An Alert On Potential Emerging Problems With Mobile Devices and E-Health.

The following appeared very recently.

Clinical software on personal mobile devices needs regulation

Juanita I E Fernando

Juanita Fernando says clinicians need some legal certainty around phone and tablet use

The regulation of clinical software for personal mobile devices (PMDs) has increased in relevance for physician practice.1 The plausible benefits of using software such as iStethoscope, Flipboard, Skype or MedCalc on smart phones and tablets include up-to-date access to health data, support for distributed health care and improved quality of interactions with patients. Recent World Health Organization (WHO) survey findings confirm that use of PMDs by clinicians offers tangible patient-care benefits including the integration of mobile health into existing services regardless of geography, connection to an electrical grid and income level. And yet, the legal vacuum in guidelines governing smart phone and tablet use is a key implementation barrier in upper-middle income regions such as Europe (reported by 56% of countries) and the Americas (50%).2 Increasingly, governments overseas are at least thinking about, if not acting upon, this challenge — but Australian governments remain silent.

Software on computers, and portable memory, such as USB sticks, share several security risks associated with software on a PMD that are not addressed by legislation. These include transmission of user log-ons and address-book details, message interception and activity tracking. Professional self-regulation has begun to fill legislative gaps but does not guide the clinical use of PMDs.

One security risk related to PMDs concerns “root-kits” — software applications that are hidden by manufacturers to monitor program performance or installed by attackers for malicious purposes. Unknown to the person using a PMD, root-kits can log key-presses and user locations and can receive messages without notification. They often transmit data in unprotected clear text, too.

Another danger concerns the mix of more than 600 000 software applications, both personal and professional, that people, including physicians, install on mobile devices. Almost 70% of American doctors have downloaded and installed 1500 types of clinical software applications, and Australian physicians are close behind.

Much more with references found here:

doi: 10.5694/mja11.11390

The paper will be available at www.mja.com.au on Monday 16^th April.

Author details

Juanita I E Fernando Grad Cert BusSys, MA, PhD Researcher, Mobile Health Research Group,1 and Chair, Health Sub-Committee2

1 Faculty of Information Technology and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC.

2 Australian Privacy Foundation, Canberra, ACT.

juanita.fernando@monash.edu

I think Dr Fernando has an important set of points here - especially around the need for some clear accountability as to who needs to be accountable for regulation of this area - especially if we start to see any patient harm or privacy breach result from device use.

Well worth a browse.

David.