Improving patient privacy and confidentiality in one regional Emergency Department – a quality project

Background: Patient privacy and confidentiality (PPaC) is an important consideration for nurses and other members of the health care team. Can a patient expect to have confidentiality and in particular privacy in the current climate of emergency health care? Do staff who work in the Emergency Department (ED) see confidentiality as an important factor when providing emergency care? These questions are important to consider. Methods: This is a two phased quality improvement project, developed and implemented over a six month period in a busy regional, tertiary referral ED. Results: Issues identified for this department included department design and layout, overcrowding due to patient flow and access block, staff practices and department policies which were also impacted upon by culture of the team, and use of space. Conclusions: Changes successful in improving this issue include increased staff awareness about PPaC, intercom paging prior to nursing handover to remove visitors during handover, one visitor per patient policy, designated places for handover, allocated bed space for patient reviews/assessment and a strategy to temporarily move the patient if procedures would have been undertaken in shared bed space. These are important issues when considering policy, practice and department design in the ED.

A taint marking approach to confidentiality violation detection

This article presents a novel approach to confidentiality violation detection based on taint marking. Information flows are dynamically tracked between applications and objects of the operating system such as files, processes and sockets. A confidentiality policy is defined by labelling sensitive information and defining which information may leave the local system through network exchanges. Furthermore, per application profiles can be defined to restrict the sets of information each application may access and/or send through the network. In previous works, we focused on the use of mandatory access control mechanisms for information flow tracking. In this current work, we have extended the previous information flow model to track network exchanges, and we are able to define a policy attached to network sockets. We show an example application of this extension in the context of a compromised web browser: our implementation detects a confidentiality violation when the browser attempts to leak private information to a remote host over the network.

Split leverage : attacking the confidentiality of linked databases by partitioning

This article considers the risk of disclosure in linked databases when statistical analysis of micro-data is permitted. The risk of disclosure needs to be balanced against the utility of the linked data. The current work specifically considers the disclosure risks in permitting regression analysis to be performed on linked data. A new attack based on partitioning of the database is presented.

Inconsistencies in and the inadequacies of the family counselling and FDR confidentiality and admissibility provisions: The need for reform

In this article the author discusses issues arising from counselling and family dispute resolution (FDR) in relation to confidentiality and admissibility, such as whether an admission of abuse to a child, or a threat to harm the other parent, can be disclosed by the counsellor or family dispute resolution practitioner (FDRP) and used in court proceedings. It is found that the admissibility provisions in the Family Law Act 1975 (Cth) are far more narrowly defined than the confidentiality requirements and have been interpreted strictly by the courts. There are competing policy considerations: the strict “traditionalist” approach, that people can have absolute faith in the integrity of counsellors and mediators and in the confidential nature of the process, must be balanced against a more “protectionist” stance, being the individual rights of victims to have all relevant information placed before the court and to be protected from violence and abuse. It is suggested that legislative reform is required to ensure that courts balance these considerations appropriately and don’t compromise the safety of victims of abuse and family violence.

Confidentiality issues in information systems in social care

Cooper, J. & Urquhart, C. (2004). Confidentiality issues in information systems in social care. In K. Grant, D.A. Edgar & M. Jordan (Eds.), Reflections on the past, making sense of today and predicting the future of information systems, 9th annual UKAIS (UK Academy of Information Systems) conference proceedings, Annual conference, 5-7 May 2004, Glasgow Caledonian University (CD-ROM). Glasgow: Glasgow Caledonian University for UKAIS Sponsorship: AHRC

Confidentiality or disclosure?

Considers the discretion of the trustees to disclose the settlor's wishes to the beneficiaries of a family discretionary trust. Discusses the confidentiality principle relating to family discretionary trusts and whether a settlor's wish letter falls within the scope of that principle. Sets out the guidance of the court in Breakspear v Ackland for trustees faced with a request for disclosure from a beneficiary.

Risks to patient confidentiality when communicating health information to blind and partially sighted patients.

The research reports on a survey of 228 blind and partially sighted persons in 15 health authorities across Scotland. The survey reports data on patient experience of receiving health information in accessible reading formats. Data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves. The implications for patient privacy, confidentiality and wider impact on life and health care are highlighted. The implications for professional ethical medical practice and for public policy are also discussed. Recommendations for improved practice are made.

Comfort, confidence and confidentiality: the experiences of two e-learners

This paper is based on the authors’ experiences as e-learners on a MEd in Collaborative Networked Learning during 2000-2002. Although this course was delivered completely online, a strong sense of community developed early and continued as a key theme throughout the two years of the course. Our paper examines how this sense of community was facilitated and maintained, based on narrative analysis of our learning journals and personal recollections.

Use of Novel Algorithms MAJE4 and MACJER-320 for Achieving Confidentiality and Message Authentication in SSL & TLS

Extensive use of the Internet coupled with the marvelous growth in e-commerce and m-commerce has created a huge demand for information security. The Secure Socket Layer (SSL) protocol is the most widely used security protocol in the Internet which meets this demand. It provides protection against eaves droppings, tampering and forgery. The cryptographic algorithms RC4 and HMAC have been in use for achieving security services like confidentiality and authentication in the SSL. But recent attacks against RC4 and HMAC have raised questions in the confidence on these algorithms. Hence two novel cryptographic algorithms MAJE4 and MACJER-320 have been proposed as substitutes for them. The focus of this work is to demonstrate the performance of these new algorithms and suggest them as dependable alternatives to satisfy the need of security services in SSL. The performance evaluation has been done by using practical implementation method.