Security Risks Associated with Radio Frequency Identification in Medical Environments

Radio frequency identification (RFID) is a form of wireless communication that is used to identify assets and people. RFID has significant benefits to the medical environment. However, serious security threats are present in RFID systems that must be addressed in a medical environment. Of particular interest are threats to patient privacy and safety based on interception of messages, interruption of communication, modification of data, and fabrication of messages and devices. This paper presents an overview of these security threats present in RFID systems in a medical environment and provides guidance on potential solutions to these threats. This paper provides a roadmap for researchers and implementers to address the security issues facing RFID in the medical space.     

荆州市某医院志愿者服务工作实践与思考

本文系统阐述了医院志愿服务在构建和谐医患关系及优化就医环境中所起的作用,从项目背景、组织架构、管理培训、激励机制等方面介绍湖北省荆州市某医院志愿服务在医疗卫生服务中的实践与取得的工作成效.提出在医疗行业中,志愿服务对于促进医患关系的和谐和缓解目前医疗体制所造成的弊端有着重要的作用,同时,正确引导和有效激励是避免志愿服务流失的保障.     

医学图书馆在公共突发事件中的角色定位

阐述医学图书馆的职能,分析其在应对突发事件中的优势以及存在的问题。基于此探讨医学图书馆在突发事件中服务机制的创新,包括组建专业情报服务团队、积极编制突发事件应急预案、注重与各家医学图书馆及媒体建立沟通渠道等,使医学图书馆在面临突发事件时做出应有的贡献。     

浙江省某医院微信公众平台的实践研究

微信公众平台作为信息技术领域的一项新生事物,对社会生活产生了重要的影响。能否将此工具应用到医院管理和医疗服务的实践中是值得研究的问题。本文对浙江省某医院微信公众平台的建设和应用情况进行了考察。研究显示,通过构建组织基础、保障信息安全、加强宣传推广等措施,该院建立的微信公众平台为提升便民服务水平,促进医患关系和谐,打造医院品牌形象等发挥了积极的功效。而为了发挥微信公众平台更大的作用,就必须在组织基础、信息安全、宣传推广等方面采取更为有效的创新策略。     

Barriers of HIPAA Regulation to Implementation of Health Services Research

Although many perspectives on the impact of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on health services research have been wide spread, little empirical evidence has been reported about HIPAA-related barriers during the implementation of research projects. Using three cases of health services research projects, this study examined practical barriers created by HIPAA regulation. During the stage of implementation of the three projects, we experienced some HIPAA-related concerns, previously raised in the field of health services research. We found that technically complicated consent forms and privacy protection forms as well as socially-sensitive clinical conditions make patients less willing to participate in research projects; concerns about safety of patient medical information makes health organizations more hesitant to let researchers have access to the patient’s information, especially through electronic transfer; more restrictive IRB processes and challenging patient recruiting processes make health services researchers reluctant to go through the process; and as a result, they may compromise with the scientific soundness of the project. Overall, HIPAA complicates the research process and requires more resources and longer time to conduct research.     

从医疗质量安全到患者安全：医疗风险治理的观念更新与政策优化

在现代医疗风险治理中,患者安全的理念和相关制度逐渐引起重视。与医疗质量安全相比,患者安全更强调权利导向、伦理照护、社会协同,有其独特价值。目前,我国患者安全相关制度发展迅速,但仍存在专门政策法规缺少、有效伦理制约机制不足、医患沟通机制不完善等问题。应当进一步树立患者安全观念,通过完善患者安全相关政策法规、构建不良事件报告制度、设立医师道歉制度、设立患者安全组织和数据库等措施,优化医疗风险治理政策,实现医患共赢。     

