The Experts below are selected from a list of 10485 Experts worldwide ranked by ideXlab platform
Junwei Zhang - One of the best experts on this subject based on the ideXlab platform.
-
privacy preserving search over encrypted Personal Health Record in multi source cloud
IEEE Access, 2018Co-Authors: Xin Yao, Yaping Lin, Qin Liu, Junwei ZhangAbstract:Cloud-based Personal Health Record systems (CB-PHR) have great potential in facilitating the management of individual Health Records. Security and privacy concerns are among the main obstacles for the wide adoption of CB-PHR systems. In this paper, we consider a multi-source CB-PHR system in which multiple data providers, such as hospitals and physicians are authorized by individual data owners to upload their Personal Health data to an untrusted public cloud. The Health data are submitted in an encrypted form to ensure data security, and each data provider also submits encrypted data indexes to enable queries over the encrypted data. We propose a novel Multi-Source Order-Preserving Symmetric Encryption (MOPSE) scheme whereby the cloud can merge the encrypted data indexes from multiple data providers without knowing the index content. MOPSE enables efficient and privacy-preserving query processing in that a data user can submit a single data query, the cloud can process over the encrypted data from all related data providers without knowing the query content. We also propose an enhanced scheme, MOPSE+, to more efficiently support the data queries by hierarchical data providers. Extensive analysis and experiments over real data sets demonstrate the efficacy and efficiency of MOPSE and MOPSE+.
-
privacy preserving search over encrypted Personal Health Record in multi source cloud
IEEE Access, 2018Co-Authors: Junwei ZhangAbstract:Cloud-based Personal Health Record systems (CB-PHR) have great potential in facilitating the management of individual Health Records. Security and privacy concerns are among the main obstacles for the wide adoption of CB-PHR systems. In this paper, we consider a multi-source CB-PHR system in which multiple data providers, such as hospitals and physicians are authorized by individual data owners to upload their Personal Health data to an untrusted public cloud. The Health data are submitted in an encrypted form to ensure data security, and each data provider also submits encrypted data indexes to enable queries over the encrypted data. We propose a novel Multi-Source Order-Preserving Symmetric Encryption (MOPSE) scheme whereby the cloud can merge the encrypted data indexes from multiple data providers without knowing the index content. MOPSE enables efficient and privacy-preserving query processing in that a data user can submit a single data query, the cloud can process over the encrypted data from all related data providers without knowing the query content. We also propose an enhanced scheme, MOPSE+, to more efficiently support the data queries by hierarchical data providers. Extensive analysis and experiments over real data sets demonstrate the efficacy and efficiency of MOPSE and MOPSE+.
Kim M Nazi - One of the best experts on this subject based on the ideXlab platform.
-
potential of Personal Health Record portals in the care of individuals with spinal cord injuries and disorders provider perspectives
Journal of Spinal Cord Medicine, 2018Co-Authors: Jennifer N Hill, Bridget Smith, Frances M Weaver, Barry Goldstein, Timothy P Hogan, Kim M Nazi, Florian P ThomasAbstract:Context/Objective: Although Personal Health Record (PHR) portals are designed for patients, Healthcare providers are a key influence in how patients use their features and realize benefits from them. A few studies have examined provider attitudes toward PHR portals, but none have focused on those who care for individuals with spinal cord injuries and disorders (SCI/D). We characterize SCI/D provider perspectives of PHR portals, including perceived advantages and disadvantages of PHR portal use in SCI/D care.Design: Cross-sectional; semi-structured interviews.Setting: Spinal Cord Injury (SCI) Centers in the Veterans Health Administration.Participants: Twenty-six SCI/D Healthcare providers.Interventions: None.Outcome Measures: Perceived advantages and disadvantages of PHR portals.Results: The complex situations of individuals with SCI/D shaped provider perspectives of PHR portals and their potential role in practice. Perceived advantages of PHR portal use in SCI/D care included the ability to coordinate inf...
