Exploring Current Challenges on Security and Privacy in an Operational eHealth Information System

Exploring Current Challenges on Security and Privacy in an Operational eHealth Information System

Volume 9, Issue 2, Page No 45-54, 2024

Author’s Name: Viktor Denkovski1, a), Irena Stojmenovska1, Goce Gavrilov1, Vladimir Radevski1, Vladimir Trajkovik2

View Affiliations

1 University American College Skopje, School of Computer Science and Information Technology, Skopje, 1000, North Macedonia
2 University “Ss. Cyril and Methodius”, Faculty of Computer Science and Engineering, Skopje, 1000, North Macedonia

a)whom correspondence should be addressed. E-mail: viktor.denkovski@uacs.edu.mk

Adv. Sci. Technol. Eng. Syst. J. 9(2), 45-54 (2024); a  DOI: 10.25046/aj090206

Keywords: eHealth Information System, Security and Privacy Issues, Medical Providers, eHealth Challenges

Share

32 Downloads

Export Citations

Bearing in mind that patient data is extremely sensitive, it is crucial to establish strong protection when the security and privacy of healthcare data are concerned. Prioritizing data security and privacy is essential for the overall healthcare industry in order to maintain the reliability of electronic healthcare (eHealth) information systems. This study explores the gathered data and information from the surveys and interviews by looking at the security and privacy concerns in using eHealth information technologies. The surveys and interviews were performed on the medical practitioners in N. Macedonia. The main goal is to find out how well-informed are the medical practitioners on the already in-place privacy measures that have been implemented by the medical authorities and to assess their attitudes regarding the need for additional improvements of the system. From the executed interviews, eight healthcare professionals participated in a thorough email interview in order to discover security and privacy issues associated with eHealth systems usage. This information served as the groundwork for administrating an online survey, to which 370 medical practitioners responded from primary and secondary healthcare. The findings emphasize how essential it is to promptly address the system usability concerns on the security and privacy procedures that are implemented when using eHealth technologies.

Received: 27 February 2024, Revised: 08 March 2024, Accepted: 05 April 2024, Published Online: 16 April 2024

