Sharing with care : an information accountability perspective

Health information sharing has become a vital part of modern healthcare delivery. E-health technologies provide efficient and effective ways of sharing medical information, but give rise to issues that neither the medical professional nor the consumers have control over. Information security and patient privacy are key impediments that hinder sharing information as sensitive as health information. Health information interoperability is another issue which hinders the adoption of available e health technologies. In this paper we propose a solution for these problems in terms of information accountability, the HL7 interoperability standard and social networks for manipulating personal health records.

Information accountability for online healthcare social networks

Online social networking has become one of the most popular Internet applications in the modern era. They have given the Internet users, access to information that other Internet based applications are unable to. Although many of the popular online social networking web sites are focused towards entertainment purposes, sharing information can benefit the healthcare industry in terms of both efficiency and effectiveness. But the capability to share personal information; the factor which has made online social networks so popular, is itself a major obstacle when considering information security and privacy aspects. Healthcare can benefit from online social networking if they are implemented such that sensitive patient information can be safeguarded from ill exposure. But in an industry such as healthcare where the availability of information is crucial for better decision making, information must be made available to the appropriate parties when they require it. Hence the traditional mechanisms for information security and privacy protection may not be suitable for healthcare. In this paper we propose a solution to privacy enhancement in online healthcare social networks through the use of an information accountability mechanism.

Privacy by information accountability for e-health systems

Privacy has become one of the main impediments for e-health in its advancement to providing better services to its consumers. Even though many security protocols are being developed to protect information from being compromised, privacy is still a major issue in healthcare where privacy protection is very important. When consumers are confident that their sensitive information is safe from being compromised, their trust in these services will be higher and would lead to better adoption of these systems. In this paper we propose a solution to the problem of patient privacy in e-health through an information accountability framework could enhance consumer trust in e-health services and would lead to the success of e-health services.

Good faith in contractual performance and enforcement : Australian doctrinal hurdles

In the ongoing and spirited debate about the relative merits of an obligation of good faith in contractual performance and enforcement, widely divergent views have been expressed about the appropriateness and content of the putative obligation. However, relatively less time has been devoted to discussion of the sparseness of tools available to facilitate doctrinal development and the hurdles necessarily imposed by such limited doctrinal resources. This article seeks to examine the Australian doctrinal position against the backdrop of good faith as it finds application in the wider global context.

Not-for-profits and risk accountability : insuring the third sector

Not for profit organisations face significant challenges in managing organisational risk. In this regard not-for-profits are not unique but they are distinguishable from their 'for-profit' counterparts in that they are less likely to have the resources to find sufficient risk management strategies and plans, are very vunerable to cyclical changes in the insurance market and are not usually in a position to pass on the costs of increased premiums to third parties such as consumers of their services. This article explores the nature and extent of risks faced by the not-for-profit sector; the appropriateness and scope of risk management to reduce and manage the likelihood and incidence of risk; and the types of insurance and options to cover risks that materialise. It concludes with a recommendation for a potential course of action.

Big, bigger, best? The impact of reforms on the not-for-profit sector in Queensland

Organisations within the not-for-profit sector provide services to individuals and groups that government and for-profit organisations cannot or will not consider. The not-for-profit sector has come to be a vibrant and rich agglomeration of services and programs that operate under a myriad of philosophical stances, service orientation, client groupings and operational capacities. In Australia these organisations and services are providing social support and service assistance to many people in the community; often targeting their assistance to the most difficult of clients. Initially, in undertaking this role, the not-for-profit sector received limited sponsorship from government. Over time governments assumed greater responsibility in the form of service grants to particular groups: ‘the worthy poor’. More recently, they have entered into contractual service agreements with the not-for-profit sector, which specify the nature of the outcomes to be achieved and, to a degree, the way in which the services will be provided. A consequence of this growing shift to a more marketised model of service contracting, often offered-up under the label of enhanced collaborative practice, has been increased competitiveness between agencies that had previously worked well together (Keast and Brown, 2006). Another trend emerging from the market approach is the entrance of for-profit providers. These larger organisations have higher levels of organisational capacity with considerable organisational slack to allow them to adopt new service roles. Shaped almost as ‘shadow governments’ they appear to be a strong preference for governments looking for greater accountability of outcomes and an easier way to control the interaction with the conventional not-for-profit sector. The question is will governments’ apparent preference for larger organisational arrangements lead to the demise of the vibrancy of the not-for-profit sector and impact on service provision to those people who fall outside of the remit of the new service providers? To address this issue, this paper uses information gleaned from a state-wide survey of not-for-profit organisations in Queensland, Australia which included organisational size, operational scope, funding arrangements and governance/management approaches. Supplementing this information is qualitative data derived from 17 focus groups and 120 interviews conducted over ten years of study of this sector. The findings contribute to greater understanding of the practice and theory of the future provision of social services.

Information Accountability Framework for a Trusted Health Care System

Trusted health care outcomes are patient centric. Requirements to ensure both the quality and sharing of patients’ health records are a key for better clinical decision making. In the context of maintaining quality health, the sharing of data and information between professionals and patients is paramount. This information sharing is a challenge and costly if patients’ trust and institutional accountability are not established. Establishment of an Information Accountability Framework (IAF) is one of the approaches in this paper. The concept behind the IAF requirements are: transparent responsibilities, relevance of the information being used, and the establishment and evidence of accountability that all lead to the desired outcome of a Trusted Health Care System. Upon completion of this IAF framework the trust component between the public and professionals will be constructed. Preservation of the confidentiality and integrity of patients’ information will lead to trusted health care outcomes.

