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Personal Health Record (PHR) in a Talisman: An Approach to Providing Continuity of Care in Developing Countries Using Existing Social Customs
Abstract
The idea is to use the talisman as a portable electronic device that holds the personal health record (PHR) of the wearer of the talisman. We perceive this PHR-talisman as a removable memory device that can be updated with information from any computer that a clinic or a doctor uses to store the patient's case history and/or treatment information (Safran, 2006). Once updated with the person's health information, the talisman becomes the personal health record of the wearer and is available with the patient whenever and where ever he visits a doctor, clinic or a hospital. While the information contained in the talisman PHR may not initially be a complete electronic health record, it serves as the starting point for the continuum of the entire electronic health record of the individual. In terms of data storage capacity, current (as of May 2007) memory devices have a memory of up to 4 GB, which can carry textual information and some important images as well related to a person's entire life-time. An important feature of the talisman is that with appropriate security and privacy protocols in place, over a period of time the talisman has the potential to become the unique identifier that links all electronic health records of an individual spread across several hospitals and clinics around the entire globe.
... This contrasts sharply with smart card technology, which requires large investment in infrastructure for cards and readers [30]. Costs associated with new technology are a barrier to their adoption, and so portable USB storage devices are preferred over smartcards because they are half of the cost, and do not necessitate new readers because they work with existing interfaces [30,27]. ...
... The privacy of patient prescription data can be provided in a variety of ways. Hardware mechanisms for privacy preservation include wearable tokens and encrypted smart cards which can selectively disclose information according to the patient's wishes [27,19]. Software can be used to manage policies for access control to encrypted electronic prescriptions, removing the burden of storage from the individual but also removing their ability to explicitly control the prescription in favor of the third party hosting the data [29]. ...
The Drug Enforcement Agency (DEA) has announced the implementation of the use of both computerized and biometric security protocols in the electronic prescription of controlled substances. Electronic prescriptions which were up until this point not allowed to be prescribed by electronic means will now be easier for physicians and the DEA to monitor and prescribe. This paper will examine the various practical, political, and privacy issues as well as the potential benefits of the use of biometric information for the prescription of narcotics and other controlled substances. The proposed changes will build in non-repudiation and improve accountability, while introducing problems such as delegation, privacy, cost, and information security. Another consequence of strong biometric authentication is false acceptance and false rejection rates. Not only are there annoyances due to false reject rates, there are serious medical consequences when a drug cannot be obtained due to failed biometric authentication.
... For all the above mentioned reasons, the USB-pen is the most likely candidate for a portable personal health record device [8]. ...
... They can also be bought with added features like hardware cryptography and biometric authentication. For all the above mentioned reasons, the USB-pen is the most likely candidate for a portable personal health record device [8]. ...
Personal health information is constituted in its greatest part by complementary diagnostic tests which are an important medical aid. This information is generated dispersedly because the patient seeks medical care in many different places over his lifetime. Access to a comprehensive set of a patient’s health information is a challenge. It revolves around the patient so any managing scheme must be patient-centric. We took a pragmatic approach to this problem and developed a software standalone platform for secure personal health information storage, namely complementary diagnostic tests, on a portable device for mobility. Simplicity and ease of use were main objectives. A special attention was given to the security aspects associated with storing this kind of information.
Personal health information is constituted in its greatest part by complementary diagnostic tests which are an important medical aid. This information is generated dispersedly because the patient seeks medical care in many different places over his lifetime. Access to a comprehensive set of a patient's health information is a challenge. It revolves around the patient so any managing scheme must be patient-centric. We took a pragmatic approach to this problem and developed a software standalone platform for secure personal health information storage, namely complementary diagnostic tests, on a portable device for mobility. Simplicity and ease of use were main objectives. A special attention was given to the security aspects associated with storing this kind of information.
Alongside good governance, technology is considered among the greatest enablers for improved quality of life. However, the majority of its benefits have been concentrated in industrialized nations and therefore limited to a fraction of the world's population. We believe that technology has a large role to play in developing regions, that "First World" technology to date has been a poor fit in these areas, and that there is thus a need for technology research for developing regions. Despite the relative infancy of technology studies in developing regions, anecdotal evidence suggests that access to technology has a beneficial economic impact. Cellular telephony is probably the most visible application, but there are many others, some of which we cover in this article. The World Bank's infoDev site catalogs hundreds of information and communications technologies (ICT) projects, albeit not all successful. Most of these projects use existing off-the-shelf technology designed for the industrialized world. Although it is clear that there are large differences in assumptions related to cost, power, and usage, there has been little work on how technology needs in developing regions differ from those of industrialized nations. We argue that Western market forces continue to meet the needs of developing regions accidentally at best.
This document outlines various available and emerging information and communication technologies (ICTs) and provides a framework to assess how these technologies may be used to improve the efficiency of the delivery of safety net programs. These technologies include: mobile computing, biometrics, satellite communications, simple and smart cards, global positioning systems, radio frequency identification tags, automated teller machines and solar power. Their use in the administration, delivery and monitoring of SSN programs offers numerous advantages including increased accuracy, reliability and timeliness of information, performance measurement and service provider accountability. However, these new and emerging technologies typically require higher initial investment costs that benefit current and future time periods. The optimal solution to design an advanced and efficient delivery system for a safety net program may be a combination of traditional service delivery methods and new technologies that draws on a needs assessment that accounts for local conditions and program characteristics.
Web-based applications have been developed that allow patients to enter their own information into secure personal health records. These applications are being promoted as a means of providing patients and providers with universal access to updated medical information. The authors evaluated the functionality and utility of a selection of personal health records.
A targeted search strategy was used to identify eleven Web sites promoting different personal health records. Specific criteria related to the entry and display of data elements were developed to evaluate the functionality of each PHR. Information abstracted from an actual case was used to create a series of representative PHRs. Output generated for review was evaluated to assess the accuracy and completeness of clinical information related to the diagnosis and treatment of specific disorders.
The PHRs selected for review employed data entry methods that limited the range and content of patient-entered information related to medical history, medications, laboratory tests, diagnostic studies, and immunizations. Representative PHRs created with information abstracted from an actual case displayed varying amounts of information at basic and comprehensive levels of representation.
Currently available PHRs demonstrate limited functionality. The data entry, validation, and information display methods they employ may limit their utility as representations of medical information.
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