Protection of Patient Data in Digital Oral: Comparison
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Please note this is a comparison between Version 2 by Jason Zhu and Version 1 by Gaetano La Mantia.

The use of digital health technologies, including telemedicine and teledentistry, has become a necessity in healthcare due to the SARS-CoV-19 pandemic. These technologies allow for the reduction of the workload of healthcare providers and the improvement of patient outcomes in cases of remote monitoring, diagnosis, and communication. While there are no doubtful benefits, there are some counterparts, such as concerns about clinical risks, data security, and privacy protection. 

  • social app
  • WhatsApp
  • GDPR
  • HIPAA
  • sensitive data
  • mobile health
  • Covid
  • Dentistry
  • secure messaging app

1. Introduction

A rapid transition to digital health technologies is becoming effective in all medical fields [1], and e-health is considered a solution to safely provide care to patients and ensure continuous health care even at a distance [2]. The SARS-CoV-19 pandemic of recent years has accelerated all aspects of health care, including oral health care [3]. In particular, conventional dentistry was reduced and, in some cases, interrupted to minimize the risk of exposure to the SARS-CoV-19 virus for both practitioners and patients by avoiding in-person visits. Health and dental care organizations had to propose and plan alternative protocols [1][4][5][6].
Telemedicine and teledentistry are used to support clinicians and patients by providing remote monitoring services, remote diagnosis, counseling, home care, and education with self-care management [7][8][9]; at the same time, they are useful in reducing the workload of health care providers, simplifying interprofessional communication, providing an easy way to share patient information, and giving remote instructions [10][11][12].
Telemedicine has revolutionized healthcare by providing patients with convenient and accessible medical services. With the help of wireless patient monitoring devices, smartphones, personal digital assistants, and tablets, patients can now connect with specialists in real-time [13]. This eliminates the need for physical visits to the hospital, reducing lost time and allowing for quicker diagnoses. The feedback system in telemedicine also allows for continuous monitoring of the patient’s health status, enabling healthcare providers to track any changes and respond promptly. This proactive approach to health management aims to improve outcomes and reduce health risks.
Moreover, telemedicine promotes informed decision-making by giving patients access to their health data and enabling them to actively participate in their own care. This can result in increased patient engagement and improved health outcomes as patients are empowered to make informed choices about their health and take action to maintain good health [9][14][15].
Social media platforms, including WhatsApp, have become an integral part of modern life, with almost half of the world’s population using them [16]. As a result, healthcare professionals have adopted these platforms in their daily work to communicate and share information with their peers and patients [17][18][19][20][21][22]. While there is some evidence to suggest that using social media in healthcare can have many benefits, such as improved communication and data transfer, there are also concerns about the risks associated with its use [21][23][24][25].
One of the main risks is the potential for breaches of patient privacy and confidentiality. Social media platforms are public forums, and patient information shared on these platforms can be easily accessed by individuals who are not authorized to view it. In addition, patients may inadvertently disclose sensitive health information on social media, compromising their privacy and putting them at risk for discrimination or other negative consequences [26].

2. Data Security Policies

Data security is a critical issue in the healthcare industry. The need for comprehensive policies and regulations is well documented in the literature. A review of 24 articles revealed that 19 [15][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] of them focused on the topic of data security policies, with a specific emphasis on the challenges faced in protecting patient data. The articles pointed out that the lack of comprehensive regulation was a major concern and that the need for an app control system was crucial in preventing the sharing of patient data with unauthorized third parties. The majority of the articles also emphasized the need for more research in this area, particularly to address the growing concerns around data privacy and security. They suggested that awareness and initiatives by healthcare professionals, healthcare users, and decision-makers were essential in promoting better data security practices. This is especially true in European and American nations that follow GDPR and HIPAA regulations, respectively. Overall, the findings of these articles highlight the importance of ensuring that patient data is protected and that appropriate policies and regulations are in place to prevent unauthorized access to and sharing of sensitive information. The need for further research, awareness, and initiatives by various stakeholders in the healthcare industry cannot be overemphasized, as data security is critical to protecting the privacy and well-being of patients.

3. Privacy Policies

Health-related app policies have been widely discussed in the academic literature, with 15 [15][27][28][29][30][37][38][39][40][41][42][43][45][46][47] out of 24 articles specifically covering this topic. The studies analyzed the policies in several countries, such as India, Spain, Australia, Zurich, Canada, Brazil, Sweden, Germany, and Italy, and identified challenges related to safety and privacy. These challenges highlight the need for more robust regulations in the areas of operationalization, implementation, and international transferability of approvals. The lack of proper regulations has been identified as a significant barrier to the widespread adoption and safe utilization of telemedicine platforms, despite their potential benefits, such as improving access to health services and reducing healthcare costs. The studies suggest that more work is needed in the area of health-related app policies to ensure that telemedicine platforms can be effectively and safely used by people around the world. The regulation of telemedicine is a complex issue that requires cross-national collaboration and commitment to ensuring that these technologies are used to improve health outcomes.

