The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster

Relational ethics in global commerce

This article identifies the fragility of relationships and ethical practices in the context of global commercial relationships and reflects upon the centrality of human relationships in commerce. The connections between people in global business are underpinned by ethical actions and outcomes and influenced by the degree that information and communication technology are part of the commercial relationship. Issues of trust, privacy, sharing, communication, security, anonymity, and learning emerge as relevant. This analysis positions relational ethics into the field of commerce, exposes the critical issues, and makes recommendations for ways to work with and further develop the link between commerce and relational ethics at the global level, especially in the light of developing technologies and the growth of e-commerce.

A trusted approach to e-commerce

It has been well documented that lack of trust between commercial entities and purchasers can restrict the potential of e-commerce. This may be because the purchaser is required to provide sensitive information to the commercial entity or because the purchaser may be suspicious that after payment has been processed, the goods purchased will not arrive. The challenge for the researcher is to determine the e-commerce model which maximizes the trust relationship. In this paper, we introduce a measure of the trust based on the information distributed to the parties in the transaction and isolate the instances which maximize trust for the purchaser. This leads us to propose four new models for e-commerce which would improve consumer trust and therefore likely lead to an increase in on-line commerce. We demonstrate that no new technologies are needed in order to implement these new models.

Healthcare in continuum for an ageing population: national self monitoring or remote offshore monitoring for Australia?

Australia is a country, similar to other developed nations, confronting an ageing population with complex demographics. Ensuring continued healthcare for the ageing, while providing sufficient support for the already aged population requiring assistance, is at the forefront of the national agenda. Varied initiatives are with foci to leverage the advantages of lCTs leading to e-Health provisioning and assisted technologies. While these initiatives increasingly put budgetary constraints on local and federal governments, there is also a case for offshore resourcing of non-critical health services, to support, streamline and enhance the continuum of care, as the nation faces acute shortages of medical practitioners and nurses. However, privacy and confidentiality concerns in this context are a significant issue in Australia. In this paper, we take the position that if the National and state electronic health records system initiatives, are fully implemented, offshore resourcing can be a feasible complementary option resulting in a win-win situation of cutting costs and enabling the continuum of healthcare.

Security and ethical issues in the virtual world of Second Life

In recent times, Virtual Worlds such as Second Life have generated substantial publicity due to the participation of Fortune 500 companies, and other public and private organisations. As practitioners continue to discuss how organisations could derive business value from Virtual Worlds, new security and ethical issues in Virtual Worlds have emerged to challenge Virtual World users and stakeholders. This paper discusses privacy, intellectual property and a host of other security and ethical issues in Virtual Worlds. It contributes to practice and research by (i) providing insight into emerging security and ethical issues in Virtual Worlds, (ii) analysing the implication of these issues, within and beyond Virtual Worlds, and (iii) raising awareness on security and ethics among Virtual World users and stakeholders.

Comparison of Australian and Malaysian views on the use of biometric devices in everyday situations

Since the September 11, 2001 terrorist attacks in New York City, many countries including Australia and Malaysia have been able to justify the use biometric devices such as fingerprint scans, retina scans and facial recognition for identification and surveillance of its citizens and others in the name of national security. In addition, biometric devices are increasingly being used worldwide by organizations to keep track of their employees and their productivity, leading to concerns of privacy and civil rights violations. Taking the critical theory perspective, this paper will analyse the data collected and report on the findings of a survey carried out in Australia and Malaysia, with respect to the responses provided and opinions expressed to the survey's open ended and other questions by individuals as to their current use, experiences, preferences, concerns about the devices and the situations in which they think biometric devices should be used, including in their workplaces. This descriptive study uses both quantitative and qualitative data to examine what Australians and Malaysians think about the use of biometric devices in everyday situations and compare them as to their similarities and differences within the context of each nation's culture and political systems. The paper will then critically examine the ethical and civil rights issues involved in the use of biometric devices in everyday life and what regulatory and legal measures should be taken to safeguard the rights of citizens while maintaining security and productivity, in order to avoid the situation of Michel Foucault's Panopticon becoming an unpleasant everyday reality, which could negatively influence social justice and create social change due to its effects on individuals in two multicultural societies. the apper will argue about the need to educate the general public as to the issues of surveillance and privacy involved in the use of biometric devices in everyday situations.

