D

DARPA. See Defense Advanced Research Projects Agency (DARPA)

Data

availability of (See Availability of data)

backups (See Backups)

collection, 11, 69

economic value of, 28, 56, 60

encryption (See Encryption)

flow (See Flow of data, representative example)

integrity of (See Integrity of data)

linking (See Linkage of records)

ownership of, 50, 216

patient-identifiable (See Patient-identifiable data)

secondary users of (See Secondary use, controlling)

security of (See Security of data)

sharing (See Sharing data)

Data custodians, 142

Data Encryption Standard (DES), 87

Data stewards, 141-142

Debate. See Public debate, need for

Decision support systems, 26

Defense, Department of, 41-42

Defense Advanced Research Projects Agency (DARPA), 11n, 106n, 113

Defense Information Systems Agency, 56

Degaussing, 100-101

Denial-of-service attacks, 64, 105-106

Department of Defense. See Defense, Department of

Department of Health, Education, and Welfare. See Health, Education, and Welfare, Department of

Department of Health and Human Services. See Health and Human Services,

Department of

DES. See Data Encryption Standard (DES)

Detailing, 144

Dial-back procedure, 172

Dialysis patients, 229

Digital health care records. See Electronic medical records (EMRs)

Disaster recovery procedures. See Backups

Disciplinary policies and procedures, 4, 9, 12, 61, 81, 149, 151-153, 174, 214-215

incremental, 152

strengthening, 165

Discrimination issues. See Privacy, interests at stake

Distributed Computing Environment (DCE), 91, 96, 111, 125-126

DNS. See Domain Name Service (DNS) information

Domain Name Service (DNS) information, 103

Drug interactions, adverse, 225

Drug treatment information. See Substance abuse information

E

Education and training, 174

for health care workers, 4, 9, 13, 61-62, 109, 142-149, 215

formal, 143-144

informal, 144-145

for medical staff, 143-144, 146-147

for patients, 13

publications useful in, 147-148

videos useful in, 148-149

Elderly patients, 222

Electrical failure. See Alternative power;

Backups

Electronic medical records (EMRs), 2-4, 21n, 25-26, 122-126, 216

advantages of, 26, 160

difficulties of building, 122-123

transition to, 122-123

E-mail, problems based on, 8, 61, 64

Embarrassing revelations. See Privacy, interests at stake

Front Matter (R1-R22)

Executive Summary (1-18)

1 Introduction (19-36)

2 The Public Policy Context (37-53)

3 Privacy and Security Concerns Regarding Electric Health Information (54-81)

4 Technical Approaches to Protecting Electronic Health Information (82-126)

5 Organizational Approaches to Protecting Electronic Health Information (127-159)

6 Findings and Recommendations (160-196)

Bibliography (197-208)

Appendix A Study Committee's Site Visit Guide (209-220)

Appendix B Individuals Who Briefed the Study Committee (221-221)

Appendix C National Library of Medicine Awards to Develop Health Care Applications of the National Information Infrastructure (222-232)

Appendix D Sections of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191) Related to the Privacy and Security of Electronic Health Information (233-246)

Appendix E Committee Biographies (247-254)

Index (255-264)