4. Professional Legacy Liabilities

The study of 24 articles on online medical consultations revealed that 10 articles [15][30][36][37][39][40][41][48][49][50] addressed the issue of liability and legacy concerns. These articles highlighted the risks associated with informed consent, data privacy, medical negligence, and ethical issues in the context of virtual consultations. The articles discussed the potential risks and challenges associated with providing medical services through online consultations. One of the major issues identified was the need for clear and consistent standards regarding professional liability for medical practitioners who offer online consultations. This is important as the liability issues that arise from online consultations may be different from those associated with traditional face-to-face consultations. Informed consent was also a weakness in online consultations, as patients may not fully understand the risks and limitations of online medical services. The security of health data was also a concern, as the transmission of sensitive information over the internet could result in data breaches or unauthorized accesses. Medical negligence was another issue raised in the articles selected. The risk of medical malpractice in online consultations is significant, as medical practitioners may not be able to accurately diagnose or treat patients without physically examining them. There is also a potential for ethical issues to arise in online consultations, such as the confidentiality of medical information and the autonomy of patients. Therefore, the articles emphasized the importance of harmonizing the different laws and regulations across different jurisdictions in order to establish a uniform standard for professional liability in online consultations. This will ensure that medical practitioners are held accountable for their actions and that patients are protected from potential harm.

