ࡱ> JI  !"#$%&'(*+,-./0123456789:;<=>?@BCDEFGHRdO)+yK@PowerPoint Document(LSummaryInformation()/DocumentSummaryInformation8A( / 0LDTimesA4H&H&","#,"!  @n?" dd@  @@`` HE     c $0 f3@ g4kdkd",4ĂAppp@ <4BdBdgH&8#? %a0Computerized Patient Records at Montefiore/AECOM     >Essential Data & Informatics for Clinical Research at Einstein    # Informatics Issues and Tools   BWhat s new since the first the chart review? How computers change the risk to the patient How computers change the risk to the institution How does aggregation of multi-institutional data reveal new problems? Patient identification Problem identification Data sharing at a structural levelH-^FQ-^FQ " 1Policy, Law, and Ethics on Health Information Use 2 IRBs - informed consent, waiver of consent, unidentifiable information Health Insurance Portability & Accountability Act - Federal penalties for breech of privacy Access vs. Use & Clinical vs. Research RolesB      Patient Identification  bSocial Security Number A  new national id number Objections of privacy advocates Numberless (open) identification Minimal data needed to match records Inter-institutional trust$s?s?  Patient Identification  Scrubbing - removing anything identifying Blurring - purposely generalizing data Noise - addition of random variations Subsetting - limiting the view into the data Anti-zeroing - preventing queries that retrieve single records w   a Patient Identification  One-time  tossed keys One-way encrypted  open identification using Public Key - Private Key pairs d  Problem Identification  Aggregating numeric data is easy as compared to aggregating descriptive data  Free versus Controlled text data Atomic versus Precoordinated vocabularies Existing vocabularies MeSH, ICD, SNOMED, CPT, Read Code$""6~  #    Problem Identification  National Library of Medicine - Unified Medical Language System (UMLS) Started as a database of information ABOUT controlled vocabularies Increasingly being used AS a controlled vocabulary    Problem Identification  2Meta-thesaurus Concepts linked to  strings Semantic Network A system for categorizing  concepts Lexical Analysis Tools for analyzing and matching wordsl%'%'   #Patient Identification & Encryption $ Social Security Agency http://www.ssa.gov/pubs/10002.html Electronic Privacy Information Center http://www.epic.org/privacy/ Computer Programmers for Social Responsibility http://www.cpsr.org/cpsr/privacy/ssn/ssn.faq.html Pretty Good Privacy http://www.pgp.com/#&/2#&/2"               &    Problem Identification  >UMLS Knowledge Source Server (KSS) http://umlsks2.nlm.nih.gov/$##L2         Data Aggregation  Computer Patient Record Institute Corba-Med - http://www.omg.org/homepages/corbamed/ Health Level 7 - http://www.hl7.org Administrative Data, Lab Data, ... DICOM - http://www.nema.org/nema/medical/dicom/Z"3$#0"3$#0!         \         Available Data  Medicare and Medicaid http://www.hcfa.gov/ord/resdac0.htm New York State Cancer Registry http://www.health.state.ny.us/nysdoh/cancer/cancer.htm Computer Retrieval of Information on Scientific Projects http://www-commons.cit.nih.gov/crisp/l$79&$79&!         7      L         ` ̙33` ` ff3333f` 333MMM` f` f` 3` >?" dd@,|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>>  k(    6DGA P I  V Click to edit Master title style! !   0GA  I  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S ^B  6DԔ00^B   6D``   0dHA `P o#Albert Einstein College of Medicine$#  $    0$IA 0P fComputer Based Education       0IA  P fChristopher Cimino, M.D.    