A Multi-Constraint Scheme with Authorized Mechanism for the Patient Safety

Many research works have attempted to introduce passive RFID technology into medical systems to reduce medical errors. However, most of these proposed works focused on identifying patients and objects. If an RFID based medical system is only good for identifying patients and medical objects but not capable of halting any medical process immediately, then it is not possible to prevent medical errors from happening. Our research focuses on a mechanism to detect and to avoid medical harm before it occurs to patients. In this paper, we propose to incorporate multiple-constraints into the authorization scheme and used this scheme as a basis for implementing a medical management system avoiding medical errors to assist medical staff. Specifically, our scheme ensures that a medical operation is if and only if enabled when the constraints are being satisfied that an “identified patient” is being treated by a “certified medical staff member” within an “authorized area”. In practical environments, our authorization scheme can be applied to various healthcare applications, and we develop a prototype system and test it in three applications: X-ray control, specimen collection, and blood transfusion management. The experimental results show that the system can be used to enable X-ray when the X-ray is in authorized location and operated by authorized operator. For the specimen collection and blood transfusion, the logs showing which medical staff has done specimen or blood transfusion on which patient at authorized location are correctly recorded into Hospital Information System (HIS). The locating process can be performed within 10 to 20 seconds, and the locating error is less than 2 meters.     

The General Hospital Colombo Rehabilitation Project.

The General Hospital Colombo (GHC) Rehabilitation Project was to be implemented in 6 phases in about 25 years. The proposed funding was a grant of 100% from Finland for technical assistance and training, and 85% for investments. The development objective was to reinforce the status of the hospital as the apex of the medical care system. In Phase I (1985-1990) an 8 storeyed accident and orthopaedic services building with modern facilities has been commissioned. A water tower and a 'septic' operating theatre have been built. Infection control and maintenance organizations have been started. Phase I cost Rs.960 million. In the Bridging Phase, the existing six storeyed building is being renovated. Phase II has been drastically curtailed. It will concentrate on infrastructure development such as water supply, kitchen, stores and transport, and the construction of four new medical wards. The project will end in 1993.     

The Adoption and Implementation of RFID Technologies in Healthcare: A Literature Review

Radio Frequency Identification (RFID) technology not only offers tracking capability to locate equipment, supplies and people in real time, but also provides efficient and accurate access to medical data for health professionals. However, the reality of RFID adoption in healthcare is far behind earlier expectation. This study reviews literature on the use of RFID in healthcare/hospitals following a formal innovation-decision framework. We aim to identify the common applications, potential benefits, barriers, and critical success factors. Our study facilitates quick assessment and provides guidance for researchers and practitioners in adopting RFID in medical arenas. Many earlier adopters in healthcare found RFID to be functional and useful in such areas as asset tracking and patient identification. Major barriers to adoption include technological limitations, interference concerns, prohibitive costs, lack of global standards and privacy concerns. Better designed RFID systems with low cost and privacy issues addressed are needed to increase acceptance of RFID in healthcare.     

暴力侵犯医生权利现状的原因分析

暴力侵犯医生权利严重地损害了医务工作者的身心健康,扰乱了医院的正常诊疗秩序。通过对全国10省市80所医院的调查显示,目前,暴力侵权现象时有发生,且呈上升趋势。这一现象的发生在不同医疗群体、不同医疗机构中存在明显差异。从社会、医院、医患角度分析了暴力产生的原因。     

A Clinical Decision Support System with an Integrated EMR for Diagnosis of Peripheral Neuropathy

This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient.     

基于外联平台的就医服务模式研究与实践

卫生信息化是国家医改的重要支柱,目前各大型医疗机构信息化水平己达到院内信息共享与交互的程度,需要进一步采用信息技术手段,优化就医流程,缓解群众看病就医难题,利用社会资源参与医院服务,方便群众就医与健康咨询,改善就医体验,真正达到国务院关于惠民工程的目的.“外联平台”正是这种背景下诞生的产物,对外部接入业务进行统一的规划、接入、管理和监控.     

Development of an Ease-of-Use Remote Healthcare System Architecture Using RFID and Networking Technologies

The study aims to provide an ease-of-use approach for senior patients to utilize remote healthcare systems. An ease-of-use remote healthcare system (RHS) architecture using RFID (Radio Frequency Identification) and networking technologies is developed. Specifically, the codes in RFID tags are used for authenticating the patients' ID to secure and ease the login process. The patient needs only to take one action, i.e. placing a RFID tag onto the reader, to automatically login and start the RHS and then acquire automatic medical services. An ease-of-use emergency monitoring and reporting mechanism is developed as well to monitor and protect the safety of the senior patients who have to be left alone at home. By just pressing a single button, the RHS can automatically report the patient's emergency information to the clinic side so that the responsible medical personnel can take proper urgent actions for the patient. Besides, Web services technology is used to build the Internet communication scheme of the RHS so that the interoperability and data transmission security between the home server and the clinical server can be enhanced. A prototype RHS is constructed to validate the effectiveness of our designs. Testing results show that the proposed RHS architecture possesses the characteristics of ease to use, simplicity to operate, promptness in login, and no need to preserve identity information. The proposed RHS architecture can effectively increase the willingness of senior patients who act slowly or are unfamiliar with computer operations to use the RHS. The research results can be used as an add-on for developing future remote healthcare systems.     

