1. HEALTH CARE IN INDIA
A.Suguna,
C.Geetha,
IIMCA,
IIMCA,
Ayya Nadar Janaki Ammal College,
Ayya Nadar Janaki Ammal College,
E-Mail:sugunass@ymail.com
E-Mail:geetha.starose@gmail.com
Abstract :
“Health is the vital principle of bliss”- Thomson
Healthcare in India features a universal health care system run by the
constituent states and territories of India. The Constitution charges every state with
"raising of the level of nutrition and the standard of living of its people and the
improvement of public health as among its primary duties". The National Health Policy
was endorsed by the Parliament of India in 1983 and updated in 2002.Information
security and privacy in the health care sector is an issue of growing importance. The
adoption of digital patient records, increased regulation, provider consolidation and the
increasing need for information exchange between patients, providers and payers, all
point towards the need for better information security. We critically survey the literature
on information security and privacy in healthcare, published in information systems
journals as well as many other related disciplines including health informatics, public
health, law, medicine, the trade press and industry reports. In this paper, we provide an
information security, privacy, healthcare information systems, research literature, ehealthcare, electronic healthcare.
Introduction:
Health is a state of complete physical, mental and socialwell-being and not merely
the absence of disease or informity.The face of health care is changing as new
technologies are being incorporated into the existing infrastructure. Electronic Patient
Records and sensor networks for in-home patient monitoring are at the current forefront
of new technologies. Paper-based patient records are being put in electronic format
enabling patients to access their records via the Internet. Remote patient monitoring is

2. becoming more feasible as specialized sensors can be placed inside homes. The
combination of these technologies will improve the quality of health care by making it
more personalized and reducing costs and medical errors. E-healthcare as field of activity
between information technology, healthcare, and business administration holds great
potential of improving healthcare efficiency, patient value , and cost development, and
will profoundly influence relationships between professionals and patients.
1)Security and Privacy Issues with Health Care Information Technology:
The health care system has long been plagued by problems such as diagnoses
being written illegibly on paper, doctors not being able to easily access patient
information, and limitations on time, space, and personnel for monitoring patients. With
advancements in technology, opportunities exist to improve the current state of health
care to minimize some of these problems and provide more personalized
service.
TECHNICAL BACKGROUND:
Data from in-home sensors and media records will be communicated
electronically via the Internet and wireless transmissions.
A. ELECTRONIC PATIENT RECORDS:Electronic patient records take the current paperbased documents and convert them to a digital format so they are available
electronically. The records include different types of data, such as physician’s
notes, MRIs, and clinical lab results. Using EPRs allows real-time access to health
care records independent of the physical location of the user.
B. In-home Remote Patient Monitoring: With the evolution of sensor networks, realtime in-home patient monitoring is more feasible. Figure 1 shows the overall
remote patient monitoring system. Different types of sensors can be used at home
to monitor a patient’s vital signs. Wearable devices, such as electrocardiogram
sensors and pulse oximeters, are being used along with non-wearable ambient
temperature and humidity sensors. New sensors are also being developed to do
different forms of monitoring.
PRIVACY AND SECURITY ISSUES:
While the above mentioned technologies can help improve overall quality of
health care delivery, the benefits of these technologies must be balanced with the
privacy and security concerns of the user. Data from in-home sensors and medical

3. records will be communicated electronically via the Internet and wireless
transmissions.
A. Data Access and Storage : There has long been concern over a patient’s health
record privacy and confidentiality . Connecting personal health information to the
Internet exposes this data to more hostile attacks compared to the paper-based
medical records. Currently, patients have to physically go into a health care
facility to get their medical record. Since the records are in paper format, this
physically limits the number of people who see the record and how it gets
transmitted. However, once this information is available electronically, it opens
the door for hackers and other malicious attackers to access the records as well as
those who are authorized. In addition, given the distributed nature of sensor
networks for in-home patient monitoring, there is a greater challenge in ensuring
data security and integrity compared to the traditional health care system.
Eavesdropping and skimming are a possibility when the sensor data is
transmitted wirelessly. Data access, storage, and integrity are key challenges
when implementing EPRs and in-home sensor networks.
B. Data Mining : Data mining is the process of analyzing data to identify patterns
and/or relationships. Human medical data is seen to be one of the more rewarding
and yet most difficult of all biological data to mine and analyze. Data mining on
human subjects can provide observations that cannot be gained or easily
extrapolated from animal studies.
2)
E-HealthCare:
Health and healthcare are goods of eminent importance. Parallel to healthcare
cost increase, information technology has begun to fundamentally change both
production as well as distribution of goods in many areas, opening entirely new
opportunities for services and products, and consequent business. Many commendable
efforts of developing and adopting innovations of e-healthcare have emerged, some
successful, some aborted for the sake of better knowledge.
Definition of E-Healthcare:
Integration of functional, institutional and processual views on both individual
and collective healthcare under particular consideration of information and
communication technology.
Scope of E-Healthcare:
When looking at e-healthcare from a functional point of view we have identified
five elements:
A. Content: Medical information databases Healthcare provider directories
B. Commerce: Online pharmacies and shopping portals Transfer of healthcare
billing data
C. Connectivity: Interconnection of involved parties (physician, laboratory,
pharmacy, hospital, insurance)
D. Computer Application: Applications enabling content providing Applications
enabling connectivity providing

