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Publications (10 of 18) Show all publications
Iwaya, L. H., Li, J., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. (2019). E-Consent for Data Privacy: Consent Management for Mobile Health Technologies in Public Health Surveys and Disease Surveillance. In: Lucila Ohno-Machado, Brigitte Séroussi (Ed.), MEDINFO 2019: Health and Wellbeing e-Networks for All. Paper presented at MEDINFO 2019, the 17th World Congress on Medical and Health Informatics, Lyon, France, 25-30 August 2019 (pp. 1224-1227). IOS Press, 264
Open this publication in new window or tab >>E-Consent for Data Privacy: Consent Management for Mobile Health Technologies in Public Health Surveys and Disease Surveillance
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2019 (English)In: MEDINFO 2019: Health and Wellbeing e-Networks for All / [ed] Lucila Ohno-Machado, Brigitte Séroussi, IOS Press, 2019, Vol. 264, p. 1224-1227Conference paper, Published paper (Refereed)
Abstract [en]

Community health workers in primary care programs increasingly use Mobile Health Data Collection Systems (MDCSs) to report their activities and conduct health surveys, replacing paper-based approaches. The mHealth systems are inherently privacy invasive, thus informing individuals and obtaining their consent is important to protect their right to privacy. In this paper, we introduce an e-Consent tool tailored for MDCSs. It is developed based on the requirement analysis of consent management for data privacy and built upon the solutions of Participant-Centered Consent toolkit and Consent Receipt specification. The e-Consent solution has been evaluated in a usability study. The study results show that the design is useful for informing individuals on the nature of data processing, privacy and protection and allowing them to make informed decisions

Place, publisher, year, edition, pages
IOS Press, 2019
Series
Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365
Keywords
mobile health, privacy, public health surveillance
National Category
Computer and Information Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-70211 (URN)10.3233/SHTI190421 (DOI)978-1-64368-002-6 (ISBN)978-1-64368-003-3 (ISBN)
Conference
MEDINFO 2019, the 17th World Congress on Medical and Health Informatics, Lyon, France, 25-30 August 2019
Available from: 2018-11-21 Created: 2018-11-21 Last updated: 2019-10-28Bibliographically approved
Iwaya, L. H. (2019). Engineering Privacy for Mobile Health Data Collection Systems in the Primary Care. (Doctoral dissertation). Karlstad: Karlstads universitet
Open this publication in new window or tab >>Engineering Privacy for Mobile Health Data Collection Systems in the Primary Care
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mobile health (mHealth) systems empower Community Health Workers (CHWs) around the world, by supporting the provisioning of Community-Based Primary Health Care (CBPHC) – primary care outside the health facility into people’s homes. In particular, Mobile Health Data Collection Systems (MDCSs) are used by CHWs to collect health-related data about the families that they treat, replacing paper-based approaches for health surveys. Although MDCSs significantly improve the overall efficiency of CBPHC, existing and proposed solutions lack adequate privacy and security safeguards. In order to bridge this knowledge gap between the research areas of mHealth and privacy, the main research question of this thesis is: How to design secure and privacy-preserving systems for Mobile Health Data Collection Systems? To answer this question, the Design Method is chosen as an engineering approach to analyse and design privacy and security mechanisms for MDCSs. Among the main contributions, a comprehensive literature review of the Brazilian mHealth ecosystem is presented. This review led us to focus on MDCSs due to their impact on Brazil’s CBPHC, the Family Health Strategy programme. On the privacy engineering side, the contributions are a Privacy Impact Assessment (PIA) for the GeoHealth MDCS and three mechanisms: (a) SecourHealth, a security framework for data encryption and user authentication; (b) an Ontology-based Data Sharing System (O-DSS) that provides obfuscation and anonymisation functions; and, (c) an electronic consent (e-Consent) tool for obtaining and handling informed consent. Additionally, practical experience is shared about designing a MDCS, GeoHealth, and deploying it in a large-scale experimental study. In conclusion, the contributions of this thesis offer guidance to mHealth practitioners, encouraging them to adopt the principles of privacy by design and by default in their projects.

Abstract [en]

Mobile health (mHealth) systems empower Community Health Workers (CHWs) around the world, by supporting the provisioning of Community-Based Primary Health Care (CBPHC). In particular, Mobile Health Data Collection Systems (MDCSs) are used by CHWs to collect health-related data about the families that they treat, replacing paper-based approaches. Although MDCSs improve the efficiency of CBPHC, existing solutions lack adequate privacy and security safeguards.

