M.Tech. (Radiography) / The Radiology Information System and the Picture Archiving and Communication System have contributed to improved patient care by eradicating delays in the clinical management of patients. This is achieved by permitting access to instantaneous radiology interpretations and secondary consultations; creating a basis for teleradiology and reducing storage costs by replacing conventional archives with cheaper digital storage. However, the former has attributed to the recent rise in confidentiality breaches involving medical data in the United States of America. Yet, reports of this nature remain unknown in the South African context. Breaches by authorised users remain an under investigated issue and continue to threaten the confidentiality of data. This assumption was employed as the conceptual basis for this study while, the Theory of Planned Behaviour was utilised to generate probable causes of deviant behaviour. A sample of health professionals (n=115) and information technologists (n=2) was drawn to collect data. The extent of compliance was expressed as a percentage error of the discrepancy between the observed behaviour and the regulations stipulated by the Health Insurance Portability and Accountability Act. The independent variable (work practices) were categorised into access restriction, intrinsic security measures and the actual breach incidences. The non-parametric Chi-Square test was used to calculate statistical significance the correlational extent of which was determined using the phi coefficient. Both Research Settings indicated poor compliance (percentage errors of 67.3 and 70.37) with the mandated regulations. The study provides insight about the confidentiality status within the South African context. This is the kind of information sought by regulators to aid keep pace with the rapid advances in Information Technology.

Indiana University-Purdue University Indianapolis (IUPUI) / As medical data continues to transition to electronic formats, opportunities arise for researchers to use this microdata to discover patterns and increase knowledge that can improve patient care. Now more than ever, it is critical to protect the identities of the patients contained in these databases. Even after removing obvious “identifier” attributes, such as social security numbers or first and last names, that clearly identify a specific person, it is possible to join “quasi-identifier” attributes from two or more publicly available databases to identify individuals. K-anonymity is an approach that has been used to ensure that no one individual can be distinguished within a group of at least k individuals. However, the majority of the proposed approaches implementing k-anonymity have focused on improving the efficiency of algorithms implementing k-anonymity; less emphasis has been put towards ensuring the “utility” of anonymized data from a researchers’ perspective. We propose a new data utility measurement, called the research value (RV), which extends existing utility measurements by employing data constraints rules that are designed to improve the effectiveness of queries against the anonymized data. To anonymize a given raw dataset, two algorithms are proposed that use predefined generalizations provided by the data content expert and their corresponding research values to assess an attribute’s data utility as it is generalizing the data to ensure k-anonymity. In addition, an automated algorithm is presented that uses clustering and the RV to anonymize the dataset. All of the proposed algorithms scale efficiently when the number of attributes in a dataset is large.

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / Access to healthcare is regarded as a basic and essential human right. It is widely known that ICT solutions have potential to improve access to healthcare, reduce healthcare cost, reduce medical errors, and bridge the digital divide between rural and urban healthcare centres. The access to personal healthcare records is, however, an astounding challenge for both patients and healthcare professionals alike, particularly within resource-restricted environments (such as rural communities). Most rural healthcare institutions have limited or non-existent access to electronic patient healthcare records. This study explored the accessibility of personal healthcare records by patients and healthcare professionals within a rural community hospital in the Eastern Cape Province of South Africa. The case study was conducted at the St. Barnabas Hospital with the support and permission from the Faculty of Informatics and Design, Cape Peninsula University of Technology and the Eastern Cape Department of Health. Semi-structured interviews, observations, and interactive co-design sessions and focus groups served as the main data collection methods used to determine the accessibility of personal healthcare records by the relevant stakeholders. The data was qualitatively interpreted using thematic analysis. The study highlighted the various challenges experienced by healthcare professionals and patients, including time-consuming manual processes, lack of infrastructure, illegible hand-written records, missing records and illiteracy. A number of recommendations for improved access to personal healthcare records are discussed. The significance of the study articulates the imperative need for seamless and secure access to personal healthcare records, not only within rural areas but within all communities.

No description available.

Data matching is the automated process permitting the comparison of significant amounts of personal data from two or more different databanks in order to produce new information. Its use by governments implicates many rights and freedoms, including the protection against unreasonable search and seizure under section 8 of the Canadian Charter. / In the author's opinion, a governmental data matching program will probably constitute a search or seizure under section 8 when a positive answer is given to two questions. First, is there a use or transfer of information which implicates constitutionally protected information? Generally, section 8 will only protect biographical personal information, as described in the Plant case. Second, one must determine if a reasonable expectation of privacy exists as to the purpose for which the information will be used. In other words, one must determine if the two governmental databanks are separate on the constitutional level. / However, a positive answer to both of theses questions does not mean that the matching program necessarily infringes section 8. It will not be considered unreasonable if it is authorised by law, if the law itself is reasonable, and if the execution of the program is reasonable. Presuming that the program is authorised by law, it is probable that a matching program aimed to detect individuals collecting illegally social benefits will not be considered unreasonable.