4. E. Care (Telemedicine): Physician to physician: Teleconsultation, teleeducation
F. Physician to patient: Telediagnostics, teletherapy, telemonitoring
Change in Healthcare and Implication on E-Healthcare:
More recent historic change in healthcare due to cultural and structural in?uence
at the example of western civilized countries, drawing conclusions on current
expectations towards healthcare. It depicts a contemporary patient social type and lists
changes that affect healthcare from the public (or demand) side as well as from the
supply side.
A. Socio-Economic and Demographic Shift : Society and economy are so strongly
interdependent that contemporary nomenclature often merges the two terms and
uses them as one. Economy drives and empowers society, but the latter forms the
mental and physical fundament of the first. Their interaction forms a culture,
which, in turn, consists of a system of values. The evolution of society and
economy continually shifts and shapes culture and therefore influences its
constituting values. Societal evolution may then be seen as the cross-product of
two interdependent circles of change :
• Structural Change - Quantitative Developments: (Demography, social
structure, infrastructure)
• Cultural Change - Qualitative Developments: (Values, belief, social norms,
life styles, self-concepts)
B. Role Shifts and Raise of Transparency : The relation of medical doctor and
patient as we know it today is rather young. 200 years ago, physicians had only
been at the disposal of small social stratum, namely aristocracy and bourgeoisie.
Only after World War I, modern medicine has become a fundamental service of
modern democracy. In many rural villages, there had only been three or four
scholars, namely a schoolteacher, a priest, a doctor, and some times a pharmacist.
• Functional Physician-Patient Relationship:
•
Normative Physician-Patient Relations:

5. Current Efforts in E-healthcare:
Regardless of place, e-healthcare is still in early stage of development. As for
Switzerland, innovative efforts are not coordinated, but usually based on the initiatives of
individuals or institutions. Triggers of such projects are typically practical needs. A coher
ent nationwide strategy for the introduction of e-healthcare is still missing .
Issues Facing E-healthcare:
E-healthcare aims to introduce information technology into healthcare
infrastructure. To large parts, its introduction lag in healthcare does not originate from
problems created by e-healthcare itself. Instead, many adoption problems are caused by
characteristics of healthcare systems, which differ fundamentally from conventional open
market systems.
A. Social Insurance Issues :In most civilized states, socially funded healthcare
insurances are compulsory. Instead every healthcare beneficiary pays an
averaged stake, or premium, of collectively accrued healthcare costs. This
premium is then made direct function of collective health-care costs.
Premiums may be individually weighted by factors of income, property or
tax volume, although these elements of solidarity are currently not
incorporated in Switzerland.
B. Financial Issues : E-healthcare solutions typically improve service efficiency
or effectiveness. How ever, healthcare providers are only incentivized in
centivized for the adoption of e-healthcare solutions if these benefits
accrue to themselves. If benefits should be handed over to payers, for
example through less frequent face-to-face visits, physicians would even
incurloss of income. Incentives strongly depend on the means of payment.
Under fee-for-service payment, physicians have little interest in improving
their efficiency.
C. Political Issues: Swiss healthcare politics are centered around the healthcare
insurance law (KVG: Krankenversicherungsgesetz), which is under
constant debate. The term of „insurance” is actually misleading because
according law revisions include more than just insurance matters. After
long-lasting debate, the proposed second revision of KVG has finally
failed in December 2003 in National Assembly. Core issues had been the
abandonment of enforced physician contracting by insurances as well as
higher cost participation for patients
D. Technological Issues: Most technological problems in the adoption of ehealthcare do not actually lie in technology itself, but rather in the
application thereof: First, and foremost, data and communication standards
are under continuous development, and many have not yet reached wide
acceptance. Concerning data standards, e-healthcare is confronted with the
problem of how to transform healthcare information into electronic data.
Second, physical interconnection of healthcare providers is still lacking. In
Switzerland, a secure healthcare data transaction platform does exist .

6. 3) Research Literature on Health Care:
The literature on priority setting in healthcare. It adopts an economic
perspective on the problem of choosing the optimal portfolio of programmers that can be
afforded from a limited national healthcare budget. The traditional economic approach,
proposes maximizing health gain subject to a budget constraint, which implies ranking
programs according to their cost-effectiveness ratio.
Three important difficulties: limitations in economic evaluation methodology,
incorporating equity principles, and practical constraints. These suggest a need for a
fundamental rethink of the role of cost-effectiveness analysis in priority setting.
Evaluating the Literature :
Emergency physicians provide care for patients with a wide variety of medical
conditions in diverse clinical scenarios. The wide scope of practice and resultant required
breadth of knowledge demand frequent use of the latest medical literature. Many specific
reasons exist why an emergency physician might review the literature on a particular
topic. Among them include the following:
•
•
•
•
To understand the pathophysiology, etiology, or clinical course and features of a
disorder
To learn how experts recommend handling a clinical problem
To learn the benefits of a new diagnostic test and how it relates to existing
technology
To evaluate the safety, efficacy, benefits, risks, and cost of new diagnostic or
therapeutic options
The evidence-based medicine process can be thought of as involving 5 steps:
(1) formulation of a clinical question,
(2) locating the best evidence,
(3) critically appraising that evidence,
(4) acting on the evidence, and
(5) critiquing the result of the process.
CONCLUSION:

7. Technology is enabling medical health records to be put in the electronic format,
EPRs, and making them available to the users via the Internet. In addition, advances in
the area of sensor networks are making the idea of remote patient monitoring a reality. In
this paper we discussed the privacy and security issues that arise when integrating these
new technology into the traditional health care system. E-healthcare clearly enhances
possibilities of monitoring as well as screening of physician activity. Therefore,
physicians handle the matters of e-healthcare with suspicion, especially when raising
transparency, lowering their potential of moral hazard, and equalizing the information
asymmetry they benefit from. The state of knowledge of evidence- based healthcare
design has grown rapidly in recent years. The evidence indicates that well-designed
physical settings play an important role in making hospitals safer and more healing for
patients and better places for staff to work.
Reference:
1. www.orcatech.org/Meingast_security_issues
2. www.cardiff.ac.uk/insrv/resources
3. www.ifi.uzh.ch/archive/mastertheses