internet trust and security, much faster internet access and better investment in research and development. Some are particularly close to concrete issues faced by
such as ageing, health, security and climate change We refer to them as societal challenges This brochure illustrates how Information
to the European emergency services (112 emergency number) and the potentialities of the European Health insurance card, a document shared by all persons insured
participants, whose majority experienced an increased sense of security 15 DREAMING DREAMING integrated familiar devices-such as blood pressure cuffs, mobile phones and
A mobile emergency response system, a cooker safety solution, and a nurse alarm system were tested among the solutions.
The feedback enabled the suppliers to develop or redevelop their products, resulting in new user-driven innovations.
It is estimated that one in three people aged over 65 is at risk of falling †going up to
consequences, including a real risk of fatality. Technology permits the development of solutions which enable the elderly and the disabled with severe injuries to walk
principal output of the project was a prototype of an innovative alarm system for fall detection and prevention, targeting elderly users living independently at home.
operational programmes for prevention, early identification and minimisation of risk and management of falls Making technologies accessible to the ageing population
The concern for security is as old as humankind. What is â€oenew†is its extension to our digital environment.
but also carries risks. Only 12%of European web users feel completely safe making online transactions. 38%of users had concerns with the
with security issues: 18%are less likely to buy goods online and 15%are less likely
to a wide range of evolving threats (lack of privacy, loss of data, malfunctioning of the network due to a cyberattack.
Therefore, the DAE has defined a number of objectives in the field of trust and security
•security of networks †the internet has become a critical information infrastructure, encompassing IT systems and networks across the globe.
It must be resilient and secure against all sorts of threats. Strong cooperation between EU governments, public bodies and private companies is necessary
to improve information exchange and to ensure that security problems are addressed quickly and effectively.
The European Network Information and Security Agency (ENISA) serves as a focal point for this exchange
and cooperation. To react to threats in real-time conditions, the European Commission will establish a network of Computer Emergency Response
Teams (CERTS), also for European institutions •fight against cybercrime and cyberattacks †attacks against information
systems are a growing threat, and there is an increasing concern about the potential for terrorist or politically motivated attacks against information
systems which form part of the critical infrastructures of Member States and the Union. The forthcoming European Strategy on Cybersecurity will
34 set out ways to strengthen network and information security across the EU It will protect the public and private sectors from intrusion and fraud, by
strengthening cross-border cooperation and information exchange •trust in technology †74%of EU Internet users in 2012 think that the risk
of becoming a victim of cybercrime has increased in the past year. Building citizens†confidence in the digital world needs an EU-wide solution †also
because cyber attackers do not respect national borders •safety of children online †whereas the Digital Agenda for Europe aims to
have every European digital, children, who start using Internet from the age of 7, need quality content online to stimulate their imagination and help them
Commission will propose the EU€ s Strategy for Cyber security. It has also created a Task force Legislation Team (eidas) to deliver a predictable
Over the past decade we have witnessed an ever-increasing amount of cyber attacks on the Internet.
Ranging in style from large-scale worms to phishing attempts, cyber attacks have evolved to unprecedented levels of sophistication.
threat; unless addressed, this asymmetrical threat will have locked the defenders into a vicious cycle: chasing after attackers without ever being able to catch up
The Project Syssec†s objective is to be proactive instead of being reactive to cyber attacks.