T  <fd޽h ? $Blank Presentation 0 ( 3  l  C $Np I  l  C N` @  I  H  0޽h ? ̙33  @( `P l  C dNP  I  l  C N` I  H  0޽h ?   P( D| l  C DNP  I  l  C N I  H  0޽h ?   `(   l  C NP  I  l  C $N I  H  0޽h ?   p(  l  C NP  I  l  C N I  H  0޽h ? 3   s( 9  l  C $OP  I  l  C O I  X  0 p   0DOp D  `Jim Jones 6/2/58 etc 2    0O @  O Institution 1 2  X  0    0O@   `Jim Jones 6/2/58 etc 2    0TO `  O Institution 2 2  R  s *P   0O00  XResearch Oversight 2  R  s *0 @ p  0ԓO   Q Researchers 2     0O0    bGenerates Key Pair" 2  ^B  @ 6Dpp ^B  6Dp0 ^B  6D` p@P ^B  @ 6D P ^B  6DP    0TO t  V Public Key 2     0O`@t  V Public Key 2     0ԖO `  X Encrypted ID 2     0O `  X Encrypted ID 2     0TO    l Oversight Decrypt in Emergencies! 2  !   0O @ $ p&GIBBERA5$% MATCHED IDs GIBBERA5$%'0P2'  ' H  0޽h ?   0(   0l 0 C ԙOP  I  l 0 C 4O I  H 0 0޽h ?   4(  4l 4 C TOP  I  l 4 C OPp I  H 4 0޽h ?   8(  8l 8 C ԜOP  I  l 8 C 4O I  H 8 0޽h ?   ,( # ,l , C DOP  I  l , C O I  H , 0޽h ?    D( p  Dl D C dNAP  I  l D C NA I  H D 0޽h ?   <( P4)Ơ <l < C dOP  I  l < C O I  H < 0޽h ?   @( l( @l @ C OP  I  l @ C DO` I  H @ 0޽h ? r@&}(]*=,./D8?ABHxJF?XLXst for (i=0;ifjq{CA=;@AC@}~fjq{eadkmlh@ fjq{!"@   fjq{ >momloqxY\ZY[]`jq{=?>??CJ>  jq{  >:6*&!!'/-$!"jq{(#!>58DH;#>@GLD-jq{BCKOD,> "1 "3jq{ );>21,'()+**&"! jq{   > jq{>́jq{<q{  <'&!&#q{<MeO://3=WE4&$%q{IbN<.-/<~|q{jikljig< # q{ <    q{  <ľq{<q{<   q{ {{{{{{{{{{{{{{1 1 {{{1{{{{{{{  {{{ {{{{{{{ {    {{{ {{{{{{{{     {{{{{ {{{{{{{{`{{{{{{{2ڇ2ۇ&݁ɇ&݁ɇ&݁ɇkՇԇ  ԇ    ԇ    Ԕ    Ԕ    Ԕ  Ք $݁$$݁$"݁"1݁  (k)f331CChh"݁+7i(݁pڳE      ڳ  /    ڳ  2  ڳ ڳ ݁.kB݁T!    77  ii      077ii(k؜B+7i݁݁"kk݁݁݁݁݁݁݁݁݁݁݁݁݁݁݁݁݁݁݁*Μ΁Μ΁Μ݁111!   ݁!݁Χ̧Χ"ߟ@ߟ@ߟ@́$   "'&% %266$20*/5-%*' &.''$#*" <6674,# <6477." ICB8-$7631223+($!#$&#!& !%(#+0$~x^`c_XbhGGHB:DJ$A@=98.'23/*&13-& )S ͏vOgxn[Ul0<>ޛZmÐfpD6~SxckS:JdM#Z*H ՜.+,D՜.+,@     'On-screen ShowaA.E.C.O.M.-C.B.E.aLV : TimesBlank Presentation1Computerized Patient Records at Montefiore/AECOMInformatics Issues and Tools2Policy, Law, and Ethics on Health Information UsePatient IdentificationPatient IdentificationPatient IdentificationProblem IdentificationProblem IdentificationProblem Identification$Patient Identification & EncryptionProblem IdentificationData AggregationAvailable Data  Fonts UsedDesign Template Slide Titles  6> _PID_GUID'AN{78AD2C80-10BF-11D4-AC95-000A27E1765E}ORޖ6J,\ DUi=&Zm!Inh{;U`Jx킱nF6{1VU:kx#eìE)9Iedǽ&C #Z[Jȱ0"@PΙ.Y.\À.gPʏ@k2:z_mG.E9rW@\m vc>4Fb\zRLME/Y*L&);Xp [2(9aV_exg .o>+83i gahcWu˔k2¡qHI Qxoa[} Z.-Mwh3!DE}%/1N9rg?_B˙bb0 cEaJ#A^M\%{VuG[Sh~l)gnc|a595p1W9-XUt܄NT@ ?@>>rئTaVDcDxD~X+=̠o\!&X]Þ߹[Icw0#~Ks P%S(p؈hjIJģXTb@jwP}ͯP`)]B:G/Xbw`K$*B &O^'@:*2]GHg .(0>|4To=&r?Nnp4] zKF~Q5lp$°n)A ֘ Rv4Ǭd-&)n%ǁՑ#X?mG1m?.!Al@&Y0mIz_@vQmG/3J;$/CQ̄vs_惧F4Yrw\ ,[UٙKi=Z]$ >(2SPޡ9GU1n=kv`2^8YyN':ߍɀ igxf 2ݗcKA!bQc9T)}=r$J_,KKk.ū: TJ;KCUn{R-> Ta*u v:Y^kcP%@|m\<L _Yz{+ &?A`TU\{797&" huVd=@ X'}Xa,)bN?vNylk^]!^ E{"zf|TKƇmJG sY77+8wBlFw;I> -.~nC/"W@_0eLçu-+!;]8ZWT]MwSq4ϳn2O_BlG2Щ5"'nIU"Ad$Z֤+!QQzR rM-T %˓"/sw%sNY*BJ #On S?p\(HU|*؞;K(G鼨31<_l7zhJ@+콞L)g%f@6m,:Xa{T`O&hCK;$= v/(*G!hp#I9|8W$#5898'qwfw?]Dl*f_%+OZT[.~]|}GP=Υpδ.pX?l7ki@`:H1%~PNb렷S(gYT*y93)Y~!RC~ʁ ;D*a(Kn:qv߫Kn20 pIF8h)w:wE!pTN)N= %{jDB},p .BJ;e$cb&[}RSJ뮺W~Xo1n 钪]x ڝDY.Όۙ .;pbZBc;JqmMN#/Qb7ܾX,]w2ւ <K/oP37>Jw6l11(75el_㟁ՆE?-HQQ2=³;e%*([DH[o_Qeas999Iꈞ݄5.;Flr~JmY&Q+xh4 6؜ɧA(4hvSЭtӎ'-3eǒ#L{j28,Tk(qbXEE,>Qw)&ZWZ`1~0fʐOF%(tҾMFoH{<}| 2f:j Uʐ (½1IS‚RvB׵ƩVb9d+G NNޠmJIjlMW1WUFTӥf,\])){Ga ϒtCpk"[}twbZe~<:i`&QۦEnVxBp;jEfzPpob^ɠm u~>c68@$ۺ!]f! \1:Kѻ멽Ѽ՞!?cx=u<6j4mtCurrent User2*_LChristopher Cimino\)jͫ,?N;:}iW qċWx'N G뻔 붮)3[[ `-l|#k",2$DПa!tzBTgtId _F,oT`3dG  ?9 Z%m4ONL*=mҙC!eI#C҃ g h耒Z7DC|*qxpCS)DCz g