To bridge this knowledge gap between the research areas of mHealth and privacy, we start by asking: How to design secure and privacy-preserving systems for Mobile Health Data Collection Systems? To answer this question, an engineering approach is chosen to analyse and design privacy and security mechanisms for MDCSs.

Among the main contributions, a comprehensive literature review of the Brazilian mHealth ecosystem is presented. On the privacy engineering side, the contributions are a Privacy Impact Assessment (PIA) for the GeoHealth MDCS and three mechanisms: SecourHealth, a security framework for data encryption and user authentication; an Ontology-based Data Sharing System (O-DSS) that provides obfuscation and anonymisation functions; and, an electronic consent (e-Consent) tool for obtaining and handling informed consent.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2019. p. 55
Series
Karlstad University Studies, ISSN 1403-8099 ; 2019:1
Keywords
Privacy, data protection, information security, mobile health, community-based primary care, privacy impact assessment, consent management, anonymisation
National Category
Computer and Information Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-70216 (URN)978-91-7063-900-5 (ISBN)978-91-7063-995-1 (ISBN)
Public defence
2019-01-31, 1A305, Lagerlöfsalen, Karlstad, 10:00 (English)
Opponent
Supervisors
Available from: 2019-01-08 Created: 2018-11-27 Last updated: 2019-09-19Bibliographically approved
Iwaya, L. H., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. (2019). Mobile Health Systems for Community-Based Primary Care: Identifying Controls and Mitigating Privacy Threats. JMIR mhealth and uhealth, 7(3), 1-16, Article ID e11642.
Open this publication in new window or tab >>Mobile Health Systems for Community-Based Primary Care: Identifying Controls and Mitigating Privacy Threats
2019 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 7, no 3, p. 1-16, article id e11642Article in journal (Refereed) Published
Abstract [en]

Background: Community-based primary care focuses on health promotion, awareness raising, and illnesses treatment and prevention in individuals, groups, and communities. Community Health Workers (CHWs) are the leading actors in such programs, helping to bridge the gap between the population and the health system. Many mobile health (mHealth) initiatives have been undertaken to empower CHWs and improve the data collection process in the primary care, replacing archaic paper-based approaches. A special category of mHealth apps, known as mHealth Data Collection Systems (MDCSs), is often used for such tasks. These systems process highly sensitive personal health data of entire communities so that a careful consideration about privacy is paramount for any successful deployment. However, the mHealth literature still lacks methodologically rigorous analyses for privacy and data protection.

Objective: In this paper, a Privacy Impact Assessment (PIA) for MDCSs is presented, providing a systematic identification and evaluation of potential privacy risks, particularly emphasizing controls and mitigation strategies to handle negative privacy impacts.

Methods: The privacy analysis follows a systematic methodology for PIAs. As a case study, we adopt the GeoHealth system, a large-scale MDCS used by CHWs in the Family Health Strategy, the Brazilian program for delivering community-based primary care. All the PIA steps were taken on the basis of discussions among the researchers (privacy and security experts). The identification of threats and controls was decided particularly on the basis of literature reviews and working group meetings among the group. Moreover, we also received feedback from specialists in primary care and software developers of other similar MDCSs in Brazil.

Results: The GeoHealth PIA is based on 8 Privacy Principles and 26 Privacy Targets derived from the European General Data Protection Regulation. Associated with that, 22 threat groups with a total of 97 subthreats and 41 recommended controls were identified. Among the main findings, we observed that privacy principles can be enhanced on existing MDCSs with controls for managing consent, transparency, intervenability, and data minimization.

Conclusions: Although there has been significant research that deals with data security issues, attention to privacy in its multiple dimensions is still lacking for MDCSs in general. New systems have the opportunity to incorporate privacy and data protection by design. Existing systems will have to address their privacy issues to comply with new and upcoming data protection regulations. However, further research is still needed to identify feasible and cost-effective solutions.

Place, publisher, year, edition, pages
JMIR Publications, 2019
Keywords
Mobile health, mHealth, information security, information privacy, data protection, privacy impact assessment, community-based primary care, family health strategy
National Category
Computer and Information Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-70212 (URN)10.2196/11642 (DOI)2-s2.0-85067895402 (Scopus ID)
Available from: 2018-11-21 Created: 2018-11-21 Last updated: 2019-07-10Bibliographically approved
Fischer-Hübner, S., Martucci, L., Fritsch, L., Pulls, T., Herold, S., Iwaya, L. H., . . . Albin, Z. (2018). A MOOC on Privacy by Design and the GDPR. In: Lynette Drevin, Marianthi Theocharidou (Ed.), Information Security Education: Towards a Cybersecure Society. Paper presented at 11th IFIP World Conference on Information Security Education (WISE 11), Held at the 24th IFIP World Computer Congress, WCC 2018, Poznan, Poland, September 18–20, 2018, Proceedings (pp. 95-107). Cham, Switzerland: Springer
Open this publication in new window or tab >>A MOOC on Privacy by Design and the GDPR
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2018 (English)In: Information Security Education: Towards a Cybersecure Society / [ed] Lynette Drevin, Marianthi Theocharidou, Cham, Switzerland: Springer, 2018, p. 95-107Conference paper, Published paper (Refereed)
Abstract [en]