Information accountability with policy languages for e-Health

ICT is becoming a prominent part of healthcare delivery but brings with it information privacy concerns for patients and competing concerns by the caregivers. A proper balance between these issues must be established in order to fully utilise ICT capabilities in healthcare. Information accountability is a fairly new concept to computer science which focuses on fair use of information. In this paper we investigate the different issues that need to be addressed when applying information accountability principles to manage healthcare information. We briefly introduce an information accountability framework for handling electronic health records (eHR). We focus more on digital rights management by considering data in eHRs as digital assets and how we can represent privacy policies and data usage policies as these are key factors in accountability systems.

An information accountability framework for shared eHealth policies

Privacy issues have hindered the evolution of e-health since its emergence. Patients demand better solutions for the protection of private information. Health professionals demand open access to patient health records. Existing e-health systems find it difficult to fulfill these competing requirements. In this paper, we present an information accountability framework (IAF) for e-health systems. The IAF is intended to address privacy issues and their competing concerns related to e-health. Capabilities of the IAF adhere to information accountability principles and e-health requirements. Policy representation and policy reasoning are key capabilities introduced in the IAF. We investigate how these capabilities are feasible using Semantic Web technologies. We discuss with the use of a case scenario, how we can represent the different types of policies in the IAF using the Open Digital Rights Language (ODRL).

Accounterability and the problematics of accountability

This paper seeks to contribute to the emerging stream of literature on the problematics of accountability ( [McKernan, in this issue], [Messner, 2009] and [Roberts, 2009]) and the possibilities of accounterability (Kamuf, 2007) by questioning whether and how accounterability can appear as a response to the problematics of accountability's operationalisation. To answer this question, this research considers the problematics of accountability found in the limits inherent to the giving of an account (Messner, 2009), in the ambiguous relationship between accountability and transparency (Roberts, 2009), and in the as yet unresolved contradictions of accountability (McKernan, in this issue). Accounterability is seen as a practice of resisting accountability demands while giving an account. Alternative practices arising out of such resistance are inductively identified through an ethnographic study of the day-to-day practices of the Salvation Army used as an extreme case. This case shows how an ideal form of accountability raises more questions than it answers in practice, thereby leading individuals to develop their own counter-abilities. Because accountability to a Higher-Stakeholder appears to be an unreachable ideal, identifying to whom one should give an account of oneself becomes problematic. A working response to the problematics of accountability, accounterability emerges as the mechanism whereby the limits and contradictions of account giving are transformed into the conditions of its realisation: unreachable accountability is transformed into tangible day-to-day practices that may differ slightly from expected ideal conduct. It transpires from this study that the main strength of accountability lies in its ability to absorb and to override its limits and contradictions, transforming them into conditions of its possibility. As such, accounterability emerges as the ultimate manifestation of this strength.

Rational avoidance of accountability

Anthony Downs public choice theory proposes that every rational person would try to meet their own desires in preference to those of others, and that such rational persons would attempt to obtain these desires in the most efficient manner possible. This paper will demonstrate that the application of this theory would mean that public servants and politicians would perform acts of corruption and maladministration in order to efficiently meet their desires. As such action is unavoidable, political parties must appear to meet the public demand for accountability systems, but must not make these systems viable lest they expose the corruption and maladministration that would threaten the government’s chance or re-election. It is therefore logical for governments to display a commitment for accountability whilst simultaneously ensuring the systems would not be able to interfere with government control or expose its flaws.

Corporate profit and impression management in developing markets

In this study, we examine how organisations in Fiji communicate or legitimise their profit. We base the need for understanding this phenomenon on the following premise. Organisations are part of a wider society, and in competition for scarce resources. Organisations obtain the rights to consume resources upon conception, but must continually legitimise their rights of existence and the need to access the resources. Legitimacy is the ability to continue to justify one’s authority to exist in a society. Organisations rights to resources are contractual, and have a moral obligation to act in a responsible manner and justify their outcomes, actions, and activities to external stakeholders. Such justifications would be an attempt at legitimizing their existence by some form of impression management. Impression management refers to the process by which individuals attempt to influence the impression of others (Melo et al. 2009). In corporate reporting, impression management occurs when management selects, display, and presents that information in a manner that distorts readers’ perceptions of corporate achievements (Neu 1991; Patten 2002), and is managed best through disclosures (O’Donovan 2002). In developing economies, there is significant Government protection that creates near-monopoly sectors and industries. The rendered protection permits organisations to provide essential services to the community at reasonable costs. Organisations in these sectors and industries have an ominous need to legitimise their position and actions. The bond between the organisations and the society is much stronger, making organisations devote more effort in communicating their activities. Protection permits organisations to make reasonable profits to sustain their operations. Society may not accept abnormal profits from operational efficiencies. Profit is fundamental to the society’s perception of an organisation, amplifying the need for the firm to justify a level of profit. Abnormal profit for organisations construes bad news, and organisations would make relevant disclosures to manage stakeholder impressions on profit (Patten 2002). Organisations can manage impressions by disclosing information in a particular way. That is, organisations would want to put the impression that the abnormal profit is justified and the society will obtain its benefits in future. Such form of impression management requires unambiguous disclosure of information. The readability of corporate disclosures is an important indicator of organisational abnormal profit-related legitimacy efforts in developing economies.