION TECHNOLOGY ETHICAL, LEGAL, and SOCIAL ISSUES and EVALUATION: TELEHEALTH/TELEMEDICINE and COVID-19. |
| Authors | Kaplan, B |
| Journal | International journal of medical informatics |
| Publication Date | 1 Nov 2020 |
| Date Added to PubMed | 6 Nov 2020 |
| Abstract | Information technologies have been vital during the COVID-19 pandemic. Telehealth and telemedicine services, especially, fulfilled their promise by allowing patients to receive advice and care at a distance, making it safer for all concerned. Over the preceding years, professional societies, governments, and scholars examined ethical, legal, and social issues (ELSI) related to telemedicine and telehealth. Primary concerns evident from reviewing this literature have been quality of care, access, consent, and privacy. To identify and summarize ethical, legal, and social issues related to information technology in healthcare, as exemplified by telehealth and telemedicine. To expand on prior analyses and address gaps illuminated by the COVID-19 experience. To propose future research directions. Literature was identified through searches, forward and backward citation chaining, and the author's knowledge of scholars and works in the area. EU and professional organizations' guidelines, and nineteen scholarly papers were examined and categories created to identify ethical, legal, and social issues they addressed. A synthesis matrix was developed to categorize issues addressed by each source. A synthesis matrix was developed and issues categorized as: quality of care, consent and autonomy, access to care and technology, legal and regulatory, clinician responsibilities, patient responsibilities, changed relationships, commercialization, policy, information needs, and evaluation, with subcategories that fleshed out each category. The literature primarily addressed quality of care, access, consent, and privacy. Other identified considerations were little discussed. These and newer concerns include: usability, tailoring services to each patient, curriculum and training, implementation, commercialization, and licensing and liability. The need for interoperability, data availability, cybersecurity, and informatics infrastructure also is more apparent. These issues are applicable to other information technologies in healthcare. Clinicians and organizations need updated guidelines for ethical use of telemedicine and telehealth care, and decision- and policy-makers need evidence to inform decisions. The variety of newly implemented telemedicine services is an on-going natural experiment presenting an unparalleled opportunity to develop an evidence-based way forward. The paper recommends evaluation using an applied ethics, context-sensitive approach that explores interactions among multiple factors and considerations. It suggests evaluation questions to investigate ethical, social, and legal issues through multi-method, sociotechnical, interpretive and ethnographic, and interactionist evaluation approaches. Such evaluation can help telehealth, and other information technologies, be integrated into healthcare ethically and effectively. |
| Link | http://doi.org/10.1016/j.ijmedinf.2020.104239 |
| Title | Ethical considerations for artificial intelligence in dermatology: a scoping review. |
| Authors | Gordon, ER; Trager, MH; Kontos, D; Weng, C; Geskin, LJ; Dugdale, LS; Samie, FH |
| Journal | The British journal of dermatology |
| Publication Date | 17 May 2024 |
| Date Added to PubMed | 8 Feb 2024 |
| Abstract | The field of dermatology is experiencing the rapid deployment of artificial intelligence (AI), from mobile applications (apps) for skin cancer detection to large language models like ChatGPT that can answer generalist or specialist questions about skin diagnoses. With these new applications, ethical concerns have emerged. In this scoping review, we aimed to identify the applications of AI to the field of dermatology and to understand their ethical implications. We used a multifaceted search approach, searching PubMed, MEDLINE, Cochrane Library and Google Scholar for primary literature, following the PRISMA Extension for Scoping Reviews guidance. Our advanced query included terms related to dermatology, AI and ethical considerations. Our search yielded 202 papers. After initial screening, 68 studies were included. Thirty-two were related to clinical image analysis and raised ethical concerns for misdiagnosis, data security, privacy violations and replacement of dermatologist jobs. Seventeen discussed limited skin of colour representation in datasets leading to potential misdiagnosis in the general population. Nine articles about teledermatology raised ethical concerns, including the exacerbation of health disparities, lack of standardized regulations, informed consent for AI use and privacy challenges. Seven addressed inaccuracies in the responses of large language models. Seven examined attitudes toward and trust in AI, with most patients requesting supplemental assessment by a physician to ensure reliability and accountability. Benefits of AI integration into clinical practice include increased patient access, improved clinical decision-making, efficiency and many others. However, safeguards must be put in place to ensure the ethical application of AI. |
| Link | http://doi.org/10.1093/bjd/ljae040 |
| Title | Privacy and Security in Mobile Health (mHealth) Research. |
| Authors | Arora, S; Yttri, J; Nilse, W |
| Journal | Alcohol research : current reviews |
| Publication Date | 1 Dec 2014 |
| Date Added to PubMed | 11 Aug 2015 |
