The DOI matches its Crossref record; 123 of the 127 references it cites were found in a registry or an index.
Security and privacy in electronic health records: a systematic literature review.
Open accessAbstract
Objective To report the results of a systematic literature review concerning the security and privacy of electronic health record (EHR) systems.Data sources Original articles written in English found in MEDLINE, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database.Study selection Only those articles dealing with the security and privacy of EHR systems.Data extraction The extraction of 775 articles using a predefined search string, the outcome of which was reviewed by three authors and checked by a fourth.Results A total of 49 articles were selected, of which 26 used standards or regulations related to the privacy and security of EHR data. The most widely used regulations are the Health Insurance Portability and Accountability Act (HIPAA) and the European Data Protection Directive 95/46/EC. We found 23 articles that used symmetric key and/or asymmetric key schemes and 13 articles that employed the pseudo anonymity technique in EHR systems. A total of 11 articles propose the use of a digital signature scheme based on PKI (Public Key Infrastructure) and 13 articles propose a login/password (seven of them combined with a digital certificate or PIN) for authentication. The preferred access control model appears to be Role-Based Access Control (RBAC), since it is used in 27 studies. Ten of these studies discuss who should define the EHR systems' roles. Eleven studies discuss who should provide access to EHR data: patients or health entities. Sixteen of the articles reviewed indicate that it is necessary to override defined access policies in the case of an emergency. In 25 articles an audit-log of the system is produced. Only four studies mention that system users and/or health staff should be trained in security and privacy.Conclusions Recent years have witnessed the design of standards and the promulgation of directives concerning security and privacy in EHR systems. However, more work should be done to adopt these regulations and to deploy secure EHR systems.
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“Integrating Artificial Intelligence (AI) and robotics in healthcare heralds a new era of medical innovation, promising enhanced diagnostics, streamlined processes, and improved patient care.”
From Ethical implications of AI and robotics in healthcare: A review (2023) · cites this paper as [1]
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Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Shamir, A. (1979) · Communications of the ACM · doi:10.1145/359168.359176 · Cited by 13,756
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.006 · Cited by 10,578
k-ANONYMITY: A MODEL FOR PROTECTING PRIVACY
SWEENEY, L. (2002) · International Journal of Uncertainty, Fuzziness and Knowledge-Based Systems · doi:10.1142/s0218488502001648 · Cited by 8,571
Ciphertext-Policy Attribute-Based Encryption
Bethencourt, J., Sahai, A., & Waters, B. (2007) · 2007 IEEE Symposium on Security and Privacy (SP '07) · doi:10.1109/sp.2007.11 · Cited by 5,131
Proposed NIST standard for role-based access control
Ferraiolo, D. F., Sandhu, R. S., Gavrila, S. I., Kuhn, D. R., & Chandramouli, R. (2001) · ACM Transactions on Information and System Security · doi:10.1145/501978.501980 · Cited by 2,553
Certificateless Public Key Cryptography
Al-Riyami, S. S., & Paterson, K. G. (2003) · Lecture notes in computer science · doi:10.1007/978-3-540-40061-5_29 · Cited by 2,218
Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors
Koppel, R. (2005) · JAMA · doi:10.1001/jama.293.10.1197 · Cited by 2,126
Westin, A. F. (1967) · Cited by 1,908
Westin, A. F. (1970) · CERN Document Server (European Organization for Nuclear Research) · Cited by 1,861
Flagged first, then by citations
4 of the 127 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- Sainz-Abajo, 2010, Evolución, beneficios y obstáculos en la implantación del Historial Clínico Electrónico en el sistema sanitario, RevistaeSalud.com, 6, 1
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A systematic review of gamification in e-Health
Sardi, L., Idri, A., & Fernández‐Alemán, J. L. (2017) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2017.05.011 · Cited by 1,041
Self-citationEmpirical Studies on Usability of mHealth Apps: A Systematic Literature Review
Zapata, B. C., Fernández-Alemán, J. L., Idri, A., & Toval, A. (2015) · Journal of Medical Systems · doi:10.1007/s10916-014-0182-2 · Cited by 585
“An SLR is a research technique that gathers all empirical evidence in a specific field of study [28].”
Self-citationAn exhaustive survey on security and privacy issues in Healthcare 4.0
Hathaliya, J. J., & Tanwar, S. (2020) · Computer Communications · doi:10.1016/j.comcom.2020.02.018 · Cited by 462
Blockchain Technology Use Cases in Healthcare
Zhang, P., Schmidt, D. C., White, J., & Lenz, G. (2018) · Advances in Computers · doi:10.1016/bs.adcom.2018.03.006 · Cited by 441
Shi, S., He, D., Li, L., Kumar, N., Khan, M. K., & Choo, K. R. (2020) · Computers & Security · doi:10.1016/j.cose.2020.101966 · Cited by 431
“…and patients medical data sharing) have also attracted the interest of the research community ( Boonstra et al., 2014; Car-valho et al., 2016; Crameri et al., 2020; Fernández-Alemán et al., 2013a; Ho et al., 2019; Lluch, 2011; Miah et al., 2019; Strudwick and Eyasu, 2015; Tovanich et al., 2020 ).”
Metadata
- Authors
- Fernández-Alemán, J. L., Señor, I. C., Lozoya, P. Á. O., & Toval, A.
- Affiliations
- Universidad de Murcia (ES)
- Corresponding author
- Señor, Inmaculada Carrión
- ORCID
- Toval, Ambrosio
- Venue
- Journal of Biomedical Informatics
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 46
- Issue
- 3
- Pages
- 541-562
- ISSN
- 1532-0464 (ISSN-L)
- OpenAlex
- W2128232860
- Cited by
- 675
- References
- 127
- Citations by year
- 2026: 23 · 2025: 39 · 2024: 72 · 2023: 59 · 2022: 46 · 2021: 59 · 2020: 57 · 2019: 82 · 2018: 57 · 2017: 48 · 2016: 56 · 2015: 38 · 2014: 29 · 2013: 10
- FWCI
- 7.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Biomedical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Spanish Ministry of Science and Technology (TIN2009-13718-C02-01, TIN2009-13718-C02-02)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Physical Sciences › Computer Science › Computer Networks and Communications › Access Control and Trust
- Health Sciences › Health Professions › Health Information Management › Thoreau and American Literature
- Keywords
- electronic health records, health information security, privacy, HIPAA, Data Protection Directive 95/46/EC, public key infrastructure, digital signatures, pseudo-anonymity, role-based access control, access control, audit logging, user authentication
- MeSH terms
- Europe, United States, Computer Security, Privacy, Health Insurance Portability and Accountability Act, Electronic Health Records
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