  1. V. Denkovski, I. Stojmenovska, G. Gavrilov, V. Radevski, V. Trajkovik, “Investigating Privacy and Security Concerns in a Running eHealth Information System,” in 2023 IEEE International Mediterranean Conference on Communications and Networking (MeditCom), 39-44, 2023, doi:10.1109/MeditCom58224.2023.10266398.
  2. T. O. Abolade, “The benefits and challenges of e-Health applications in developing nations: A review,” in 14th iSTEAMS Conference, 14, 37-44, 2018.
  3. B. Atanasovski, M. Bogdanovic, G. Velinov, L. Stoimenov, D. Sahpaski, I. Skrceska, M. Kon-Popovska, D. Jankovic, B. Jakimovski, “Transforming an Enterprise E-Health Syste,m from Process Oriented to Model Driven Architecture,” in 7th International Conference on Information Society and Technology ICIST, 159-162, 2021.
  4. S. Olsson, A. Lymberis, D. Whitehouse, “European Commission activities in eHealth”, International Journal of Circumpolar Health, 63(4), 310–316, 2004, doi:10.3402/ijch.v63i4.17747.
  5. P. G. Svensson, “eHealth Applications in Health Care Management,” Ehealth international, 1(1), 5, 2002, doi:10.1186/1476-3591-1-5.
  6. S. Faber, M. van Geenhuizen, M. de Reuver, “eHealth adoption factors in medical hospitals: A focus on the Netherlands,” International journal of medical informatics, 100, 77–89, 2017, doi:10.1016/j.ijmedinf.2017.01.009.
  7. R. Mitrovska, V. Pachovski, A. Bozinovski, “Challenges, benefits and expectations from implementing an e-health system in Macedonia,” in 2015 Proceedings of the 12th International Conference on Informatics and Information Technologies (CiiT 2015), 268-272, 2015.
  8. G. Dussault, L. Lapão, “The contribution of ehealth and mhealth to improving the performance of the health workforce: a review,” Public Health Panorama, 3(3), 463-471, 2017.
  9. A. La Rocca, T. Hoholm, “Coordination between primary and secondary care: the role of electronic messages and economic incentives,” BMC Health Serv Res 17, 149, 2017, doi: 10.1186/s12913-017-2096-4.
  10. R. A. Tariq, P.B. Hackert, “Patient Confidentiality”, in StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023, Available from: https://www.ncbi.nlm.nih.gov/books/NBK519540/, [Last Accessed: January 3, 2024].
  11. S. Khanra, A. Dhir, A.K.M.N. Islam, M. Mäntymäki, “Big data analytics in healthcare: a systematic literature review”, Enterprise Information Systems, 14(7), 878–912, 2020, doi: 10.1080/17517575.2020.1812005.
  12. S. Kumar, M. Singh, “Big data analytics for healthcare industry: impact, applications, and tools”, Big Data Mining and Analytics, 2(1), 48–57, 2019, doi: 10.26599/BDMA.2018.9020031.
  13. European Commission, “Exchange of Electronic Health Records across the EU”, Shaping Europe’s digital future, Policy, 2021, Available from: https://ec.europa.eu/digital-single-market/en/exchange-electronic-health-records-across-eu#:~:text=The%20eHDSI%20connects%20eHealth%20national,such%20health%20information%20by%202021, [Last Accessed: January 3, 2024].
  14. World Health Organization Regional Office for Europe, “From innovation to implementation eHealth in the WHO European Region”, WHO Regional Office for Europe, 2016, Available from: https://intranet.euro.who.int/__data/assets/pdf_file/0012/302331/From-Innovation-to-Implementation-eHealth-Report-EU.pdf, [Last Accessed: January 3, 2024].
  15. T. Yuan, “Towards the development of best data security for big data”, Communications and Network, 9(4), 291-301, 2017, doi: 10.4236/cn.2017.94020.
  16. P. Jain, M. Gyanchandani, N. Khare, “Big data privacy: a technological perspective and review”, Journal of Big Data, 3(1), 25, 2016, doi: 10.1186/s40537-016-0059-y.
  17. U. Sivarajah, M.M. Kamal, Z. Irani, V. Weerakkody, “Critical analysis of big data challenges and analytical methods”, Journal of Business Research, 70, 263–286, 2017, doi: 10.1016/j.jbusres.2016.08.001.
  18. A. Oussous, F.Z. Benjelloun, A. Ait Lahcen, S. Belfkih, “Big data technologies: A survey”, Journal of King Saud University – Computer and Information Sciences, 30(4), 431-448, 2017, doi: 10.1016/j.jksuci.2017.06.001.
  19. H. Ye, X. Cheng, M. Yuan, L. Xu, J. Gao, C. Cheng, “A survey of security and privacy in big data”, in 2016 16th International Symposium on Communications and Information Technologies (ISCIT), 268-272, 2016.
  20. The Medical Imaging Technology Association (MITA), “DICOM® — Digital Imaging and Communications in Medicine”, 2024, Available from: https://www.dicomstandard.org/, [Last Accessed: January 4, 2024].