| Abstract | Research on the use of mobile technologies for alcohol use problems is a developing field. Rapid technological advances in mobile health (or mHealth) research generate both opportunities and challenges, including how to create scalable systems capable of collecting unprecedented amounts of data and conducting interventions-some in real time-while at the same time protecting the privacy and safety of research participants. Although the research literature in this area is sparse, lessons can be borrowed from other communities, such as cybersecurity or Internet security, which offer many techniques to reduce the potential risk of data breaches or tampering in mHealth. More research into measures to minimize risk to privacy and security effectively in mHealth is needed. Even so, progress in mHealth research should not stop while the field waits for perfect solutions. |
| Link | http://doi.org/10.1016/j.cbpra.2014.04.008 |
| Title | [Telemedicine]. |
| Authors | Juhra, C |
| Journal | Orthopadie (Heidelberg, Germany) |
| Publication Date | 1 Jul 2023 |
| Date Added to PubMed | 8 Jun 2023 |
| Abstract | The care of patients over long distances has a long tradition. Modern technology offers more and more possibilities for communication. While initially only radio signals could be exchanged, image transmission is now possible without any problems and is part of everyday life in many areas of medicine. Telemedicine includes communication between service providers with each other, with the patient, and also communication in medicine via electronic media. Success factors are the engagement of users, remuneration, legislation, human factors, interoperability, standards, performance indicators and compliance with data protection. The benefits and risks must be carefully weighed against each other. If necessary, telemedicine can bring expertise to the patient, so that not every patient has to be brought to the expert. Thus, optimal care at the optimal place can be made possible. |
| Link | http://doi.org/10.1007/s00132-023-04396-0 |
| Title | Regulating digital health. |
| Authors | |
| Journal | Bulletin of the World Health Organization |
| Publication Date | 1 Apr 2020 |
| Date Added to PubMed | 15 Apr 2020 |
| Abstract | Realizing the potential of digital health requires overcoming its inherent risks. Gary Humphreys reports. |
| Link | http://doi.org/10.2471/BLT.20.020420 |
| Title | Digital Health: Should We Be Concerned? |
| Authors | Mandrola, J |
| Journal | Methodist DeBakey cardiovascular journal |
| Publication Date | 1 Dec 2020 |
| Date Added to PubMed | 28 Jan 2021 |
| Abstract | Type "health and fitness apps" into any search engine, and thousands of options will appear-so many, in fact, that people can now measure their own heart rate, sleep habits, and dozens of other health parameters that once required a doctor's visit. While anecdotes of a personal health device capturing early signs of disease may garner media attention, the increasing quantification of human physiology can have downsides. In essence, the enhanced ability to assess surrogate measures of health, such as temperature, minute-to-minute blood pressure, and genomics, are an expansion of anticipatory health-that is, an attempt to detect and avoid events that might happen in the future. While patients used to seek out doctors when they were sick, digital tools will send increasing numbers of people to their physicians before they are sick. In a Cartesian model of the human body, wherein one system could potentially be fixed independent of another system, having more data may be beneficial. The human body, however, is far more complex than any Cartesian model could explain. This article explores the limitations of digital devices to improve health. |
| Link | http://doi.org/10.14797/mdcj-16-4-309 |
| Title | Patients' Perspectives on the Data Confidentiality, Privacy, and Security of mHealth Apps: Systematic Review. |
| Authors | Alhammad, N; Alajlani, M; Abd-Alrazaq, A; Epiphaniou, G; Arvanitis, T |
| Journal | Journal of medical Internet research |
| Publication Date | 31 May 2024 |
| Date Added to PubMed | 31 May 2024 |
| Abstract | Mobile health (mHealth) apps have the potential to enhance health care service delivery. However, concerns regarding patients' confidentiality, privacy, and security consistently affect the adoption of mHealth apps. Despite this, no review has comprehensively summarized the findings of studies on this subject matter. This systematic review aims to investigate patients' perspectives and awareness of the confidentiality, privacy, and security of the data collected through mHealth apps. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted in 3 electronic databases: PubMed, Ovid, and ScienceDirect. All the retrieved articles were screened according to specific inclusion criteria to select relevant articles published between 2014 and 2022. A total of 33 articles exploring mHealth patients' perspectives and awareness of data privacy, security, and confidentiality issues and the associated factors were included in this systematic review. Thematic analyses of the retrieved data led to the synthesis of 4 themes: concerns about data privacy, confidentiality, and security; awareness; facilitators and enablers; and associated factors. Patients showed discordant and concordant perspectives regarding data privacy, security, and confidentiality, as well as suggesting approaches to improve the use of mHealth apps (facilitators), such as protection of personal data, ensuring that health status or medical conditions are not mentioned, brief training or education on data security, and assuring data confidentiality and privacy. Similarly, awareness of the subject matter differed across the studies, suggesting the need to improve patients' awareness of data security and privacy. Older patients, those with a history of experiencing data breaches, and those belonging to the higher-income class were more likely to raise concerns about the data security and privacy of mHealth apps. These concerns were not frequent among patients with higher satisfaction levels and those who perceived the data type to be less sensitive. Patients expressed diverse views on mHealth apps' privacy, security, and confidentiality, with some of the issues raised affecting technology use. These findings may assist mHealth app developers and other stakeholders in improving patients' awareness and adjusting current privacy and security features in mHealth apps to enhance their adoption and use. PROSPERO CRD42023456658; https://tinyurl.com/ytnjtmca. |