In this paper we describe how we designed a massive open online course (mooc) on Privacy by Design with a focus on how to achieve compliance with the eu gdpr principles and requirements in it engineering and management. This mooc aims at educating both professionals and undergraduate students, i.e., target groups with distinct educational needs and requirements, within a single course structure. We discuss why developing and publishing such a course is a timely decision and fulfills the current needs of the professional and undergraduate education. The mooc is organized in five modules, each of them with its own learning outcomes and activities. The modules focus on different aspects of the gdpr that data protection officers have to be knowledgeable about, ranging from the legal basics, to data protection impact assessment methods, and privacy-enhancing technologies. The modules were delivered using hypertext, digital content and three video production styles: slides with voice-over, talking heads and interviews. The main contribution of this work is the roadmap on how to design a highly relevant mooc on privacy by design and the gdpr aimed at an heterogeneous audience.

Place, publisher, year, edition, pages
Cham, Switzerland: Springer, 2018
Series
IFIP Advances in Information Technology (AICT) ; 531
Keywords
privacy, teaching, mooc, course design
National Category
Engineering and Technology Humanities and the Arts
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-69413 (URN)10.1007/978-3-319-99734-6_8 (DOI)978-3-319-99734-6 (ISBN)
Conference
11th IFIP World Conference on Information Security Education (WISE 11), Held at the 24th IFIP World Computer Congress, WCC 2018, Poznan, Poland, September 18–20, 2018, Proceedings
Projects
WISR
Funder
Knowledge Foundation, NU16
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2019-07-11Bibliographically approved
Iwaya, L. H., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. (2018). mHealth: A Privacy Threat Analysis for Public Health Surveillance Systems. In: Bridget Kane (Ed.), 2018 IEEE 31st International Symposium on Computer-Based Medical Systems: . Paper presented at Proceedings of 31st IEEE Symposium on Computer-Based Medical Systems (CBMS 2018). Karlstad, Sweden: IEEE
Open this publication in new window or tab >>mHealth: A Privacy Threat Analysis for Public Health Surveillance Systems
2018 (English)In: 2018 IEEE 31st International Symposium on Computer-Based Medical Systems / [ed] Bridget Kane, Karlstad, Sweden: IEEE, 2018Conference paper, Published paper (Refereed)
Abstract [en]

Community Health Workers (CHWs) have been using Mobile Health Data Collection Systems (MDCSs) for supporting the delivery of primary healthcare and carrying out public health surveys, feeding national-level databases with families’ personal data. Such systems are used for public surveillance and to manage sensitive data (i.e., health data), so addressing the privacy issues is crucial for successfully deploying MDCSs. In this paper we present a comprehensive privacy threat analysis for MDCSs, discuss the privacy challenges and provide recommendations that are specially useful to health managers and developers. We ground our analysis on a large-scale MDCS used for primary care (GeoHealth) and a well-known Privacy Impact Assessment (PIA) methodology. The threat analysis is based on a compilation of relevant privacy threats from the literature as well as brain-storming sessions with privacy and security experts. Among the main findings, we observe that existing MDCSs do not employ adequate controls for achieving transparency and interveinability. Thus, threatening fundamental privacy principles regarded as data quality, right to access and right to object. Furthermore, it is noticeable that although there has been significant research to deal with data security issues, the attention with privacy in its multiple dimensions is prominently lacking.