  21. The National Library of Medicine, “SNOMED CT a standard for electronic exchange of clinical health information”, 2024, Available from: https://www.nlm.nih.gov/healthit/snomedct/index.html, [Last Accessed: January 4, 2024]
  22. The FHIR Core Work Group, “FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0”, 2024, Available from: https://hl7.org/fhir/overview.html, [Last Accessed: January 4, 2024].
  23. A. Torab-Miandoab, T. Samad-Soltani, A. Jodati, P. Rezaei-Hachesu, “Interoperability of heterogeneous health information systems: a systematic literature review”, BMC medical informatics and decision making, 23(1), 18, doi:10.1186/s12911-023-02115-5.
  24. I. Khan, G. Xitong, Z. Ahmad, F. Shahzad, “Investigating factors impelling the adoption of e-Health: A perspective of African expats in China,” SAGE Open, 9(3), 2019, doi: 10.1177/2158244019865.
  25. A. H. Seh, M. Zarour, M. Alenezi, A. K. Sarkar, A. Agrawal, R. Kumar, R. A. Khan, “Healthcare Data Breaches: Insights and Implications,” Healthcare (Basel, Switzerland), 8(2), 133, 2020, doi:10.3390/healthcare8020133.
  26. D. El Majdoubi, H. El Bakkali, S. Sadki, Z. Maqour, A. Leghmid, “The systematic literature review of privacy-preserving solutions in smart healthcare environment,” Security and Communication Networks, 1–26, 2022, doi:10.1155/2022/5642026.
  27. M. Javaid, A. Haleem, R. P. Singh, R. Suman, “Towards insighting cybersecurity for Healthcare Domains: A comprehensive review of recent practices and Trends,” Cyber Security and Applications, 1, 2023, doi:10.1016/j.csa.2023.100016.
  28. M. Pyrrho, L. Cambraia, V. F. de Vasconcelos, “Privacy and Health Practices in the Digital Age”, The American journal of bioethics : AJOB, 22(7), 50–59, 2022, doi:10.1080/15265161.2022.2040648.
  29. Council of Europe, “Convention 108+ Convention for the protection of individuals with regard to the processing of personal data”, 2018, Available from: https://coe.int/en/web/data-protection/convention108-and-protocol, [Last Accessed: January 4, 2024].
  30. Council of Europe, “Modernization of convention 108 – data protection -“, 2024, Availabe from: https://www.coe.int/en/web/data-protection/convention108/modernised, [Last Accessed: January 4, 2024].
  31. Official Gazette of the Republic of North Macedonia no. 42/20 and 294/21, “DP Law”, 2020, [Last Accessed: January 4, 2024].
  32. DLA PIPER., “Data Protection Laws of the World North Macedonia”, 2022, Available from: https://www.dlapiperdataprotection.com/index.html?t=law&c=MK#:~:text=The%20DP%20Law%20defines%20personal,his%20or%20her%20personal%20identification, [Last Accessed: January 4, 2024].
  33. J. E. Hawkins, “The practical utility and suitability of email interviews in qualitative research,” The Qualitative Report, 23(2), 493-501, 2018, doi: 10.46743/2160-3715/2018.3266.
  34. R. L. Fritz, R. Vandermause, “Data collection via in-depth email interviewing: Lessons from the field,” Qualitative Health Research, 28(10), 1640–1649, 2018, doi: 10.1177/1049732316689067.
  35. D. M. Levine, D. F. Stephan, A. S. Kathryn, Statistics for managers: Using Microsoft excel, 9th edition, Pearson, 2018.
  36. Health Insurance Fund of Republic of North Macedonia, “Code of physicians”, 2022, Available from: https://fzo.org.mk/en/node/1126, [Last Accessed: January 4, 2024].
  37. SPSS Inc., “IBM SPSS Statistics”, 2023, Available from https://www.ibm.com/products/spss-statistics, [Last Accessed: January 4, 2024].
  38. H. C. Ossebaard, L. Van Gemert-Pijnen, “eHealth and quality in health care: implementation time,” International journal for quality in health care: journal of the International Society for Quality in Health Care, 28(3), 415–419, 2016, doi:10.1093/intqhc/mzw032.
  39. A.T. Alanazi, “Clinicians’ Perspectives on Healthcare Cybersecurity and Cyber Threats”, Cureus, 14, 15(10), e47026, 2023, doi: 10.7759/cureus.47026.
  40. P. Yamcharoen, O. S. Folorunsho, A. Bayewu, O. E. Fatoye, “Advancing Healthcare Security: Developing a Composite Set of Cybersecurity Requirements for the Healthcare Industry”, Computing, Information Systems, Development Informatics & Allied Research Journal, 14(1), 9-20, 2023, doi: 10.22624/AIMS/CISDI/V14N1P2.

Citations by Dimensions

Citations by PlumX

No. of Downloads Per Month

No. of Downloads Per Country