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Table of Contents    
CORRESPONDENCE
Year : 2015  |  Volume : 63  |  Issue : 4  |  Page : 642

Author's Reply


Department of Surgery, Unit of Neurological Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal

Date of Web Publication4-Aug-2015

Correspondence Address:
Amit Thapa
Department of Surgery, Unit of Neurological Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu
Nepal
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Thapa A. Author's Reply. Neurol India 2015;63:642

How to cite this URL:
Thapa A. Author's Reply. Neurol India [serial online] 2015 [cited 2019 Oct 15];63:642. Available from: http://www.neurologyindia.com/text.asp?2015/63/4/642/162146


Sir,

We thank Kalakoti et al., for their interest in our work. They have put forward a valid concern which was addressed by the senior author during his presentation in Neurological Society of India annual meeting in Mumbai. The patient's confidentiality should be of concern to all those who are involved in his care. Data can be lost or stolen, the latter being seen in the majority of cases.[1] Recently, fraud has increased by 112 percent in one year, from 3 percent in 2008 to 7 percent in 2009[2] with theft and breach in the electronic data bases kept in hospital management information system (HMIS) and PACS system maintained by the healthcare industry (likes of Premier Blue Cross and Anthem or Griffin Hospital in Derby, Conn) as hacking into these so called "secure server" systems has been found to be easy, tempting the media to call the health information a new "low-hanging fruit."[3] To avoid such situations, the healthcare providers handling these data sets should be responsible and ethically aware as no amount of hardware and privacy policy can restrain such wrongdoings. On Viber© the administrator can select or deselect the users who can access the information. We selected viber͹ over the other portals for its privacy policy which clearly states that it does not allow third party dissemination of data sent using its app without the information being given to the users.[4] Viber© only collects the users's phone number, photo and address book for synchronization but does not record any of the calls, sms or images which are being exchanged. All the medical team members involved in the data collection were asked to login into viber© using their own account and personal phones and delete photos as soon as they are seen and discussed. If one loses his phone, nowadays it is easy to lock the phone or erase the data both on android or iPhone.[5],[6] Our article describes how to use an app in a fast and cost effective manner for clinical practice in centres which cannot afford to have effective hospital management information system (HMIS) and PACS system, and involves exchanging images rather than reports or credit card details which allows identification of patients. Moreover, the act which Kalakoti et al., have cited only mentions about misuse of data and does not suggest anything about using the mobile app which has a good privacy policy.[7] Besides, owning the PACS and HMIS is not a one-time investment as it needs continuous support by the software experts at a cost which is eventually borne by the patients. We do not deny the importance of PACS or HMIS system for a better and secure data management but owning one of these or a similar system does not guarantee complete safety.[1],[2],[3]

To conclude, we require stringent institutional information technology policy and an active internet security system while maintaining the patients' data electronically, and encourage the most important factor, an ethically motivated responsible healthcare team to keep our patients' data safe and secure.[1],[2],[8]

 
  References Top

1.
Liu V, Musen MA, Chou T. Data Breaches of Protected Health Information in the United States. JAMA 2015;313:1471-3.   Back to cited text no. 1
    
2.
Rowe J. How to combat EMR data theft. Healthcare IT News. March 30, 2010. how-combat-emr-data-theft.   Back to cited text no. 2
    
3.
Radcliffe S. Health Data Theft on the Rise, Affecting 29 Million Patients. HealthlineNews. April 14, 2015. health-data-theft-on-the-rise-affecting-29-million-patients-041415.   Back to cited text no. 3
    
4.
http:// .   Back to cited text no. 4
    
5.
https: //support.apple.com/kb/PH 2700?locale=en_US.   Back to cited text no. 5
    
6.
https: //support.google.com/accounts/answer/6160500?hl=en.   Back to cited text no. 6
    
7.
The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191). PLAW-104publ191.pdf.   Back to cited text no. 7
    
8.
Thapa A, Shrestha D, Shrestha D, Giri S. Use of viber app: A fast, easy and cost effective method of communication in neurosurgery. Neurol India 2013; 61:610-613.  Back to cited text no. 8
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