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| TISH Team Members (l-r) Eric Johnson, Sean Smith, David Kotz, Denise Anthony, and Andrew Gettinger Photo by Joseph Mehling '69 |
Healthcare in the 21st century requires secure and effective information technology systems to meet two of its most significant challenges: improving the quality of care while also controlling the costs of care. Yet developing, deploying and using information technology that is both secure and genuinely effective in the complex clinical, organizational and economic environment of healthcare is a significant challenge in its own right. This project's multidisciplinary research will drive innovation in information-sharing technology that ensures security and privacy while addressing the pragmatic needs of patients, clinical staff, and healthcare organizations to deliver efficient, high-quality care.
This multidisciplinary team of investigators will address fundamental challenges in current and emerging areas of information security, as identified by its healthcare partners: (1) protecting the security of clinical information, while ensuring that clinicians can access information they need, when and where they need it, with technology that clinicians can actually use and healthcare enterprises can actually manage, and (2) securing the collection of sensor data through personal sensor devices to enable monitoring of patient outcomes while giving patients usable control over their privacy. To be effective, such technologies must consider the economic, organizational and sociological dynamics that are critical to creating and implementing IT that is secure as well as usable and effective. Thus, the team will consider (3) usability, and its implications for secure information sharing throughout the organizational environment of medical care, (4) privacy concerns, examining how key stakeholders (patients, clinicians, and other providers) understand and evaluate the trade-offs between information sharing, usability, security, and privacy, and (5) economic risks, identifying the economically motivated threats to security and privacy in healthcare information systems and the incentives for adopting security technology. These objectives will lead the team to tackle many research challenges. For example, what authentication (and de-authentication) mechanisms are practical in a clinical setting, a fast-paced environment with diverse staff roles and physical constraints on technology? For patients sent home with mobile devices that measure their health and monitor their activity, what abstractions and interfaces allow them to easily control their privacy? What are the risks to operating continuity and efficiency from widespread security-related IT disruptions within a healthcare organization? How do security and privacy perceptions and practices vary across stakeholder groups and organizational settings? The team will approach these challenges from the user perspective, grounding solutions on the needs of real users (patients, providers, and provider organizations)- gained in part by embedding researchers into a clinical practice. Such research requires an interdisciplinary approach. The team includes three computer scientists, two sociologists, a medical clinician, and a business expert, in collaboration with local hospitals. This team brings deep experience with the challenges of authentication in dynamic environments, the use of sensor technology for personal health applications, the sociology of trust and privacy, the organization and delivery of healthcare, and the economics of enterprise security.
This project is a partnership among the Dartmouth Institute for Security, Technology, and Society (ISTS), the Dartmouth-Hitchcock Medical Center (DHMC), the Veterans Affairs Medical Center (VAMC) in White River Junction, Vermont, The Dartmouth Institute for Health Policy and Clinical Practice (TDIHPCP), Google, and Intel.
For more information on the TISH project, please email contact.tish@dartmouth.edu.
