医疗数据应用中的伦理冲突与协调

聚焦医疗数据在医疗机构的应用,阐述医疗数据应用的现实价值,分析医疗数据应用中的知情权与隐私权、个体权益与公众利益、患者情感需要与数字医疗的伦理冲突,并从完善法律法规建设、强化技术管控、完善管理制度、加强道德培训、倡导伦理参与方面提出了协调措施。     

数据校验技术在医疗健康大数据质量控制中的应用分析

伴随医疗信息体系日渐成熟,各医疗卫生机构与区域卫生信息平台间已逐渐形成有效的数据通道,实现平台端医疗健康大数据的高效汇聚积累。但各医疗卫生机构对数据质量的控制能力良莠不齐,致使医疗健康大数据仅有量的积累而缺乏质的保障。本文介绍基于"校验-反馈-优化"的数据质量控制技术,将数据质量的改善过程循序渐进的落实到数据处理的各个阶段和步骤。结合校验技术提出卫生数据质量控制解决方案,实现从根本上控制医疗健康大数据质量,有效解决医疗卫生行业内棘手的医疗健康大数据质量问题,最终为医疗健康大数据的利用提供优质数据。     

健康医疗大数据应用存在的问题及对策探讨

健康医疗大数据是国家基础战略性资源,发展好健康医疗大数据对于改善患者就医体验、提高医疗服务质量和效率等具有重大意义。通过文献回顾和深入剖析,指出健康医疗大数据应用中存在的问题:数据质量不高,数据利用不足,伦理问题亟待解决。并提出相应的促进健康医疗大数据发展的合理化建议。     

区域医疗健康大数据在医疗机构的实践应用

目的 医疗健康大数据应用背景下,打通区域医疗数据资源共享通道,利用区域医疗健康大数据进行医疗安全与质量管控,提升医院电子病历为核心的信息系统管控能力.方法 完善临床数据中心,开发区域医疗健康大数据采集平台,建设院内综合医疗健康数据库,改造业务系统利用融合后的大数据.结果 院内数据与区域医疗数据融合,医疗质量安全管理系统...     

健康医疗大数据质量治理研究

健康医疗大数据质量治理对促进医疗大数据产出具有重要的研究价值。通过分析健康医疗大数据特点,指出医疗大数据存在的质量问题,提出质量治理的对策建议,包括全面加强质量管理组织机构与人才队伍建设,加快数据质量标准体系建设,积极推动数据质量管理工具等关键技术的发展,落实医疗机构内部数据质量安全管理规范等。     

健康医疗大数据的应用范围与价值分析

健康医疗大数据是国家重要的基础性战略资源,其应用和发展将深刻地改变着健康医疗服务模式,健康医疗大数据的开放、融合、共享、应用,有利于激发深化医疗体制改革的动力和活力。本文主要从产生背景、涵盖内容、当前主要研究及应用热点对健康医疗大数据进行了阐述,探讨了健康医疗大数据在辅助医生临床诊断、促进疾病诊治标准化、助力医药科学研究等方面的应用研究,展望并讨论了健康医疗大数据的潜在挖掘价值与共享探索方向。     

健康医疗大数据标签体系构建方法研究

在界定健康医疗大数据标签相关概念的基础上,以国家全民健康保障信息平台为应用场景,分析了健康医疗大数据用户的类别及其信息需求,提出了健康医疗大数据标签体系的分类框架、标签维度和标签的设计方法,以及标签命名和取值的标准化原则,搭建了健康医疗大数据标签管理系统的基本架构,研究结果能够为该领域数据标签体系构建提供适宜的方法学指导。建立健康医疗大数据标签体系,不仅能够提升用户利用数据资源的效率,而且有利于机器学习和数据挖掘算法的深度应用,支持科学管理与循证决策。     

职业健康大数据的应用现状与发展前景

随着大数据时代的发展,职业健康大数据的应用受到越来越多研究者的关注。概述了大数据在职业健康领域的来源特征、发展现状以及需要关注的问题。通过梳理职业健康大数据在职业病防治、群体职业卫生管理和个人职业安全的应用情况,对职业健康大数据的来源、应用和储存过程中应注意的问题提出建议。加大职业健康大数据的应用分析可以为预测职业人群的健康状况提供数据支撑,加快职业病预测模型的应用,实现职业病防治的精准防控。     

健康医疗大数据驱动下的疾病防控新模式

随着互联网技术的快速发展和医疗信息化的不断推进，健康医疗大数据已逐渐成为创新健康管理、满足人民群众日益增长的健康需求的重要资源，成为国家全面实施大数据战略的重要组成部分。宁波市鄞州区通过构建健康大数据平台及大数据技术的应用，积极探索健康医疗大数据在传染病、预防接种、慢性病等疾病防控领域的防控模式创新，期望通过"互联网+健康医疗"提高区域疾病防控和健康管理水平，培育发展新业态，成为健康中国的有力支撑。本文对鄞州区的这一防控新模式的实践探索进行介绍，并对模式的初步成效进行讨论。     

数字化医院条件下医疗统计数据质量的意义

医疗统计数据质量是数字化医院的医疗统计工作的生命。医院信息化建设进入数字化阶段后，对医疗数据信息的需求量越来越大，要求越来越高。数字化医院医疗数据质量的高低直接影响和决定着医疗数据、统计信息的有用性及其价值，直接关系到医院的经济效益、社会效益，以及医院管理和发展的顺利进行。数字化医院医疗数据的应用需求决定了医疗数据本身的独具特点，也决定了数字化医院条件下对于数据质量的更高要求。数字化条件下，要求医疗数据必须具备数据集中管理，多粒度共存，高效存储和调用以及有权限共享等，对于数据质量管理则要做到源头控制，环节监控，实时反馈。总之，既要实现数据信息准确、有效、快捷地传递，同时又要保证所提供数据信息的真实性、可用性和适用性等，就必须充分认识到数据质量的重要意义以及怎样维护和监控数据质量。本文系统地阐述了数字化医院医疗统计数据质量的内涵、特点、现状及存在的问题，并提出了相应的对策。     