References

  1. Ali, S.A.; El Ansari, W. Is Tele-Diagnosis of Dental Conditions Reliable during COVID-19 Pandemic? Agreement between Tentative Diagnosis via Synchronous Audioconferencing and Definitive Clinical Diagnosis. J. Dent. 2022, 122, 104144.
  2. Gurgel-Juarez, N.; Torres-Pereira, C.; Haddad, A.E.; Sheehy, L.; Finestone, H.; Mallet, K.; Wiseman, M.; Hour, K.; Flowers, H.L. Accuracy and Effectiveness of Teledentistry: A Systematic Review of Systematic Reviews. Evid. Based Dent. 2022, 23, 1–8.
  3. Ghai, S. Teledentistry during COVID-19 Pandemic. Diabetes Metab. Syndr. 2020, 14, 933–935.
  4. Turkistani, K.A. Precautions and Recommendations for Orthodontic Settings during the COVID-19 Outbreak: A Review. Am. J. Orthod. Dentofac. Orthop. 2020, 158, 175–181.
  5. Nejatidanesh, F.; Khosravi, Z.; Goroohi, H.; Badrian, H.; Savabi, O. Risk of Contamination of Different Areas of Dentist’s Face during Dental Practices. Int. J. Prev. Med. 2013, 4, 611.
  6. Peng, X.; Xu, X.; Li, Y.; Cheng, L.; Zhou, X.; Ren, B. Transmission Routes of 2019-NCoV and Controls in Dental Practice. Int. J. Oral Sci. 2020, 12, 611–615.
  7. Almubarak, H. The Potential Role of Telemedicine in Early Detection of Oral Cancer: A Literature Review. J. Pharm. Bioallied Sci. 2022, 14, 19.
  8. Jampani, N.D.; Nutalapati, R.; Dontula, B.S.K.; Boyapati, R. Applications of Teledentistry: A Literature Review and Update. J. Int. Soc. Prev. Community Dent. 2011, 1, 37–44.
  9. Catan, G.; Espanha, R.; Mendes, R.V.; Toren, O.; Chinitz, D. Health Information Technology Implementation-Impacts and Policy Considerations: A Comparison between Israel and Portugal. Isr. J. Health Policy Res. 2015, 4, 41.
  10. Moen, A.; Hackl, W.O.; Hofdijk, J.; Van Gemert-Pijnen, L.; Ammenwerth, E.; Nykänen, P.; Hoerbst, A. EHealth in Europe-Status and Challenges. Yearb. Med. Inform. 2013, 8, 59–63.
  11. Callens, S. The EU Legal Framework on E-Health. Health Systems Governance in Europe: The Role of European Union Law and Policy; Cambridge University Press: Cambridge, UK, 2010; pp. 561–588.
  12. Lewis, J.; Ray, P.; Liaw, S.T. Recent Worldwide Developments in EHealth and MHealth to More Effectively Manage Cancer and Other Chronic Diseases–A Systematic Review. Yearb. Med. Inform. 2016, 25, 93–108.
  13. Haleem, A.; Javaid, M.; Singh, R.P.; Suman, R. Telemedicine for Healthcare: Capabilities, Features, Barriers, and Applications. Sens. Int. 2021, 2, 100117.
  14. Terry, M. Telemedicine and E-Health. 2010. Available online: https://home.liebertpub.com/tmj (accessed on 13 March 2023).
  15. Maaß, L.; Freye, M.; Pan, C.C.; Dassow, H.H.; Niess, J.; Jahnel, T. The Definitions of Health Apps and Medical Apps from the Perspective of Public Health and Law: Qualitative Analysis of an Interdisciplinary Literature Overview. JMIR Mhealth Uhealth 2022, 10, e37980.
  16. Digital in 2019: Global Internet Use Accelerates-We Are Social UK. Available online: https://wearesocial.com/uk/blog/2019/01/digital-in-2019-global-internet-use-accelerates/ (accessed on 7 March 2023).
  17. Thomas, K. Wanted: A WhatsApp Alternative for Clinicians. BMJ 2018, 360, k622.
  18. Giansanti, D. WhatsApp in MHealth: An Overview on the Potentialities and the Opportunities in Medical Imaging. Mhealth 2020, 6, 19.
  19. Koparal, M.; Ünsal, H.Y.; Alan, H.; Üçkardeş, F.; Gülsün, B. WhatsApp Messaging Improves Communication in an Oral and Maxillofacial Surgery Team. Int. J. Med. Inform. 2019, 132, 103987.
  20. Mohamed, I.N.; Elseed, M.A. Utility of WhatsApp in Healthcare Provision and Sharing of Medical Information with Caregivers of Children with Neurodisabilties: Experience from Sudan. Sudan. J. Paediatr. 2021, 21, 48.
  21. Salam, M.A.U.; Oyekwe, G.C.; Ghani, S.A.; Choudhury, R.I. How Can WhatsApp® Facilitate the Future of Medical Education and Clinical Practice? BMC Med. Educ. 2021, 21, 54.
  22. Mars, M.; Escott, R. WhatsApp in Clinical Practice: A Literature Review. Stud. Health Technol. Inform. 2016, 231, 82–90.
  23. Masoni, M.; Guelfi, M.R. WhatsApp and Other Messaging Apps in Medicine: Opportunities and Risks. Intern. Emerg. Med. 2020, 15, 171–173.
  24. Mars, M.; Morris, C.; Scott, R.E. WhatsApp Guidelines-What Guidelines? A Literature Review. J. Telemed. Telecare 2019, 25, 524–529.
  25. Mahmoud, K.; Jaramillo, C.; Barteit, S. Telemedicine in Low- and Middle-Income Countries During the COVID-19 Pandemic: A Scoping Review. Front. Public Health 2022, 10, 1854.
  26. Lee Ventola, C. Social Media and Health Care Professionals: Benefits, Risks, and Best Practices. Pharm. Ther. 2014, 39, 491.
  27. Agarwal, N.; Jain, P.; Pathak, R.; Gupta, R. Telemedicine in India: A Tool for Transforming Health Care in the Era of COVID-19 Pandemic. J. Educ. Heal. Promot. 2020, 9, 190.