Intersection of autonomy and social control : negotiating teenage motherhood

Contrary to popular belief, teenage mothers are a declining proportion of birthing women; however they receive much negative public attention. Of particular public concern is the high cost of supporting teenage mothers, in terms of financial, health and welfare resources. Historically, the typical founding mother of white Australia was single, but post-war changes in the family structure incorporated the expectation that children be born into two-parent households with the male as the breadwinner. Policy changes in the seventies saw the introduction of the Sole Parents Pension which meant that many birthing teenage women could choose to keep their infants rather than have a clandestine adoption or an enforced marriage. The parenting practices of teenage mothers have been criticised for being less than optimal, and mother and child are reported as being disadvantaged cognitively, psychosocially, and educationally. One widespread nursing service which provides support for new mothers in Victoria is the Maternal and Child Health Service; however, teenage mothers appear reluctant to use such services. Why this should be so became an important question for this research, since little is known about the parenting practices of teenage mothers. This study therefore sought to explore mothering from the perspective of five sole supporting teenage mothers each of whom had a child over six months of age. The research methodology took an interpretive ethnographic approach and was guided by feminist principles. The data were collected through repeated interviewing, participant observation, informal discussions with key informants, field notes and journalling. Data analysis was aided by the use of the software, program NUD-IST. It was found that the young women in this study each chose to give birth with full realisation that their existence was dependent on the Welfare State. Unanticipated, however, were the many structural barriers which made their lives cataclysmic, but these reinforced their determination to prove themselves worthy and capable mothers. The young women negotiated motherhood through a range of social supports and through maternal practice. Unquestionably, their social dependency on the welfare system forced them into marginal citizen status. Moreover, absolute and intrinsic poverty levels were experienced, brought about by inadequate welfare payments. Formal support agencies, such as the Maternal and Child Health nurses were rarely approached to provide childrearing support beyond the initial months following birthing, since the teenagers' basic needs such as shelter, food and clothing took precedence over their parenting needs. Additionally, some nurses were perceived to hold judgmental attitudes towards teenage mothers. It was far easier to forestall confrontation with nurses and the other 'older' women clientele by avoiding them. Thus XI they turned to charitable agencies who provided a safety net in the form of emergency supplies of money, food, or equipment. Informal networks of friends provided alternative modes of support when family help failed to materialise. The children, however, provided the young women with an opportunity to transform their lives by breaking free of the past, and by creating a new, mature existence for themselves. Despite being abandoned by family, friends, lovers and society, in the privacy and isolation of their own homes, they attempted to provide a more nurturing environment for their children than they themselves had received. Each bestowed unconditional maternal love on the child and were rewarded through the pleasures of watching their children grow and develop into worthwhile individuals. The children became the focus of their attention and their reason for living. In the course of their welfare dependency, the young women became public property, targets of surveillance, and were subjected to stigmatising and condescending public attitudes wherever they went. In this way, it was evident that they were an oppressed group, but each found ways of resisting. Rather than focussing on their oppressive or disabling lives, or dwelling on their disadvantaged status, the young women sought their identities as mature women through motherhood and by demonstrating that they could do this important job well. Through motherhood their lives had meaning and a sense of purpose. The thesis concludes that motherhood in the teenage years is difficult. However, if appropriate supports are made available, teenage mothers need be no different from non-teenage mothers. But with state resources shrinking, and their own resources limited, teenage mothers are disadvantaged. In some ways, this study showed that all levels of support were inadequate, although those provided through the charitable organizations were seen to be the most appropriate. This reflects the current policy of economic rationalism adopted by most Western liberal democracies in the 1980s and 1990s and no less by the former Keating Labor Government in Australia.