-
the Personal Health Record paradox Health care professionals perspectives and the information ecology of Personal Health Record systems in organizational and clinical settings
Journal of Medical Internet Research, 2013Co-Authors: Kim M NaziAbstract:Background: Despite significant consumer interest and anticipated benefits, overall adoption of Personal Health Records (PHRs) remains relatively low. Understanding the consumer perspective is necessary, but insufficient by itself. Consumer PHR use also has broad implications for Health care professionals and organizational delivery systems; however, these have received less attention. An exclusive focus on the PHR as a tool for consumer empowerment does not adequately take into account the social and organizational context of Health care delivery, and the reciprocal nature of patient engagement. Objective: The purpose of this study was to examine the experiences of physicians, nurses, and pharmacists at the Department of Veterans Affairs (VA) using an organizationally sponsored PHR to develop insights into the interaction of technology and processes of Health care delivery. The conceptual framework for the study draws on an information ecology perspective, which recognizes that a vibrant dynamic exists among technologies, people, practices, and values, accounting for both the values and norms of the participants and the practices of the local setting. The study explores the experiences and perspectives of VA Health care professionals related to patient use of the My HealtheVet PHR portal and secure messaging systems. Methods: In-depth interviews were conducted with 30 VA Health care professionals engaged in providing direct patient care who self-reported that they had experiences with at least 1 of 4 PHR features. Interviews were transcribed, coded, and analyzed to identify inductive themes. Organizational documents and artifacts were reviewed and analyzed to trace the trajectory of secure messaging implementation as part of the VA Patient Aligned Care Team (PACT) model. Results: Study findings revealed a variety of factors that have facilitated or inhibited PHR adoption, use, and endorsement of patient use by Health care professionals. Health care professionals’ accounts and analysis of organizational documents revealed a multidimensional dynamic between the trajectory of secure messaging implementation and its impact on organizational actors and their use of technology, influencing workflow, practices, and the flow of information. In effect, secure messaging was the missing element of complex information ecology and its implementation acted as a catalyst for change. Secure messaging was found to have important consequences for access, communication, patient self-report, and patient/provider relationships. Conclusions: Study findings have direct implications for the development and implementation of PHR systems to ensure adequate training and support for Health care professionals, alignment with clinical workflow, and features that enable information sharing and communication. Study findings highlight the importance of clinician endorsement and engagement, and the need to further examine both intended and unintended consequences of use. This research provides an integral step toward better understanding the social and organizational context and impact of PHR and secure messaging use in clinical practice settings. [J Med Internet Res 2013;15(4):e70]
-
patient experiences with full electronic access to Health Records and clinical notes through the my Healthevet Personal Health Record pilot qualitative study
Journal of Medical Internet Research, 2013Co-Authors: Susan Woods, Kim M Nazi, Carolyn Turvey, Erin Schwartz, Anais Tuepker, Nancy A Press, Paul W NicholAbstract:Background: Full sharing of the electronic Health Record with patients has been identified as an important opportunity to engage patients in their Health and Health care. The My HealtheVet Pilot, the initial Personal Health Record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic Health Record, including clinical notes, laboratory tests, and imaging reports. Objective: A qualitative study with purposeful sampling sought to examine patients’ views and experiences with reading their Health Records, including their clinical notes, online. Methods: Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic Health Records participated in the sessions. Results: Four themes characterized patient experiences with reading the full complement of their Health information. Patients felt that seeing their Records positively affected communication with providers and the Health system, enhanced knowledge of their Health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their Health Record information provided benefits. Conclusions: Patients and their delegates had predominantly positive experiences with Health Record transparency and the open sharing of notes and test results. Viewing their Records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full Record access on patient well-being. While shared Records may or may not impact overall clinic workload, it is likely to change providers’ work, necessitating new types of skills to communicate and partner with patients.