  28. Benjumea, J.; Ropero, J.; Rivera-Romero, O.; Dorronzoro-Zubiete, E.; Carrasco, A. Privacy Assessment in Mobile Health Apps: Scoping Review. JMIR Mhealth Uhealth 2020, 8, e18868.
  29. Caetano, R.; Silva, A.B.; Guedes, A.C.C.M.; de Paiva, C.C.N.; da Rocha Ribeiro, G.; Santos, D.L.; da Silva, R.M. Challenges and Opportunities for Telehealth during the COVID-19 Pandemic: Ideas on Spaces and Initiatives in the Brazilian Context. Cad. Saude Publica 2020, 36, e00088920.
  30. Ghosh, A.; Gupta, R.; Misra, A. Telemedicine for Diabetes Care in India during COVID-19 Pandemic and National Lockdown Period: Guidelines for Physicians. Diabetes Metab. Syndr. 2020, 14, 273–276.
  31. Kaplan, B. Revisiting health information technology ethical, legal, and social issues and evaluation: Telehealth/telemedicine and COVID-19. Int. J. Med. Inform. 2020, 143, 104239.
  32. Mahtta, D.; Daher, M.; Lee, M.T.; Sayani, S.; Shishehbor, M.; Virani, S.S. Promise and Perils of Telehealth in the Current Era. Curr. Cardiol. Rep. 2021, 23, 115.
  33. Kichloo, A.; Albosta, M.; Dettloff, K.; Wani, F.; El-Amir, Z.; Singh, J.; Aljadah, M.; Chakinala, R.C.; Kanugula, A.K.; Solanki, S.; et al. Telemedicine, the Current COVID-19 Pandemic and the Future: A Narrative Review and Perspectives Moving Forward in the USA. Fam. Med. Community Health 2020, 8, e000530.
  34. Moura, P.; Fazendeiro, P.; Inácio, P.R.M.; Vieira-Marques, P.; Ferreira, A. Assessing Access Control Risk for MHealth: A Delphi Study to Categorize Security of Health Data and Provide Risk Assessment for Mobile Apps. J. Healthc. Eng. 2020, 2020, 5601068.
  35. Gowda, V.; Cheng, G.; Harvey, H.B. Safeguarding Data Security in the Era of Imaging MHealth. AJR Am. J. Roentgenol. 2021, 218, 820–821.
  36. Hoaglin, M.C.; Brenner, L.H.; Teo, W.; Bal, B.S. Medicolegal Sidebar: Telemedicine-New Opportunities and New Risks. Clin. Orthop. Relat. Res. 2021, 479, 1671–1673.
  37. Pool, J.; Akhlaghpour, S.; Fatehi, F. Health Data Privacy in the COVID-19 Pandemic Context: Discourses on HIPAA. Stud. Health Technol. Inform. 2021, 279, 70–77.
  38. Alfawzan, N.; Christen, M.; Spitale, G.; Biller-Andorno, N. Privacy, Data Sharing, and Data Security Policies of Women’s MHealth Apps: Scoping Review and Content Analysis. JMIR Mhealth Uhealth 2022, 10, e33735.
  39. Essén, A.; Stern, A.D.; Haase, C.B.; Car, J.; Greaves, F.; Paparova, D.; Vandeput, S.; Wehrens, R.; Bates, D.W. Health App Policy: International Comparison of Nine Countries’ Approaches. NPJ Digit. Med. 2022, 5, 31.
  40. Grundy, Q. A Review of the Quality and Impact of Mobile Health Apps. Annu. Rev. Public Health 2022, 43, 117–134.
  41. Mazzuca, D.; Borselli, M.; Gratteri, S.; Zampogna, G.; Feola, A.; Della Corte, M.; Guarna, F.; Scorcia, V.; Giannaccare, G. Applications and Current Medico-Legal Challenges of Telemedicine in Ophthalmology. J. Environ. Res. Public Health 2022, 19, 5614.
  42. Sujarwoto, S.; Augia, T.; Dahlan, H.; Sahputri, R.A.M.; Holipah, H.; Maharani, A. COVID-19 Mobile Health Apps: An Overview of Mobile Applications in Indonesia. Front. Public Health 2022, 10, 879695.
  43. Venkatesh, U.; Aravind, G.P.; Velmurugan, A.A. Telemedicine Practice Guidelines in India: Global Implications in the Wake of the COVID-19 Pandemic. World Med. Health Policy 2022, 14, 589–599.
  44. Tangari, G.; Ikram, M.; Sentana, I.W.B.; Ijaz, K.; Kaafar, M.A.; Berkovsky, S. Analyzing Security Issues of Android Mobile Health and Medical Applications. J. Am. Med. Inform. Assoc. 2021, 28, 2074.
  45. Tangari, G.; Ikram, M.; Ijaz, K.; Kaafar, M.A.; Berkovsky, S. Mobile Health and Privacy: Cross Sectional Study. BMJ 2021, 373, n1248.
  46. Eisenstein, E.; Kopacek, C.; Cavalcante, S.S.; Neves, A.C.; Fraga, G.P.; Messina, L.A. Telemedicine: A Bridge Over Knowledge Gaps in Healthcare. Curr. Pediatr. Rep. 2020, 8, 93–98.
  47. Perez-Noboa, B.; Soledispa-Carrasco, A.; Sanchez Padilla, V.; Velasquez, W. Teleconsultation Apps in the COVID-19 Pandemic: The Case of Guayaquil City, Ecuador. IEEE Eng. Manag. Rev. 2021, 49, 27–37.
  48. Wang, C.J.; Liu, T.T.; Car, J.; Zuckerman, B. Design, Adoption, Implementation, Scalability, and Sustainability of Telehealth Programs. Pediatr. Clin. N. Am. 2020, 67, 675–682.
  49. Lee, D.W.H.; Tong, K.W.; Lai, P.B.S. Telehealth Practice in Surgery: Ethical and Medico-legal Considerations. Surg. Pract. 2021, 25, 42.
  50. Ferorelli, D.; Moretti, L.; Benevento, M.; Mastrapasqua, M.; Telegrafo, M.; Solarino, B.; Dell’Erba, A.; Bizzoca, D.; Moretti, B. Digital Health Care, Telemedicine, and Medicolegal Issues in Orthopedics: A Review. Int. J. Environ. Res. Public Health 2022, 19, 15653.
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