predicting threats and vulnerabilities, and build the defence before threats materialise Syssec will create a Network of Excellence in the field of Systems Security for Europe
to play a leading role in changing the rules of the game Current trends in Internet applications such as Web 2. 0, cloud computing, and the
Internet of things are bound to bring more pervasive data collection, longer persistence of collected data, higher and more heterogeneous
•create a virtual centre of excellence consolidating the Systems Security research community in Europe
•promote cyber security education and to engage a think-tank in discovering the threats and vulnerabilities of the Current and Future Internet
•create an active research roadmap in the area, and •develop a joint working plan to conduct State-of-the-art collaborative research
http://www. syssec-project. eu /Funded by the Seventh Framework Programme (FP7 Duration: 2010-2014
not only today†s threats, but also those of tomorrow. DEMONS€ s objective is to realise this infrastructure by applying novel distributed systems technologies and leveraging
have prevented previously other security solutions from being deployed widely and have rendered therefore them ineffective Trust, privacy and identity in the digital economy
Moreover, there are plans to exploit DEMONS technologies after the conclusion of the project in actual operational networks
companies in the high security field but also emerging small and medium sized enterprises (SMES) that wish
depending on attributes such as availability, quality, price and security Thus, the applications that end users see may be composed of multiple services
or service supplier will actually offer the security claimed The ANIKETOS project will help to establish and maintain
and developing new technology, methods, tools and security services Tabula rasa Trusted Biometrics under Spoofing Attacks
•propose countermeasures such as combining biometric information from multiple sources •examine novel biometrics that may be inherently robust to direct attacks
mitigation of new threats and vulnerabilities. A platform will be constructed for creating and maintaining secure and trusted composite services
•provide solutions for security engineering and trust management on the Future Internet •develop an integral framework to support secure interoperation and manage
way to achieve optimal energy efficiency and higher supply security for end-users http://www. smarthouse-smartgrid. eu
Trust and Security http://cordis. europa. eu/fp7/ict/security/home en. html https://ec. europa. eu/digital-agenda/en/telecoms-internet/cybersecurity
http://www. enisa. europa. eu /@EU TRUSTSEC Smart Cities and Sustainability https://ec. europa. eu/digital-agenda/node/1100
For further information connect-h@ec. europa. eu European commission ICT for Societal Challenges ISBN: 978-92-79-27933-1
messaging, surveillance systems, and on-road access and charging systems, while others are mobile in the sense that they are in-vehicle systems or personal (portable) systems.
Video Surveillance and Response (fixed)( public private Variable Message Signs (VMS fixed)( public, private Advanced Traveler Information
Video Surveillance and Response, Informational Signing (variable messages), Advanced Traveler Information systems, Adaptive Cruise control, Intelligent Speed
Video Surveillance and Response Informational Signing and the previously discussed Signalization, belong to larger systems of
Video Surveillance and Response Several cities maintain a continuous monitoring of key network locations to determine if traffic
system,(1) high costs for users and operators compared with the perceived benefits,(2) risk of
Video Surveillance and Response (fixed)( public private Variable Message Signs (VMS)( fixed and mobile)( public, private
and should result in fewer emergency admissions ICT€ s Role in Healthcare Transformation Report of the Health ICT Industry Group Page 12
•Patient safety (reduced risk of patient harm •Quality of care (effectiveness and efficiency of care service provision
patterns, identify at-risk patients, and review the performance of individual physicians Business intelligence and in particular Data mining are useful tools in the detection of
and the hospital faced significant risk with written off debt. The claims office were constantly fielding calls from consultants
healthcare centres, six emergency centres and more than 40 associated hospitals Trying to coordinate operations among more than 140 properties,
â â Assurance that all hospital treatments, procedures medication, management plans investigations are fully available
environment, Ireland has a tremendous opportunity to exploit multiple opportunities in these international markets. Our enhanced reputation will
which patient safety and security, but also trust and privacy are of utmost im -portance. To ensure the adoption of new healthcare services, the new innovative
user friendly access control 1 Introduction The high bandwidth connectivity provided by the Internet enables new services to
Existing techniques address part of the trust and security requirements, for example tools for identity management and for encryption of connections.
Missing are tech -niques that help end-users to establish trust in a healthcare service in terms of privacy
for an integrated and easy to understand approach to trust in terms of security, priva -cy, and transparency, where users can make informed decisions
they are exposed to different security and safety threats as the patient is far from healthcare providers,
and it becomes simpler to collect, store, and search electronic health data, thereby endangering people's privacy
Standard Internet security techniques provide authentication and encryption of the communication with a service provider. However, they do not provide the user with means to control
or even know how a service provider will actually use their personal information. It is important to
service provider on the basis of facts, such as reputation and security attributes The THECS project addresses the very important trust questions (transparency, pri
-vacy and security) for healthcare services. THECS is a Dutch national project in the COMMIT program with 11 partners including representatives from industry, Dutch
4. 3 User friendly advanced access control Healthcare services deal with very personal and sensitive information. The protection
of sensitive information is enforced usually using access control. Several access con -trol models have been proposed in the literature (see 25 for a survey.
access control for the healthcare domain has been studied intensively in 26-28. The challenge in designing an access control system for healthcare is that, while posing
strict constraints on the access to sensitive information, the system has to cope with the dynamic environment of healthcare and the potential exceptions that are raised in
In this trend, content-based access control 29,30 and tag -based access control 31,32 has been proposed. For instance, content-based ap
-proaches have been used for the protection of medical images 33. Although these access control models are very expressive
and allow the specification of a wide range of authorization policies, they are usually difficult to use by end-users
privacy management and access control systems. For instance, various enterprises designed platforms which allow users to set their privacy and access control policies
One example is Google dashboard privacy tool, which through a web interface dis -plays to users what information about them is stored
of the specified policies nor ensure secure access control Therefore, a need for more flexible yet friendly privacy management exists.