User participation in the performance assessment of school buildings : a study of six primary schools in the Bellarine Peninsula region

Young children spend a significant portion of their lives at primary school. This research traces the development of school facilities in Victoria and examines the performance of six primary schools from the users' perspective. Performance assessments were carried out using participatory evaluation methods that included Touring Interviews with small groups of students aged from six to twelve years. The study found that participatory evaluation methods with both student and staff users generate significant information to improve school facilities. User comments were analysed with respect to 14 aspects of building quality and serviceability including character, thermal environment, privacy and flexibility. The study concludes that school buildings do not meet a number of key user requirements. Children expressed dissatisfaction with furniture and equipment in their classrooms and the playground, and to a lesser extent with student toilets, security of their school bags and personal privacy. Staff were dissatisfied with the provision of withdrawal areas and specialist spaces. Department of School Education facilities guidelines do not address the concerns of school users or meet user needs.

Meaning of home : a comparison of the meaning of home as identified by samples of Victorians with, and without, an intellectual disability

This phenomenological study of the meaning of home from the perspectives of people with and without an intellectual disability sought to identify, (a) any common ‘essence’ of meaning held by and, (b) the nature of any differences of perception between, the groups. Purposive samples of 18 people with an intellectual disability and 21 non-disabled people were surveyed using a semi-structured interview to ascertain their experiences of home and 'non-homes'. Inductive analysis of the data revealed a shared understanding of the meaning of home at a fundamental level. This shared meaning of home was found to comprise: the ability to exert control over an area; having a personalised space; feeling content with the living situation; a sense of familiarity with the setting; a set of behaviours and routines usually only enacted when at home; common names and uses for rooms; socialising at home with others; the importance of a positive social atmosphere in the home; and, recognition of places as non-homes because they lacked one or more of these attributes. Further analysis revealed the essence of home is its experience as the place where stress is most reduced or minimised for the individual. The study demonstrates that the concept of stress is superordinate to previously identified concepts considered fundamental to home such as privacy, control and non-homes. Major differences between the two samples were largely differences of degree with people who have an intellectual disability reporting the same fundamental attributes of home as people who do not have an intellectual disability, but in a less elaborated form. Principal among these differences of degree was the notion of control over the home and its derivative elements which encompassed the whole dwelling including its setting for people without an intellectual disability but was very restricted for people with an intellectual disability being largely confined to the person's bedroom. Socialising in or from the home was also very limited for people with an intellectual disability in comparison with that experienced by non-disabled informants with the former group conveying an impression of leading significantly socially isolated lives at home. The major implications of this study are related to the meaning of home per se, to residential service provision to people with an intellectual disability, and to future research.

Contact with nature and children's mental, emotional, and social health

This research investigated the benefits of children's contact with nature as perceived by adult educators. It was found that contact with nature is perceived to: increase self-confidence and self-esteem; provide opportunities to experience mystery, privacy, and sensory engagement; connect children with school; and accommodate different learning styles and abilities.

An anonymity revocation technology for anonymous communication

A number of privacy-enhancing technologies (PETs) have been proposed in the last three decades offering unconditional communication anonymity to their users. Unconditional anonymity can, however, be a security threat because it allows users to employ a PET in order to act maliciously while hiding their identity. In the last few years, several technologies which revoke the identity of users who use PETs have been proposed. These are known as anonymity revocation technologies (ARTs). However, the construction of ARTs has been developed in an ad hoc manner without a theoretical basis outlining the goals and underlying principles. In this chapter we present a set of fundamental principles and requirements for construction of an ART, identifying the necessary features. We then propose an abstract scheme for construction of an ART based on these features.

Human-computer interaction in ubiquitous computing environments

Purpose – The purpose of this paper is to explore characteristics of human-computer interaction when the human body and its movements become input for interaction and interface control in pervasive computing settings.

