Training for ICDL Certificate

Topics to be Discussed

Due Care
1. Confidentiality
2. Access Control
3. Security
 Measures to protect patient confidentiality

• Confirm the patient's identity before taking any

information from them, or exposing any information to
them.

• Access only to patient information when necessary.

• Access only to items that they need to know.

• Only persons directly involved in the patient care or

public health activities should have access to patient
information.
 Measures to protect patient confidentiality

• Conduct patient interviews and discussions in private rooms or

areas.

• Never discuss the patient's case with anyone without their

permission (including family and friends during off- duty
hours).

• Note that they could be held legally responsible for disclosing

any patient information without their consent.

• Never use the patients' names in public areas.

 Measures to protect patient confidentiality

• Never leave hard copies of forms or records where unauthorized

persons may access them.

• Use only secure methods to send patient information (EX: official

mail) and always mark that information as confidential.

• When using an interpreter, ensure that they determine the

importance of patient confidentiality.

• If a staff member or another healthcare worker requests patient

information, ensure they have right to do so before disclosing
anything to them.
 Measures to protect patient confidentiality

• Keep records that contain patient names and other

identifying information in closed, locked files; and printouts
that are no longer needed should be destroyed.

• Restrict access to electronic databases to designated staff.

• Carefully protect computer passwords; and never give them

to unauthorized persons.

• Keep computers in a locked or restricted area; and physically

or electronically lock the hard disk.
Patient’s rights
 Patient’s rights about their own
personal data.
• The right to get a copy of their medical records, and the
right to keep them private.

• The right of informed consent. This means that if

the patient needs a treatment, the healthcare
provider must give them accurate and easy-to-
understand information to make a sound decision.

• The right to ask questions if they do not determine

information or instructions.
 Patients rights about their
own personal data.
• The right to talk privately with the healthcare provider,
and have their medical information protected from all
other people, including family members and work
colleagues.

• The right to seek an alternate doctor or ask for a

second opinion.

• The right to know the names and roles of those caring

for them (such as doctors and nurses).
So, the health information cannot be used or shared
without the written permission of the patient, unless
allows it.

For example, without the patient authorization, the

healthcare provider cannot:

• Give the information to the patient's employer.

• Use, share, or sell the information for marketing or

advertising purposes.
• if patients find that their medical information is not
correct or not accurate, the law gives them the right to
submit a request for correcting their records.

• If the request is rejected, the healthcare provider

should explain the reason for the rejection (for
example, the healthcare provider did not create that
record, or the information is accurate with clarifying
reasons).
 A HIS fulfill with the minimum safety
requirements regarding access to electronic
medical records of the patients

• Computers are equipped with a system of personal

authentication (for access to the system), a system
of authentication to the health information and
the relevant authorizations to control the type of
access to the database of patients.
• Notifiable diseases are diseases considered to be of
great public health importance, such as malaria and
plague. So, national requirements also demand that
these diseases be reported when they are diagnosed
by doctors or laboratories.

• This allows for the collection of statistics that show

how often the disease occurs, which helps
researchers identify disease trends and track disease
outbreaks, to help control future outbreaks.
As with paper records, information from a

patient records can be electronically

transmitted to an external party by e-mail

• Although, the risk of confidentiality breaches and
security has always existed with conventional
paper-based healthcare system, the automation
and speed of electronic communication have
increased this risk.
 opt in versus opt out

• Participation in HIS is optional.

• The patient has the right to opt in (participate)

or opt out (not participate) from having their
personal health information available to their
healthcare providers.
 opt out

•opting out means that the healthcare

providers will not be able to get any
information about the medical history of the
patient.
 Benefits of opt in

• The health information will be available quickly

in case of a medical emergency, even if the

patient was unconscious.

• The laboratory test results (such as blood tests and

radiology reports) will get to the doctor faster.

 Benefits of opt in

• The medical records immediately follow the patient

when they see a new specialist or change doctors.

• The healthcare providers can avoid duplicating any

treatments already ordered by other providers, saving
the patient time and unnecessary expenses.