-agement scheme based on data obfuscation (not necessarily using encryption) and user â€oepersonasâ€. Although these proposals increase usability and flexibility, they do
In conclusion, although several studies on access control have been carried out, no comprehensive studies on user friendly access control for healthcare exist.
The chal -lenge is to define a novel access control model which guarantees an appropriate level
of security and allows users to specify the policies regulating the exposure of their 4 http://code. w3. org/privacy-dashboard/wiki
5 https://www. privacyos. eu /6 http://www. primelife. eu information to others. In addition, the model should be easy to use by end-users.
-ally, the access control system should not only allow users to define access rules to their data but also support them in â€oevisualizing†the effect of the defined access con
The design of a user friendly access control model demands to conceptually divide the access control model in two layers:
a high level layer, in which end-users can easily specify their privacy preferences, and a low-level layer, which consists of ma
-bility of information in healthcare, and user friendly access control Acknowledgements. This work has been done in the context of the THECS project
Proceedings of the 7th International Workshop on Security Measurements and Metrics, IEEE 2011 17. Petkoviä, M.,Prandi, D.,Zannone, N.:
Proceedings of the 3rd International Workshop on Security and Trust Manage -ment. (2008) 159†167
Access control: Policies, models, and mechanisms In: Foundations of Security Analysis and Design. LNCS 2171. Springer (2000) 137†196
26. Zhang, L.,Ahn, G. J.,Chu, B. T.:A role-based delegation framework for healthcare infor
Proceedings of the 7th ACM Symposium on Access control Models and Technologies, ACM (2002) 125†134
Proceedings of the 17th IEEE Workshop on Computer security Founda -tions, IEEE (2004) 139†154 28.
Access control in healthcare information systems. Phd thesis, Norwegian Univer -sity of Science and Technology (2008 29.
Access control in the Web 2. 0 In: Proceedings of the 1st Workshop on Online Social networks.
Role templates for content-based access control. In: Proceedings of the 2nd ACM Workshop on Role-Based Access control, ACM (1997) 153†159
31. Hinrichs, T. L.,Garrison, W c.,Lee, A j.,Saunders, S.,Mitchell, J. C.:TBA: A Hybrid of
Logic and Extensional Access control Systems. In: Proceedings of the 8th International Workshop on Formal Aspects of Security and Trust.
2011 32. Levy, K.,Sargent, B.,Bai, Y.:A trust-aware tag-based privacy control for ehealth 2. 0. In
Workshop on Multimedia and Security: New Challenges, ACM (2001) 52†55 34. Kahl, C.,Bttcher, K.,Tschersich, M.,Heim, S.,Rannenberg, K.:
Security and Privacy †Silver linings in the Cloud. IFIP Advances in In -formation and Communication Technology 330.
organizational structure, their low risk and receptivity are the essential features facilitating them to be innovative (Harrison and Watson 1998.
2. 6. Privacy and security are crucial...66 References...69 6 †TABLE OF CONTENTS IMPROVING HEALTH SECTOR EFFICIENCY:
and security requirements...106 References...110 Chapter 5. Using Benchmarking to Support Continuous Improvement Introduction...
and risks associated with manual claims processing In Australia, for example, electronic claiming over the internet has been
risks of failure and poor returns. The ability to share information interoperability) is also entirely dependent on the adoption of
or sharing the financial risk, and providing much more robust evidence on the advantages of health ICT can
Enabling robust and reliable privacy and security frameworks Health information can be extremely sensitive and professional ethics in
The implementation of privacy and security requirements is proving particularly challenging in the case of EHRS
maintaining privacy and security, they also have to balance this interest against the need to ensure that information can be retrieved easily when
required for care, particularly in an emergency Restoring public trust that has been undermined significantly is much more difficult than building it from the outset.