-
development and evaluation of an internet and Personal Health Record training program for low income patients with hiv or hepatitis c
Medical Care, 2013Co-Authors: Keith D Mcinnes, Kim M Nazi, Stephanie L Shimada, Jeffrey L Solomon, Beth Ann Petrakis, Barbara G Bokhour, Steven M Asch, Thomas K Houston, Allen L GiffordAbstract:BACKGROUND: Vulnerable populations face difficulties accessing and using the internet and Personal Health Record (PHR) systems for Health-related purposes. Populations disconnected from the internet also tend to be disconnected from Health care services. OBJECTIVES: To develop and evaluate an intervention to increase skills in Health-related internet and PHR use for vulnerable populations with limited computer and internet experience. RESEARCH DESIGN: Preevaluation and postevaluation using quantitative surveys, semistructured interviews, focus groups, and ethnographic observation. SUBJECTS: Fourteen low-income Veterans receiving care at Veterans Affairs medical centers for human immunodeficiency virus or hepatitis C. MEASURES: Internet and PHR use, self-efficacy, patient activation, disease knowledge, predictors of medication adherence. RESULTS: At follow-up one (FU1), mean number of internet for Health features used increased from 1.57 to 4.07 (P<0.001) as did number of PHR features, from 0.36 to 2.00 (P<0.001). Mean self-efficacy increased at FU1, from 7.12 to 8.60, (P=0.009) and was maintained at follow-up two (FU2). Patient activation increased only at FU2, from 3.42 to 3.61 (P=0.03). Disease specific knowledge showed borderline increase at FU1, from 67.9% to 72.2% (P=0.05), whereas there were no changes in predictors of medication adherence. Qualitative findings underscored the interest in using internet and PHRs and their contribution to increased engagement in care. Training cost per participant was $287. CONCLUSIONS: Group training of vulnerable patients represents a cost-effective method to increase internet and PHR skills, and improve patient confidence in finding Health-related information, making online Health-related transactions, and interacting with Health care providers.
-
patient interest in sharing Personal Health Record information
Annals of Internal Medicine, 2011Co-Authors: Donna M Zulman, Kim M Nazi, Carolyn Turvey, Todd H Wagner, Susan WoodsAbstract:Electronic Personal Health Record systems are being implemented with little understanding of how patients want their information used. In this survey of veterans who use an electronic system contai...
Susan Woods - One of the best experts on this subject based on the ideXlab platform.
-
patient experiences with full electronic access to Health Records and clinical notes through the my Healthevet Personal Health Record pilot qualitative study
Journal of Medical Internet Research, 2013Co-Authors: Susan Woods, Kim M Nazi, Carolyn Turvey, Erin Schwartz, Anais Tuepker, Nancy A Press, Paul W NicholAbstract:Background: Full sharing of the electronic Health Record with patients has been identified as an important opportunity to engage patients in their Health and Health care. The My HealtheVet Pilot, the initial Personal Health Record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic Health Record, including clinical notes, laboratory tests, and imaging reports. Objective: A qualitative study with purposeful sampling sought to examine patients’ views and experiences with reading their Health Records, including their clinical notes, online. Methods: Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic Health Records participated in the sessions. Results: Four themes characterized patient experiences with reading the full complement of their Health information. Patients felt that seeing their Records positively affected communication with providers and the Health system, enhanced knowledge of their Health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their Health Record information provided benefits. Conclusions: Patients and their delegates had predominantly positive experiences with Health Record transparency and the open sharing of notes and test results. Viewing their Records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full Record access on patient well-being. While shared Records may or may not impact overall clinic workload, it is likely to change providers’ work, necessitating new types of skills to communicate and partner with patients.
-
patient interest in sharing Personal Health Record information
Annals of Internal Medicine, 2011Co-Authors: Donna M Zulman, Kim M Nazi, Carolyn Turvey, Todd H Wagner, Susan WoodsAbstract:Electronic Personal Health Record systems are being implemented with little understanding of how patients want their information used. In this survey of veterans who use an electronic system contai...