| Link | http://doi.org/10.2196/50715 |
| Title | Privacy and security in mobile health apps: a review and recommendations. |
| Authors | Martínez-Pérez, B; de la Torre-Díez, I; López-Coronado, M |
| Journal | Journal of medical systems |
| Publication Date | 1 Jan 2015 |
| Date Added to PubMed | 10 Dec 2014 |
| Abstract | In a world where the industry of mobile applications is continuously expanding and new health care apps and devices are created every day, it is important to take special care of the collection and treatment of users' personal health information. However, the appropriate methods to do this are not usually taken into account by apps designers and insecure applications are released. This paper presents a study of security and privacy in mHealth, focusing on three parts: a study of the existing laws regulating these aspects in the European Union and the United States, a review of the academic literature related to this topic, and a proposal of some recommendations for designers in order to create mobile health applications that satisfy the current security and privacy legislation. This paper will complement other standards and certifications about security and privacy and will suppose a quick guide for apps designers, developers and researchers. |
| Link | http://doi.org/10.1007/s10916-014-0181-3 |
| Title | eHealth Cloud Security Challenges: A Survey. |
| Authors | Al-Issa, Y; Ottom, MA; Tamrawi, A |
| Journal | Journal of healthcare engineering |
| Publication Date | 1 Dec 2019 |
| Date Added to PubMed | 1 Oct 2019 |
| Abstract | Cloud computing is a promising technology that is expected to transform the healthcare industry. Cloud computing has many benefits like flexibility, cost and energy savings, resource sharing, and fast deployment. In this paper, we study the use of cloud computing in the healthcare industry and different cloud security and privacy challenges. The centralization of data on the cloud raises many security and privacy concerns for individuals and healthcare providers. This centralization of data (1) provides attackers with one-stop honey-pot to steal data and intercept data in-motion and (2) moves data ownership to the cloud service providers; therefore, the individuals and healthcare providers lose control over sensitive data. As a result, security, privacy, efficiency, and scalability concerns are hindering the wide adoption of the cloud technology. In this work, we found that the state-of-the art solutions address only a subset of those concerns. Thus, there is an immediate need for a holistic solution that balances all the contradicting requirements. |
| Link | http://doi.org/10.1155/2019/7516035 |
| Title | Privacy, Data Sharing, and Data Security Policies of Women's mHealth Apps: Scoping Review and Content Analysis. |
| Authors | Alfawzan, N; Christen, M; Spitale, G; Biller-Andorno, N |
| Journal | JMIR mHealth and uHealth |
| Publication Date | 6 May 2022 |
| Date Added to PubMed | 7 May 2022 |
| Abstract | Women's mobile health (mHealth) is a growing phenomenon in the mobile app global market. An increasing number of women worldwide use apps geared to female audiences (female technology). Given the often private and sensitive nature of the data collected by such apps, an ethical assessment from the perspective of data privacy, sharing, and security policies is warranted. The purpose of this scoping review and content analysis was to assess the privacy policies, data sharing, and security policies of women's mHealth apps on the current international market (the App Store on the Apple operating system [iOS] and Google Play on the Android system). We reviewed the 23 most popular women's mHealth apps on the market by focusing on publicly available apps on the App Store and Google Play. The 23 downloaded apps were assessed manually by 2 independent reviewers against a variety of user data privacy, data sharing, and security assessment criteria. All 23 apps collected personal health-related data. All apps allowed behavioral tracking, and 61% (14/23) of the apps allowed location tracking. Of the 23 apps, only 16 (70%) displayed a privacy policy, 12 (52%) requested consent from users, and 1 (4%) had a pseudoconsent. In addition, 13% (3/23) of the apps collected data before obtaining consent. Most apps (20/23, 87%) shared user data with third parties, and data sharing information could not be obtained for the 13% (3/23) remaining apps. Of the 23 apps, only 13 (57%) provided users with information on data security. Many of the most popular women's mHealth apps on the market have poor data privacy, sharing, and security standards. Although regulations exist, such as the European Union General Data Protection Regulation, current practices do not follow them. The failure of the assessed women's mHealth apps to meet basic data privacy, sharing, and security standards is not ethically or legally acceptable. |
| Link | http://doi.org/10.2196/33735 |