Deployment of RFID in Healthcare Facilities—Experimental Design in MRI Department

Patient safety has become an important issue due to medical errors. Some health care systems use Radio Frequency Identification (RFID) to identify patients during medical procedures. However, the RFID data readability especially depends upon the environment, an investigation of data reliability and signal loss is essential to making an effective deployment plan. The operation of Magnetic Resonance Imaging (MRI) is the major source of electromagnetic interference in the hospital. Therefore, this research conducts an experimental design of reading performance considering various notable factors in the MRI department. In addition to the readability experiment, this paper also measures the efficiency and reliability of implementing RFID technology in the MRI department using a simulation approach and helps hospitals by providing the measured outcomes.     

RFID-Enabled Healthcare Applications, Issues and Benefits: An Archival Analysis (1997–2011)

In this paper, a comprehensive review of articles published between 1997 and 2011 in the Journal of Medical Systems (JMS) on RFID technology is presented. A total of 22 papers are analyzed using a classification framework that has three dimensions: RFID-enabled healthcare applications, RFID-enabled healthcare issues, and RFID-enabled healthcare benefits. In addition, an invitation sent to all authors of the papers accepted for the special issue on RFID for the JMS allows them to position their various papers within the classification framework. Finally, a list of future research directions is presented.     

Spouse's consent to sterilization

If a medical procedure will secondarily result in the sterilization of the patient, is the consent of the patient's spouse required? Is the consent of the patient's spouse required if the procedure is not medically necessary, but is intended primarily for sterilization? If a procedure is medically necessary, the consent of the patient's spouse in not required. The consent of the spouse is not required even if it incidentally will result in the sterilization of the patient. Statutes in Georgia, North Carolina, and Virginia requie the written consent of the patient's spouse to voluntary sterilizations. In the absence of such a statute, no definitive answer can be given. Every individual does have the right to consent to any lawful Medical treatment or procedure. However, an individual also has an interest in the procreative ability of his or her spouse. While it appears that the right to consent to lawful medical procedures would be paramount to the interest of the patient's spouse, this matter has not yet been judicially resolved.     

国家基本公共卫生服务项目十年评价（2009—2019年）系列报告（三）——国家基本公共卫生服务项目实施十年：挑战与建议

国家基本公共卫生服务项目作为深化医药卫生体制改革的一项重要措施,已开展十余年。因此评估该项目实施十年（2009—2019年）的效果和尚存的问题,对进一步推进国家基本公共卫生服务意义重大。本文参照Donabedian质量理论,从项目目标、项目内容、运行机制、实施过程、产生效果等方面,总结并分析当前我国基本公共卫生服务仍存在的关键问题,并从六方面提出了相关建议,主要为：基于科学论证,动态调整项目;建议国家基本公共卫生服务进行分级、分类管理;适时修订项目规范,促进服务提质增效;逐步推进以效果为导向的评价考核制度;完善运行机制,促进可持续发展;充分发挥县域医共体作用,加强服务协同;建立科学、长效的国家基本公共卫生服务项目监测机制。以为进一步完善、优化国家基本公共卫生服务项目提供参考。     

无线射频识别技术在医疗垃圾管理系统中的应用

RFID系统在医疗行业应用日益广泛,提出了一种RFID中间件系统的设计,系统由设备管理代理和事件过程管理器组成。事件过程管理器采用一种依赖时序的、基于Petri网的RFID复杂事件检测方法和基于订阅／发布的服务机制。另外,中间件系统能屏蔽低端各种RFID物理设备的多样性,为企业级应用提供动态灵活部署框架。通过基于该中间件技术的医疗垃圾管理系统的成功应用,验证了该中间件系统的设计,也明显改善医疗垃圾处理环节的监控和管理力度,提升了医院的信息化水平。