Evaluación de los aspectos metodológicos, éticos,legales y sociales de proyectos de investigación en salud con datos masivos (big data)

The current model for reviewing research with human beings basically depends on decision-making processes within research ethics committees. These committees must be aware of the importance of the new digital paradigm based on the large-scale exploitation of datasets, including personal data on health. This article offers guidelines, with the application of the EU's General Data Protection Regulation, for the appropriate evaluation of projects that are based on the use of big data analytics in healthcare. The processes for gathering and using this data constitute a niche where current research is developed. In this context, the existing protocols for obtaining informed consent from participants are outdated, as they are based not only on the assumption that personal data are anonymized, but that they will continue to be so in the future. As a result, it is essential that research ethics committees take on new capabilities and revisit values such as privacy and freedom, updating protocols, methodologies and working procedures. This change in the work culture will provide legal security to the personnel involved in research, will make it possible to guarantee the protection of the privacy of the subjects of the data, and will permit orienting the exploitation of data to avoid the commodification of personal data in this era of deidentification, so that research meets actual social needs and not spurious or opportunistic interests disguised as research.     

健康大数据在慢性病预防控制中的应用

随着信息化的不断发展,大数据（big data）正在越来越多地被运用于慢性病预防控制领域,对居民健康产生重大且深远的影响。本文简要地介绍了大数据和健康大数据（healthy big data）的定义、特征和分类;重点阐述了健康大数据的分析方法及其在慢性病三级预防中的应用;健康大数据应用所面临的技术难题、数据管理和共享、数据质量、伦理和隐私等诸多方面的挑战。为健康大数据在慢性病预防控制方面提供更多研究思路。     

Resisting big data exploitations in public healthcare: free riding or distributive justice?

We draw on findings from qualitative interviews with health data researchers, GPs and citizens who opted out from NHS England's care.data programme to explore controversies and negotiations around data sharing in the NHS. Drawing on theoretical perspectives from science and technology studies, we show that the new socio‐technical, ethical and economic arrangements were resisted not only on the basis of individual autonomy and protection from exploitation, but also as a collective effort to protect NHS services and patient data. We argue that the resulting opt‐outs were a call for more personal control over data use. This was not because these citizens placed their personal interests above those of society. It was because they resisted proposed arrangements by networks of stakeholders, not seen as legitimate, to control flows and benefits of NHS patient data. Approaching informed consent this way helps us to explore resistance as a collective action for influencing the direction of such big data programmes towards the preservation of public access to healthcare as well as the distribution of ethical decision‐making between independent, trustworthy institutions and individual citizens.     

电子健康档案信息平台的权限与隐私控制

随着新医改政策的推进和区域卫生信息化的进一步推广,存储个人健康档案的电子健康档案信息平台可使广大医疗卫生人员快捷方便地获取客户相关的体检数据、资料,从而加快医疗人员对体检情况的掌握和诊断。然而,随着电子健康档案信息平台的运用和发展,使得健康档案的信息更利于共享、复制及快速传播,这就加深了人们对个人隐私保护的重视。因此,本文主要是探讨电子健康档案的使用权限控制和根据隐私保护技术的基本原理及实际应用提出解决问题的思路及方案。     

Research, ethics and privacy: the limits of knowledge

This paper considers the need for personal privacy within the context of epidemiological research. It concludes that privacy can be protected by early anonymisation and aggregation of personal health data without prejudicing the viability of a research project. During the period before anonymisation, however, a secure legal framework is necessary to prevent unauthorised access to potentially sensitive information. Within such a framework ethical codes need to be identified and monitored by an appropriate Local Research Ethics Committee (or a Multicentre Ethics Committee acting on behalf of a number of local committees). Present arrangements within the health care system in the UK for the handling of such data remain very unsatisfactory and put patient privacy at risk.     

Health Information: Reconciling Personal Privacy with the Public Good of Human Health

The success of the health care system depends on the accuracy, correctness and trustworthiness of the information, and the privacy rights of individuals to control the disclosure of personal information. A national policy on health informational privacy should be guided by ethical principles that respect individual autonomy while recognizing the important collective interests in the use of health information. At present there are no adequate laws or constitutional principles to help guide a rational privacy policy. The laws are scattered and fragmented across the states. Constitutional law is highly general, without important specific safeguards. Finally, a case study is provided showing the important trade-offs that exist between public health and privacy. For a model public health law, see www.critpath.org/msphpa/privacy. This revised version was published online in July 2006 with corrections to the Cover Date.     

Guía de buenas prácticas de seguridad informática en el tratamiento de datos de salud para el personal sanitario en atención primaria

The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients’ personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities.     

Health information and health insurance

In summary, the need for protection of personal privacy, especially when it comes to sensitive medical information, should be regulated to prevent unnecessary and unauthorized dissemination. At the same time, in the interests of optimal patient care at the least expense, regulations, procedures and technology must be in place to allow ready access by all professionals having responsibility for providing and managing this care. In addition, the system must provide for similar ease and right of access to insurers and their representatives who have contracted with the client for necessary health benefits.