• The healthcare providers can more easily coordinate the

medical care to the patient as a team.
2. Access Control
Access control is a balance between

confidentiality and availability based on each

healthcare worker's role and his/her duties

and responsibilities.
 what the user knows
(PIN, or password)

Methods used what the user has

to control ( a card or token)
access to HIS
data are what they are
(a biometric scan
finger prints, eye
retinas, etc).
 Methods used for controlling access
to HIS data
•PIN code
A personal identification number (PIN) is a numeric
password used to authenticate the user to a system
in order to gain access.

Access is granted only when the correct number is

entered.
 Methods used for controlling access
to HIS data

Text

• Text access control consists of a username and a

password. The username can be any name the user

chooses on their own. and the password can consist of

a simple "secret word" containing both letters and

numbers.
 Methods used for controlling access
to HIS data

Biometric Scans

• Refers to technologies for analyzing human body

characteristics such as fingerprints, eye retinas and
irises, voice patterns, facial patterns, and hand
measurements.
• Stronger authentication method.
A biometric device, such as fingerprint scanner,
consists of:

1. A reader or scanning device.

2. Software that converts the scanned information

into digital form. and compares match points.

3. A database that stores the biometric data for

comparison.
 Methods used for controlling access
to HIS data
Tokens

• Small device (such as a key fob) that provides a

different number every time.
• The user enters his PIN code, which authorizes
them as the owner of that particular device.
• Then the device displays a number which uniquely
identifies the user to the HIS, allowing them to log in.
 Methods used for controlling access
to HIS data
Smart Cards

• The smart card is the size and shape of a credit

card, and it contains a microchip with the potential
for storage and processing of large amounts of data
at high security, so you can store a variety of
information about patients.
• The smart card is inserted into a reader who reads the
information stored on the microchip.
 Methods used for controlling access
to HIS data
Barcodes
• is the special identification code printed as a set of vertical
bars of differing widths and used as an access code for
quick log-in to the HIS.

• The barcode represents binary information that can be

read by an optical scanner that uses a laser beam.

• The coding can include numbers, letters, or a combination

of two.
• Changing your password regularly is a good idea.

• You should change your HIS password regularly

(normally every few months)

• Strong password is extremely important to prevent
unauthorized access to your accounts and devices.

• It is advised that you choose a 20+ character phrase

as a password.

example, any normal sentence……….

• Passwords shorter than 20 characters must be very

complex (and therefore hard to remember).
 Guidelines for choosing a strong
password:

• Must be at least 8 characters in length, but not more than 50

characters.
• Contains both uppercase letters (A-Z) and lowercase letters (a-z).
• Includes at least one number and or punctuation mark. like:

• Do not choose a password made up of personal data

information that one could easily discover about you from
searching the internet.
• Do not choose a password that is an English or Arabic word found
in the dictionary.
• Never store your password on your computer except
in an encrypted form.

• Never accept Windows offer to save the password.

• Do not tell anyone your password, not even a close

friend or your system administrator.

• Never send your password via e-mail or other
unsecured method.
• Do not write down your password, but rather a hint
that would allow you and nobody else to reconstruct
it.

• Be careful when entering your password and there is

someone else near you.

• If you believe your password has been compromised or

that it is no longer a secret, change it immediately.
7. Recognize the need to observe the
password policies of an organization

• Maximum Password Age (in days).

• Minimum Password Length.

• Password History.

• Maximum Consecutive Failures.

• Lockout Time (in seconds)

3. Security
 Confidentiality

The main
functions of the Integrity
security in HIS are
to protect
Availability
the main functions of the security in HIS are to
protect three major issues:

•Confidentiality.
This means ensuring that information is only being seen or used
by people who are authorized to access it.

•Integrity.
This means preventing any unauthorized user from changing
the information, and tracking the changes made by authorized
users.

•Availability.
This means making sure the information will be available when
authorized users need it.
 key principles of security within a HIS In
order to provide these functions

• Awareness of system vulnerabilities, to try and correct

them, and deny any unauthorized user from logging into
the system.

