CONFIDENTIALITY IN HEALTHCARE: A COMPARATIVE ANALYSIS OF PAPER-BASED AND ELECTRONIC HEALTH RECORD SYSTEMS

Authors

  • AL Mutairi, Osamah Mousa Ministry of National Guard Health Affairs
  • AL Harbi, Rashed Faisal Ministry of National Guard Health Affairs
  • AL Harbi, Ahmed Badae Ministry of National Guard Health Affairs
  • AL Harbi, Mohammed Shabeeb Ministry of National Guard Health Affairs
  • AL Harbi, Talal Muteb Ministry of National Guard Health Affairs
  • AL Mohesen, Sultan Abdullah Ministry of National Guard Health Affairs
  • AL Harbi, Mohammed Badday Ministry of National Guard Health Affairs

DOI:

https://doi.org/10.53555/eijmhs.v8i2.183

Keywords:

Confidentiality, Healthcare, Paper-Based Systems, Electronic Health Records (HER), Security, Data Sharing, Auditing, HIPAA, GDPR

Abstract

The transition from paper-based to Electronic Health Record (EHR) systems is transforming healthcare management. Although EHRs offer operational advantages like efficiency, ease of access, and cost-saving, they present new challenges in maintaining the confidentiality of sensitive patient information. This article provides a comprehensive comparison between paper-based and EHR systems in terms of confidentiality measures, examining aspects such as physical security, access control, data sharing and transfer, and legal frameworks. Traditional paper records, stored in secure physical locations and accessed only by authorized personnel, have limitations like inefficiency and difficulty in data sharing. Conversely, EHRs, while efficient and easily accessible, are susceptible to risks like hacking and unauthorized access. Both systems fall under healthcare confidentiality laws like HIPAA in the United States or GDPR in Europe, but EHRs introduce complexities that are still under legal scrutiny. Understanding the unique risks and benefits of each system is crucial for healthcare providers to make informed decisions that protect patient confidentiality in this digital age.

 

References

. Smith, J. "The Evolution of Health Record Systems." Journal of Health Informatics, 2019.

. Johnson, A. "Cybersecurity in Healthcare: Challenges and Solutions." Journal of Health and Technology, 2020.

. HIPAA Guidelines, U.S. Department of Health & Human Services, 2021.

. GDPR Guidelines, European Union, 2018.

. Kruse CS, Smith B, Vanderlinden H, Nealand A. Security Techniques for the Electronic Health Records. J Med Syst. 2017 Aug;41(8):127. doi: 10.1007/s10916-017-0778-4. Epub 2017 Jul 21. PMID: 28733949; PMCID: PMC5522514.

. Johnson KB, Unertl KM, Chen Q, Lorenzi NM, Nian H, Bailey J, Frisse M. Health information exchange usage in emergency departments and clinics: the who, what, and why. J Am Med Inform Assoc. 2011 Sep-Oct;18(5):690-7. doi: 10.1136/amiajnl-2011-000308. PMID: 21846788; PMCID: PMC3168326.

. Thimbleby H. Technology and the future of healthcare. J Public Health Res. 2013 Dec 1;2(3):e28. doi: 10.4081/jphr.2013.e28. PMID: 25170499; PMCID: PMC4147743.

. Bradford L, Aboy M, Liddell K. International transfers of health data between the EU and USA: a sector-specific approach for the USA to ensure an 'adequate' level of protection. J Law Biosci. 2020 Oct 15;7(1):lsaa055. doi: 10.1093/jlb/lsaa055. PMID: 34221424; PMCID: PMC8249089.

. Bakare, Abdullahi & Abioye, Abiola & Issa, Abdulwahab. (2016). An Assessment of Records Management Practice in Selected Local Government Councils in Ogun State, Nigeria. Journal of Information Science Theory and Practice. 4. 49-64. 10.1633/JISTaP.2016.4.1.4.

. Quinn M, Forman J, Harrod M, Winter S, Fowler KE, Krein SL, Gupta A, Saint S, Singh H, Chopra V. Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process. Diagnosis (Berl). 2019 Aug 27;6(3):241-248. doi: 10.1515/dx-2018-0036. PMID: 30485175; PMCID: PMC6691503.

