Imaging files at risk on mobile devices
The proliferation of mobile device technology has given physicians the freedom to assess and diagnose disease from wherever they may be, but they also need to be cognizant of potential security breaches while viewing images in public, risk management specialists say.
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Bandwidth advancements and greater device capacity have enabled the sharing of high-density files like PACS and other diagnostic images, so physicians can join in on consults even from remote locations. Yet despite the convenience and immediate response capabilities, there are various security issues that must be addressed before confidential patient image files are viewed in public, says Allan Ridings, senior risk management and patient safety specialist with the Cooperative of American Physicians.
"Any time a mobile device is used to share personal health information, it triggers a number of potential HIPAA privacy violations," he said. "Doctors tell me that PACS and radiological image sharing is common and that they could be viewed in public places like coffee shops. That is very unsecure. Hackers love to surf coffee shops. There could be a person sitting outside the shop in a car grabbing all that data. "
Ironically, while mobile devices routinely have encryption capabilities built into them, "no one knows how to turn on the encryption because manufacturers aren't good at informing users that this option is available," Ridings said. "This is a serious issue. While technology brings information to our fingertips, not much has been done to protect PHI."
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Public WiFi in places like coffee shops and airports should be avoided at all costs when sharing sensitive images, and even safe networks are sensitive to data theft if a user ID and password is intercepted, Ridings said.
"If there is public WiFi in waiting rooms, patients could be putting their own data at risk," he said. "We need to educate caregivers across the country about sharing only what you need. Protect health information on mobile and wired systems. Not enough people have jumped aboard this bandwagon yet."
Mobile device functionality has improved so dramatically in recent years that detailed, sophisticated PACS images can be displayed with sufficient clarity and characteristics to make an appropriate diagnosis. So it is natural that busy physicians would want to use the devices when they are "on the go," said Pierre Lemire, chief technology officer and executive vice president for Calgary Scientific.
Lemire acknowledges that security is a delicate issue and that how the images are viewed make a difference.
"It comes down to accessing the images -- some call for downloading, but when you do that the IT department is at risk because it has to be controlled," he said. "Our solution allows for access but images are not loaded onto the device. It is a remote access system, deployed through an on-premises method that provides access without being downloaded."
Calgary Scientific's diagnostic medical imaging software ResolutionMD enables physicians to securely view patient images from a wide variety of devices. It can handle tens of thousands of users and can access any EMR from any storage system, Lemire said.
"Some IT departments have remote desktop solutions to control security, but they are not usable for devices when trying to present detailed images from a desktop onto a smaller screen," he said. "With ResolutionMD, those details are tailored for smaller screens so they can be viewed with clarity."
3G delivers 3D
Even regions like the Great Plains that are known for rural isolation now have the infrastructure to transmit highly detailed images over the landscape. Sharing diagnostic images over wide swaths of countryside is more a necessity than luxury for Academic Health System in Omaha, Neb., says telehealth coordinator Kyle Hall.
For instance, neurological scans can now be shared over the 3G network using the Calgary Scientific system, which greatly reduces the need for rural patients to travel, he said.
"Three years ago we were able to help neurosurgeons get access to CT scans through the image exchange," he said. "Before that every patient had to travel to the medical center and a large percentage didn't need to come."
Now the neurosurgeons can see the images remotely and make their diagnosis, Hall said. The cloud-based system transmits the images with impressive speed, he said, accessing a CT head exam on an iPad in less than 60 seconds.
"Using other systems could take 20 to 30 minutes to calculate this data," Hall said. "The platform renders the graphics card at the source of the data center and streams compressed pixel information at 100 percent of the original resolution. When the processing power is at the source, you can have 3D capability."