-
patient interest in sharing Personal Health Record information a web based survey
Annals of Internal Medicine, 2011Co-Authors: Donna M Zulman, Kim M Nazi, Carolyn Turvey, Todd H Wagner, Susan WoodsAbstract:BACKGROUND Electronic Personal Health Record (PHR) systems are proliferating but largely have not realized their potential for enhancing communication among patients and their network of care providers. OBJECTIVE To explore preferences about sharing electronic Health information among users of the U.S. Department of Veterans Affairs (VA) PHR system, My HealtheVet. DESIGN Web-based survey of a convenience sample. SETTING My HealtheVet Web site from 7 July through 4 October 2010. PARTICIPANTS 18 471 users of My HealtheVet. MEASUREMENTS Interest in shared PHR access and preferences about who would receive access, the information that would be shared, and the activities that users would delegate. RESULTS Survey respondents were predominantly men (92%) and aged 50 to 64 years (51%) or 65 years or older (39%); approximately 39% reported poor or fair Health status. Almost 4 of 5 respondents (79%) were interested in sharing access to their PHR with someone outside of their Health system (62% with a spouse or partner, 23% with a child, 15% with another family member, and 25% with a non-VA Health care provider). Among those who selected a family member other than a spouse or partner, 47% lived apart from the specified person. Preferences about degree of access varied on the basis of the type of information being shared, the type of activity being performed, and the respondent's relationship with the selected person. LIMITATIONS The survey completion rate was 40.8%. Results might not be generalizable to all My HealtheVet users. CONCLUSION In a large survey of PHR users in the VA system, most respondents were interested in sharing access to their electronic Health information with caregivers and non-VA providers. Existing and evolving PHR systems should explore secure mechanisms for shared PHR access to improve information exchange among patients and the multiple persons involved in their Health care. PRIMARY FUNDING SOURCE Veterans Health Administration and The Robert Wood Johnson Foundation Clinical Scholars Program.
Qin Liu - One of the best experts on this subject based on the ideXlab platform.
-
privacy preserving search over encrypted Personal Health Record in multi source cloud
IEEE Access, 2018Co-Authors: Xin Yao, Yaping Lin, Qin Liu, Junwei ZhangAbstract:Cloud-based Personal Health Record systems (CB-PHR) have great potential in facilitating the management of individual Health Records. Security and privacy concerns are among the main obstacles for the wide adoption of CB-PHR systems. In this paper, we consider a multi-source CB-PHR system in which multiple data providers, such as hospitals and physicians are authorized by individual data owners to upload their Personal Health data to an untrusted public cloud. The Health data are submitted in an encrypted form to ensure data security, and each data provider also submits encrypted data indexes to enable queries over the encrypted data. We propose a novel Multi-Source Order-Preserving Symmetric Encryption (MOPSE) scheme whereby the cloud can merge the encrypted data indexes from multiple data providers without knowing the index content. MOPSE enables efficient and privacy-preserving query processing in that a data user can submit a single data query, the cloud can process over the encrypted data from all related data providers without knowing the query content. We also propose an enhanced scheme, MOPSE+, to more efficiently support the data queries by hierarchical data providers. Extensive analysis and experiments over real data sets demonstrate the efficacy and efficiency of MOPSE and MOPSE+.
-
dynamic access policy in cloud based Personal Health Record phr systems
Information Sciences, 2017Co-Authors: Xuhui Liu, Qin Liu, Tao PengAbstract:Abstract With the development of cloud computing, an increasing number of users are using cloud-based Personal Health Record (PHR) systems. The PHR is closely tied to patient privacy, and thus existing studies suggest encrypting PHRs before outsourcing. Comparison-based encryption (CBE) was the first to implement time comparison in an attribute-based access policy by means of the forward and backward derivation functions. However, CBE cannot be directly applied to cloud-based PHR environments for the following reasons: First, the cost of encryption grows linearly with the number of attributes in the access policy. Second, policy updating incurs high communication and computation costs for the data owner. To efficiently implement a dynamic access policy for PHRs in clouds, we first propose a hierarchical comparison-based encryption (HCBE) scheme that incorporates an attribute hierarchy into CBE. The HCBE scheme encrypts a ciphertext with a small number of generalized attributes at a higher level rather than many specific attributes at a lower level, greatly improving the encryption performance. Using the HCBE scheme as a foundation, we then develop a dynamic policy updating (DPU) scheme by utilizing the proxy re-encryption (PRE) technique. The DPU scheme can avoid the transmission of ciphertexts and minimize the computation overhead on the data owner by delegating the policy updating operations to the cloud. Extensive experiments have been conducted using a synthetic data set to verify the efficiency of our proposed schemes.