• Formal commitment from healthcare users to HIS

organization security policies, so they do not threaten
the privacy and confidentiality of patient medical data.
 key principles of security within a HIS
In order to provide these functions

• Tracking who accessed the HIS system and what

operations he performed during a given period of time,

This can help in detecting security violations,

performance problems, and improper modifications of

data.
•A security policy is a document that
specifies how a healthcare organization plans
to protect their physical devices and medical
records.
 The security policy may include:
• Description of how the healthcare organization
plans to educate the employees about protecting
the patients' medical data.
• Explanation of how security measurements will be
carried out and enforced.
• Procedure for evaluating the effectiveness of the
security policy to ensure that necessary corrections
will be made.
 Security threats:
1. Natural disasters, such as earthquakes, floods,
…etc.

2. Inside attacks by malicious employees, and outside

attacks by hackers or viruses. The most common
sources of malicious damage are computer viruses
and hackers

3. Equipment failure (computer or printer).

4. Software failure leads to inaccurate results.

 Security threats

5. Accidental viewing from an unauthorized person to

some confidential or sensitive patient data.

6. Unauthorized or uncontrolled access to HIS from

outside hackers who seek to steal private medical
records.
 Security threats
7. Malicious damage (intentionally) to private medical
records or HIS equipment.

8. Risk of transferring patient data to external media,

such as CDs or USB flash drives.
 security threats

• Proper password and authentication policies.

• An anti-virus software, should be regularly updated.

• An anti-spam software, should be regularly updated.

• A hardware or software that fulfills the functions of

a firewall.

• Physically locking the server room and all other

infrastructure.
 security threats

• Periodically backing up the medical data.

• Limiting the employees rights to access the network

and applications to match their business needs.

• Reviewing activity logs to identify if user accounts and

access are being misused and when.

• Locking the screen in case of prolonged absence.

• logging off at the end of the operations.

 User Impersonation or
Identity theft

• It is the illegal use of someone else's personal

identifying information (such as username and
password) in order to log into someone's HIS
account.
1. Searching your trash for documents that contain
your personal information.

2. Shoulder surfing.

3. Social engineering (someone uses telephone or

email message to deceive you into divulging
sensitive information).
 Malware
• Malware, or malicious software, is any computer
program designed to infiltrate and damage computers
without the user's consent, or gathering information
about the computer users without permission.
• Malware includes computer :
1. Viruses.
2. Worms.
3. Trojan horses.
4. key loggers. and
5. Spyware.
• is a program that spread by attaching itself to a
legitimate software, document, or e-mail
attachments.

• They can be transmitted though e-mails or

downloaded files, and they can be present on CDs,
DVDs, USB- drives, and any other soil of digital media.
• is a program that propagates across computers,

usually by creating copies of itself in each

computer without being activated by the user,

to the extent it causes the computer to crash.

• is a destructive program disguised as a game, utility,
or application.
When run, a Trojan horse does something harmful to
the computer system while appearing to do something
useful, such as deleting files or formatting the hard disk.
• is a small program that monitors every keystroke

you enter on your keyboard, and its purpose is to

steal private information such as usernames and

passwords.
• It is any program that gathers information about
a person or organization without their
knowledge, and sends it to advertisers,
competitors, or other interested parties.
• Data storage simply means saving the HIS data either
on the main network used daily by the healthcare
workers, or on backup disks, such as an external hard
disk, USB flash drive, CD, DVD, etc.

• The goal of backing up data is to ensure that when a

system dies, there will be an available, recent copy
you can use to restore the system.

• You could simply back up the complete system at

the end of each day.
 Full Backup

Incremental
Back up Methods Backup

Differential
Backup
 Full Backup

1. Complete, comprehensive.

2. System should not be in use.

3. Once a full backup is made, you have a

complete archive of the system.

4. Full backup can be a time-consuming process on

a large system.
 Incremental Backup

• Partial backup that stores only the information that has been
changed since the last full or the last incremental backup.

• Smaller than a full backup.

• The fastest backups to preform on most systems.

• Restoring data using incremental backups takes longer.

since the restoration must use the last full backup and
every incremental backup made since the last full backup (in
order).
 Differential Backup

• Similar in function to an incremental backup.

• Nearly as large as a full backup.
• It backs up any files that have been altered since the last
full backup.
• It makes duplicate copies of files that have not changed
since the last differential backup.
• Restoring data using differential backups can be faster
than the incremental because you only need to restore the
last full backup and the most recent differential backup.