. Basil NN, Ambe S, Ekhator C, Fonkem E. Health Records Database and Inherent Security Concerns: A Review of the Literature. Cureus. 2022 Oct 11;14(10):e30168. doi: 10.7759/cureus.30168. PMID: 36397924; PMCID: PMC9647912.

. Tertulino, R., Antunes, N. & Morais, H. Privacy in electronic health records: a systematic mapping study. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-022-01795-z

. Ehrenstein V, Kharrazi H, Lehmann H, et al. Obtaining Data From Electronic Health Records. In: Gliklich RE, Leavy MB, Dreyer NA, editors. Tools and Technologies for Registry Interoperability, Registries for Evaluating Patient Outcomes: A User’s Guide, 3rd Edition, Addendum 2 [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2019 Oct. Chapter 4. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK551878/

. de Carvalho Junior MA, Bandiera-Paiva P. Health Information System Role-Based Access Control Current Security Trends and Challenges. J Healthc Eng. 2018 Feb 19;2018:6510249. doi: 10.1155/2018/6510249. PMID: 29670743; PMCID: PMC5836325.

. Al-Issa Y, Ottom MA, Tamrawi A. eHealth Cloud Security Challenges: A Survey. J Healthc Eng. 2019 Sep 3;2019:7516035. doi: 10.1155/2019/7516035. PMID: 31565209; PMCID: PMC6745146.

. Quinn M, Forman J, Harrod M, Winter S, Fowler KE, Krein SL, Gupta A, Saint S, Singh H, Chopra V. Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process. Diagnosis (Berl). 2019 Aug 27;6(3):241-248. doi: 10.1515/dx-2018-0036. PMID: 30485175; PMCID: PMC6691503.

. Evans RS. Electronic Health Records: Then, Now, and in the Future. Yearb Med Inform. 2016 May 20;Suppl 1(Suppl 1):S48-61. doi: 10.15265/IYS-2016-s006. PMID: 27199197; PMCID: PMC5171496.

. Anwar RW, Abdullah T, Pastore F. Firewall Best Practices for Securing Smart Healthcare Environment: A Review. Applied Sciences. 2021; 11(19):9183. https://doi.org/10.3390/app11199183

. Stausberg J, Koch D, Ingenerf J, Betzler M. Comparing paper-based with electronic patient records: lessons learned during a study on diagnosis and procedure codes. J Am Med Inform Assoc. 2003 Sep-Oct;10(5):470-7. doi: 10.1197/jamia.M1290. Epub 2003 Jun 4. PMID: 12807808; PMCID: PMC212784.

. Upadhyay S, Hu HF. A Qualitative Analysis of the Impact of Electronic Health Records (EHR) on Healthcare Quality and Safety: Clinicians' Lived Experiences. Health Serv Insights. 2022 Mar 3;15:11786329211070722. doi: 10.1177/11786329211070722. PMID: 35273449; PMCID: PMC8902175.

. Tariq U, Ahmed I, Bashir AK, Shaukat K. A Critical Cybersecurity Analysis and Future Research Directions for the Internet of Things: A Comprehensive Review. Sensors. 2023; 23(8):4117. https://doi.org/10.3390/s23084117

. Edemekong PF, Annamaraju P, Haydel MJ. Health Insurance Portability and Accountability Act. [Updated 2022 Feb 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500019/

. Hasan, Ragib & Winslett, Marianne & Sion, Radu. (2007). Requirements of Secure Storage Systems for Healthcare Records. 4721. 174-180. 10.1007/978-3-540-75248-6_12.

. Chiruvella V, Guddati AK. Ethical Issues in Patient Data Ownership. Interact J Med Res. 2021 May 21;10(2):e22269. doi: 10.2196/22269. PMID: 34018968; PMCID: PMC8178732.

. Payne TH, Lovis C, Gutteridge C, Pagliari C, Natarajan S, Yong C, Zhao LP. Status of health information exchange: a comparison of six countries. J Glob Health. 2019 Dec;9(2):0204279. doi: 10.7189/jogh.09.020427. PMID: 31673351; PMCID: PMC6815656.

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Published

2022-08-15