Place, publisher, year, edition, pages
Karlstad, Sweden: IEEE, 2018
Series
IEEE International Symposium on Computer-Based Medical Systems, E-ISSN 2372-9198
Keywords
Privacy, Data privacy, Security, Surveillance, Data collection, Public healthcare
National Category
Computer Sciences
Research subject
Computer Science; Information Systems
Identifiers
urn:nbn:se:kau:diva-68003 (URN)10.1109/CBMS.2018.00015 (DOI)978-1-5386-6060-7 (ISBN)978-1-5386-6061-4 (ISBN)
Conference
Proceedings of 31st IEEE Symposium on Computer-Based Medical Systems (CBMS 2018)
Available from: 2018-07-11 Created: 2018-07-11 Last updated: 2019-11-10Bibliographically approved
Iwaya, L. H., Fischer-Hübner, S., Åhlfeldt, R.-M. & Martucci, L. (2018). Overview of Privacy Challenges in Mobile Health Data Collection Systems. In: : . Paper presented at Medical Informatics Europe: MIE 2018, Gothenburg, Sweden, 24-26 April, 2018..
Open this publication in new window or tab >>Overview of Privacy Challenges in Mobile Health Data Collection Systems
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Community Health Workers (CHWs) have been using Mobile HealthData Collection Systems (MDCSs) for public health surveys, feeding the national-level databases with the families’ personal data. Since such systems are inherentlyused for public surveillance and manage sensitive data (i.e., health data), deal-ing with the privacy issues is crucial to successful deployments. In this poster wepresent the privacy challenges related to MDCSs, providing a summary speciallyimportant to health managers and developers.

Keywords
mobile health, privacy, security, mHealth data collection system
National Category
Computer and Information Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-70414 (URN)
Conference
Medical Informatics Europe: MIE 2018, Gothenburg, Sweden, 24-26 April, 2018.
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2019-09-11Bibliographically approved
Voronkov, A., Iwaya, L. H., Martucci, L. & Lindskog, S. (2018). Systematic Literature Review on Usability of Firewall Configuration. ACM Computing Surveys, 50(6), Article ID 87.
Open this publication in new window or tab >>Systematic Literature Review on Usability of Firewall Configuration
2018 (English)In: ACM Computing Surveys, ISSN 0360-0300, E-ISSN 1557-7341, Vol. 50, no 6, article id 87Article in journal (Refereed) Published
Abstract [en]

Firewalls are network security components that handle incoming and outgoing network traffic based on a set of rules. The process of correctly configuring a firewall is complicated and prone to error, and it worsens as the network complexity grows. A poorly configured firewall may result in major security threats; in the case of a network firewall, an organization’s security could be endangered, and in the case of a personal firewall, an individual computer’s security is threatened. A major reason for poorly configured firewalls, as pointed out in the literature, is usability issues. Our aim is to identify existing solutions that help professional and non-professional users to create and manage firewall configuration files, and to analyze the proposals in respect of usability. A systematic literature review with a focus on the usability of firewall configuration is presented in the article. Its main goal is to explore what has already been done in this field. In the primary selection procedure, 1,202 articles were retrieved and then screened. The secondary selection led us to 35 articles carefully chosen for further investigation, of which 14 articles were selected and summarized. As main contributions, we propose a taxonomy of existing solutions as well as a synthesis and in-depth discussion about the state of the art in firewall usability. Among the main findings, we perceived that there is a lack (or even an absence) of usability evaluation or user studies to validate the proposed models. Although all articles are related to the topic of usability, none of them clearly defines it, and only a few actually employ usability design principles and/or guidelines.

Place, publisher, year, edition, pages
New York, NY, USA: Association for Computing Machinery (ACM), 2018
Keywords
usability, Firewall, systematic literature review, visualization
National Category
Computer Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-65622 (URN)10.1145/3130876 (DOI)000419881700010 ()
Projects
HITS, High Quality Networked Services in a Mobile World (4707)
Funder
Knowledge Foundation
Available from: 2018-01-18 Created: 2018-01-18 Last updated: 2019-11-09Bibliographically approved
Näslund, M., Carvalho, T. C. M., Iwaya, L. H. & Simplício, M. A. (2016). Encrypting and Storing Data. us 20160156464.
Open this publication in new window or tab >>Encrypting and Storing Data
2016 (English)Patent (Other (popular science, discussion, etc.))
Abstract [en]

Methods and apparatus for encrypting and storing data. The methods and apparatus provide different levels of security and usability. The methods and apparatus generate two or more keys based on a shared secret made available to a user equipment and a server. The two or more keys comprise at least one perfect forward secrecy key, and at least one limited forward secrecy key. The methods and apparatus encrypt data using at least one of the two or more keys. The methods and apparatus store the encrypted data in a memory of the user equipment and/or transmit the data from the user equipment to the server

National Category
Computer and Information Sciences
Identifiers
urn:nbn:se:kau:diva-43268 (URN)
Patent
US 20160156464 (2016-06-02)
Available from: 2016-06-16 Created: 2016-06-16 Last updated: 2018-01-10Bibliographically approved
Iwaya, L. H., Voronkov, A., Martucci, L. A., Lindskog, S. & Fischer-Hübner, S. (2016). Firewall Usability and Visualization: A Systematic Literature Review.
Open this publication in new window or tab >>Firewall Usability and Visualization: A Systematic Literature Review
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2016 (English)Report (Refereed)
Abstract [en]