Carolyn Turvey - One of the best experts on this subject based on the ideXlab platform.
-
patient experiences with full electronic access to Health Records and clinical notes through the my Healthevet Personal Health Record pilot qualitative study
Journal of Medical Internet Research, 2013Co-Authors: Susan Woods, Kim M Nazi, Carolyn Turvey, Erin Schwartz, Anais Tuepker, Nancy A Press, Paul W NicholAbstract:Background: Full sharing of the electronic Health Record with patients has been identified as an important opportunity to engage patients in their Health and Health care. The My HealtheVet Pilot, the initial Personal Health Record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic Health Record, including clinical notes, laboratory tests, and imaging reports. Objective: A qualitative study with purposeful sampling sought to examine patients’ views and experiences with reading their Health Records, including their clinical notes, online. Methods: Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic Health Records participated in the sessions. Results: Four themes characterized patient experiences with reading the full complement of their Health information. Patients felt that seeing their Records positively affected communication with providers and the Health system, enhanced knowledge of their Health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their Health Record information provided benefits. Conclusions: Patients and their delegates had predominantly positive experiences with Health Record transparency and the open sharing of notes and test results. Viewing their Records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full Record access on patient well-being. While shared Records may or may not impact overall clinic workload, it is likely to change providers’ work, necessitating new types of skills to communicate and partner with patients.
-
patient interest in sharing Personal Health Record information
Annals of Internal Medicine, 2011Co-Authors: Donna M Zulman, Kim M Nazi, Carolyn Turvey, Todd H Wagner, Susan WoodsAbstract:Electronic Personal Health Record systems are being implemented with little understanding of how patients want their information used. In this survey of veterans who use an electronic system contai...
-
patient interest in sharing Personal Health Record information a web based survey
Annals of Internal Medicine, 2011Co-Authors: Donna M Zulman, Kim M Nazi, Carolyn Turvey, Todd H Wagner, Susan WoodsAbstract:BACKGROUND Electronic Personal Health Record (PHR) systems are proliferating but largely have not realized their potential for enhancing communication among patients and their network of care providers. OBJECTIVE To explore preferences about sharing electronic Health information among users of the U.S. Department of Veterans Affairs (VA) PHR system, My HealtheVet. DESIGN Web-based survey of a convenience sample. SETTING My HealtheVet Web site from 7 July through 4 October 2010. PARTICIPANTS 18 471 users of My HealtheVet. MEASUREMENTS Interest in shared PHR access and preferences about who would receive access, the information that would be shared, and the activities that users would delegate. RESULTS Survey respondents were predominantly men (92%) and aged 50 to 64 years (51%) or 65 years or older (39%); approximately 39% reported poor or fair Health status. Almost 4 of 5 respondents (79%) were interested in sharing access to their PHR with someone outside of their Health system (62% with a spouse or partner, 23% with a child, 15% with another family member, and 25% with a non-VA Health care provider). Among those who selected a family member other than a spouse or partner, 47% lived apart from the specified person. Preferences about degree of access varied on the basis of the type of information being shared, the type of activity being performed, and the respondent's relationship with the selected person. LIMITATIONS The survey completion rate was 40.8%. Results might not be generalizable to all My HealtheVet users. CONCLUSION In a large survey of PHR users in the VA system, most respondents were interested in sharing access to their electronic Health information with caregivers and non-VA providers. Existing and evolving PHR systems should explore secure mechanisms for shared PHR access to improve information exchange among patients and the multiple persons involved in their Health care. PRIMARY FUNDING SOURCE Veterans Health Administration and The Robert Wood Johnson Foundation Clinical Scholars Program.