Design/methodology/approach – The paper quantifies the performance of human movement based on Fitt's Law and discusses some of the human factors and technical considerations that arise in trying to use human body movements as an input medium.

Findings – The paper finds that new interaction technologies utilising human movements may provide more flexible, naturalistic interfaces and support the ubiquitous or pervasive computing paradigm.

Practical implications – In pervasive computing environments the challenge is to create intuitive and user-friendly interfaces. Application domains that may utilize human body movements as input are surveyed here and the paper addresses issues such as culture, privacy, security and ethics raised by movement of a user's body-based interaction styles.

Originality/value – The paper describes the utilization of human body movements as input for interaction and interface control in pervasive computing settings.

Mining frequent itemsets in distorted databases with granula computing

Data perturbation is a popular method to achieve privacy-preserving data mining. However, distorted databases bring enormous overheads to mining algorithms as compared to original databases. In this paper, we present the GrC-FIM algorithm to address the efficiency problem in mining frequent itemsets from distorted databases. Two measures are introduced to overcome the weakness in existing work: firstly, the concept of independent granule is introduced, and granule inference is used to distinguish between non-independent itemsets and independent itemsets. We further prove that the support counts of non-independent itemsets can be directly derived from subitemsets, so that the error-prone reconstruction process can be avoided. This could improve the efficiency of the algorithm, and bring more accurate results; secondly, through the granular-bitmap representation, the support counts can be calculated in an efficient way. The empirical results on representative synthetic and real-world databases indicate that the proposed GrC-FIM algorithm outperforms the popular EMASK algorithm in both the efficiency and the support count reconstruction accuracy.

Influence of Gertrude Jekyll in the Adelaide Hills : the landscape of 'Broadlees'

‘Broadlees’ exists as an Adelaide Hills hill-station retreat in Australia, established in the 1920s as a permanent residence for the Waite sisters.1 Typically most large hill-station residences and their accompanying private ‘botanic gardens’ were developed as summer residences from the summer onslaught of the Adelaide Plains, but the Waite sisters saw ‘Broadlees’ as their permanent residence. Further, although the design of the residence was not important in the eyes of Misses Eva and Lily Waite, it was the gardens of the property that were their real passion. This article reviews the history and development of the ‘Broadlees’ property and in particular the role played by the writings and gardens of Gertrude Jekyll (1843–1932)2 in its design, form and plantings, which remain the most intact and mature Jekyll-inspired landscape in South Australia today. It is a significant, extant Jekyll-influenced garden developed in the 1920s and 1930s in the Adelaide Hills3 that has been little featured in the coffee-table garden profile literature in Australia, and no article has previously been written about the property. It has been profiled in the Australian Home Beautiful and the South Australian Homes & Gardens magazines in 1932 and 1936 respectively, and also has been subject to a recent comparative assessment as to the role and influence of prominent Adelaide garden designer ElsieMarion Cornish (1870–1946).4 Perhaps because of the wishes of the owners who personally developed and sought to maintain the privacy of the gardens and house, subsequent owners have sought to respect this philosophy in their curatorship of the property.5

Micro-blogging in the workplace

Micro-blogging services such as Twitter, Yammer, Plurk and Google Buzz have generated substantial interest among members of the business community in recent years. Many CEOs, managers and front-line employees have embraced micro-blogs as a tool for interacting with colleagues, employees, customers, suppliers and investors. Micro-blogs are considered a more informal channel than emails and official websites, and thus present a different set of challenges to businesses. As a positional paper, this paper uses a case study of a bogus Twitter account to emphasise security and ethical issues relating to (i) Trust, Accuracy and Authenticity of Information, (ii) Privacy and Confidentiality, and (iii) Scams and Frauds, when micro-blogs are used in the workplace. It also highlights the potential risks businesses are exposed to if employees use micro-blogs irresponsibly. The paper contributes to practice by providing suggestions on managing security and ethical risks associated with micro-blogging in the workplace. It contributes to research by building on existing research in trust and data privacy in electronic communication.