Firewalls are network security components that allow administrators to handle incoming and outgoing traffic based on a set of rules. Such security appliances are typically the first line of defense, creating a barrier between organization’s internal network and the outside network (e.g., Internet). The process of correctly configuring a firewall is complex and error prone, and it only gets worse as the complexity of the network grows. A vulnerable firewall configuration will very likely result in major threats to the organization’s security. In this report we aim to investigate how to make administrator task of planning and implementing firewall solutions easier, from the stand points of usability and visualization. Our scientific investigation starts with the understanding of the state-of-the-art on this specific field. To do so, we conducted a Systematic Literature Review (SLR), a strict methodology to plan a literature review, to gather relevant information, to synthesize and compare approaches, and to report findings. During the initial search process thousands of papers were screened, leading us to 125 papers carefully selected for further readings. In the secondary study, ten relevant works were identified and assessed, in which authors tackled the issues of usability and visualization for Firewalls and Personal Firewalls. Among the main findings, we perceive that there is a lack (or even absence) of user studies to validate the proposed models. This leads us to a series of unwarranted solutions, that need to be prototyped and tested with real users. We also see an huge opportunity for integrative approaches, that could combine firewall research areas, such as automatic anomaly detection, advisory systems, and varying visualization schemes.

Publisher
p. 63
Series
Karlstad University Studies, ISSN 1403-8099 ; 37
Keywords
firewall, usability, visualization, systematic literature review
National Category
Computer Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-44688 (URN)978-91-7063-718-6 (ISBN)
Projects
High Quality Networked Services in a Mobile World (HITS)
Funder
Knowledge Foundation, 4707
Available from: 2016-08-26 Created: 2016-08-12 Last updated: 2018-06-04Bibliographically approved
Sá, J., Rebelo, M., Brentani, A., Grisi, S., Iwaya, L. H., Simplício, M., . . . Gutierrez, M. (2016). Georeferenced and Secure Mobile Health System for Large Scale Data Collection in Primary Care. International Journal of Medical Informatics, 94, 91-99
Open this publication in new window or tab >>Georeferenced and Secure Mobile Health System for Large Scale Data Collection in Primary Care
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2016 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 94, p. 91-99Article in journal (Refereed) Published
Abstract [en]

Introduction - Mobile health consists in applying mobile devices and communication capabilities for expanding the coverage and improving the effectiveness of health care programs. The technology is particularly promising for developing countries, in which health authorities can take advantage of the flourishing mobile market to provide adequate health care to underprivileged communities, especially primary care. In Brazil, the Primary Care Information System (SIAB) receives primary health care data from all regions of the country, creating a rich database for health-related action planning. Family Health Teams (FHTs) collect this data in periodic visits to families enrolled in governmental programs, following an acquisition procedure that involves filling in paper forms. This procedure compromises the quality of the data provided to health care authorities and slows down the decision-making process.

Objectives - To develop a mobile system (GeoHealth) that should address and overcome the aforementioned problems and deploy the proposed solution in a wide underprivileged metropolitan area of a major city in Brazil.

Methods - The proposed solution comprises three main components: (a) an Application Server, with a database containing family health conditions; and two clients, (b) a Web Browser running visualization tools for management tasks, and (c) a data-gathering device (smartphone) to register and to georeference the family health data. A data security framework was designed to ensure the security of data, which was stored locally and transmitted over public networks.

Results - The system was successfully deployed at six primary care units in the city of Sao Paulo, where a total of 28,324 families/96,061 inhabitants are regularly followed up by government health policies. The health conditions observed from the population covered were: diabetes in 3.40%, hypertension (age > 40) in 23.87% and tuberculosis in 0.06%. This estimated prevalence has enabled FHTs to set clinical appointments proactively, with the aim of confirming or detecting cases of non-communicable diseases more efficiently, based on real-time information.

Conclusion - The proposed system has the potential to improve the efficiency of primary care data collection and analysis. In terms of direct costs, it can be considered a low-cost solution, with an estimated additional monthly cost of U$ 0.040 per inhabitant of the region covered, or approximately U$ 0.106 per person, considering only those currently enrolled in the system.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Data collection, mobile health, data quality, georeference, primary care, security
National Category
Computer and Information Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:kau:diva-44392 (URN)10.1016/j.ijmedinf.2016.06.013 (DOI)000382511500011 ()
Available from: 2016-07-05 Created: 2016-07-05 Last updated: 2018-11-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9005-0543

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