The revolutionary migration within the health care sector towards the digitisation of medical records for convenience or compliance touches on many concerns with respect to ensuring the security of patient personally identifiable information (PII). Foremost of these is that a patient’s right to privacy is not violated. To this end, it is necessary that health care practitioners have a clear understanding of the various constructs of privacy in order to ensure privacy compliance is maintained. This research project focuses on an investigation of privacy from a multidisciplinary philosophical perspective to highlight the constructs of information privacy. These constructs together with a discussion focused on the confidentiality and accessibility of medical records results in the development of an artefact represented in the format of a model. The formulation of the model is accomplished by making use of the Design Science research guidelines for artefact development. Part of the process required that the artefact be refined through the use of an Expert Review Process. This involved an iterative (three phase) process which required (seven) experts from the fields of privacy, information security, and health care to respond to semi-structured questions administered with an interview guide. The data analysis process utilised the ISO/IEC 29100:2011(E) standard on privacy as a means to assign thematic codes to the responses, which were then analysed. The proposed information privacy model was discussed in relation to the compliance requirements of the South African Protection of Personal Information (PoPI) Bill of 2009 and their application in a primary health care facility. The proposed information privacy model provides a holistic view of privacy management that can residually be used to increase awareness associated with the compliance requirements of using patient PII.

MPM / Oliver Tambo Institute of Governance and Policy Studies

The primary purpose of the present study was to determine if information regarding potential parental or legal guardian access to mental health information would deleteriously impact male and female adolescent psychiatric patients' willingness to self-report personal problems and symptoms.

The study sought to investigate the factors influencing the contents of antiretroviral therapy (ART) reports in the Amathole Health District of the Eastern Cape Province. A qualitative and quantitative study was conducted to assess the challenges that inhibit this phenomenon. Structurally, the population consists of Amahlati and Nkonkobe sub-districts. Operational managers, information officers, professional nurses, data capturers, and administration clerks were randomly selected from sixteen facilities. Data collection was done on semi-structured interviews, questionnaires; observations were done using the probability sampling method, and the findings were analysed according to the same technique. The study revealed that the District Health Information System (DHIS) is the universal data management and reporting system which all healthcare and ART facilities are using to manage ART. However, regardless of all these universal arrangements such as the use of the DHIS to aid in reporting, the contents of ART reports from various facilities have not been uniform due to various factors. There is a lack of a reliable network to link DHIS computers across facilities. The shift from paper-based to electronic data management has caused the difficulties in the collating and management of ART data since some facilities are manual paper- based while others are automated using the modern DHIS. Lack of daily capturing and validation is a major challenge across the ART facilities. Further, there are Non-Governmental Organisations(NGOs) such as AFRICARE and the IYDSA that have signed a memorandum of understanding (MOU) with the district to provide a budgetary support for staff training in data management of ART reports in the district. While the NGOs keep on assisting the ART facilities with data management, there is a lack of skills transfer. The district could not account on follow-up of ART patients from one facility to another. This is increasing the number of defaulting in ART patients, thus there is no accurate figures on retention of patients in ART Programme. The officials from ART sites tend to use their own transport to carry data from facilities to the district offices and this resulted in late submission of reports. The study thus recommends that, inter alia, data management and trainings should be done to improve data quality in reporting, a reliable computer network be installed, backed-up and maintained for data and report management in the all healthcare facilities. All the ART sites should adopt and use the automated data management system for universality and eliminating the faults of manual paper data management and reporting. This would ensure that the contents of ART reports are uniform and a true reflection of the situation on the ground towards universal access to ART and healthcare in the Amathole Health District, and South Africa at large.

Indiana University-Purdue University Indianapolis (IUPUI) / There has been vast and growing amount of healthcare data especially with the rapid adoption of electronic health records (EHRs) as a result of the HITECH act of 2009. It is estimated that around 80% of the clinical information resides in the unstructured narrative of an EHR. Recently, natural language processing (NLP) techniques have offered opportunities to extract information from unstructured clinical texts needed for various clinical applications. A popular method for enabling secondary uses of EHRs is information or concept extraction, a subtask of NLP that seeks to locate and classify elements within text based on the context. Extraction of clinical concepts without considering the context has many complications, including inaccurate diagnosis of patients and contamination of study cohorts. Identifying the negation status and whether a clinical concept belongs to patients or his family members are two of the challenges faced in context detection. A negation algorithm called Dependency Parser Negation (DEEPEN) has been developed in this research study by taking into account the dependency relationship between negation words and concepts within a sentence using the Stanford Dependency Parser. The study results demonstrate that DEEPEN, can reduce the number of incorrect negation assignment for patients with positive findings, and therefore improve the identification of patients with the target clinical findings in EHRs. Additionally, an NLP system consisting of section segmentation and relation discovery was developed to identify patients' family history. To assess the generalizability of the negation and family history algorithm, data from a different clinical institution was used in both algorithm evaluations.