to address privacy and security issues Conclusions The findings discussed in this report point to a number of practices or
balanced approach to privacy and security is essential to establish the high degree of public confidence and trust needed to encourage
privacy and security frameworks and accountability mechanisms that both encourage and respond to innovation •Align incentives with health system priorities:
condition or risk, and facilitate communication between providers have been cited as providing substantial benefits in health outcomes (Bates et al.
surveillance, population and outcomes research (Kukafka et al. 2007 In the United states, the Massachusetts e-Health Collaborative
risks of failure and poor returns. The ability to share information interoperability) is also entirely dependent on the adoption of
financial risk, the decision to finance and adopt ICT, including which of the available technologies to adopt and for
and the current risk-averse culture public and private payers cannot simply rely on physicians â€oewillingness to
some of the risks and potential savings with health care providers Table 2. 3. Payment schemes in primary and specialist care, 2008
2) clinical requirements (e g. reliability of patient records, and risk management 2. 5. Lack of commonly defined and consistently implemented
implementation guidance for their standards, there is no assurance that this information will be conveyed reliably across different vendor systems or
2. 6. Privacy and security are crucial How health care organisations handle their digital information environment affects the uptake of health ICTS.
applications raises a series of privacy and security issues. For treatment purposes, an individual†s health information will need to be accessed by a
confidentiality policy and security requirements for defining access to and use of personal health care information.
well-publicised serious lapses in existing systems and stories about security breaches Similar results were reported by Canada Health Infoway, based on a
and security procedures may not always be followed by those with access to their records •The survey also found a range of initiatives that could be used to
security breaches affecting the system The case studies clearly indicate that appropriate privacy protection must be incorporated into the design of new health ICT systems and policies
a strong interest in maintaining privacy and security, they also have to balance this interest against the need to ensure that information can be
retrieved easily when required for care, particularly in an emergency 68 †CHAPTER 2. WHAT PREVENTS COUNTRIES FROM IMPROVING EFFICIENCY THROUGH ICTS
Security: Critical for Health Information Technologyâ€, Center for Democracy & Technology, Washington D c Chaudhry, B. 2005), â€oehealth Information technology (HIT) Adoption â€
or sharing financial risk, can therefore be expected to speed up ICT adoption Not surprisingly, the range of financial incentives used in the various case
reimbursement or fees paid to the care provider is at risk 76 †CHAPTER 3. ALIGNING INCENTIVES WITH HEALTH SYSTEM PRIORITIES
areas including cervical screening, child health surveillance, maternity services and contraceptive services In 2004-05, GP practices were scored against 146 performance indicators, with clinical
•Privacy and security tutorials •Post-implementation review Added-up, the basket of the PITO premiums is substantial,
stages carries a risk that EHR will not be adopted. The same MGMA study found that together with lack of capital resources, concern about loss of
share of the financial risk This level of government intervention also reflects the â€oepublic goodâ€
Partnerships lower the intervention costs (and risks) for any one health care organisation and increases the likelihood of effectiveness and
and security concerns Federal government Control costs Improve quality Favourable Financial organisational State/local governments Control costs
IT SECURITY) setting the conditions for the development of interoperable EHR systems across Canada. In British columbia, interoperability is being
instruments available to governments, certification helps mitigate risks and increases the confidence of users that the purchased systems will indeed
provide required capabilities (e g. ensuring security and confidentiality including interoperability with emerging local and national health
incentives programmes and simultaneously reduce the risks facing health ICT purchasers, thus acting as a two-stroke catalyst to accelerate adoption
electronic health record products as meeting baseline criteria for functionality, security, and interoperability. In 2007, the commission expanded certification to inpatient †or hospital â€
as well as describing technical, interoperability, security privacy and other requirements. In Canada, the only case study country
•Reducing the risk of data loss in physician offices caused by human, hardware or
and security requirements Once technical challenges are overcome and a system is capable of sharing information effortlessly and is interoperable, a policy decision needs
the risk increases that stigmatising disclosures could affect areas such as employment status, access to health
Interpretation of privacy and security requirements are still often determined locally within countries and vary significantly between
The implementation of security requirements is proving particularly challenging (and cumbersome) in the context of EHRS
security/privacy issues have been the biggest challenge. Officials from every CHAPTER 4. ENABLING A SECURE EXCHANGE OF INFORMATION †107
and security concerns were an overriding factor in every aspect of the technology deployment from start to
approaches have risks and benefits The MAEHC decided to use a global opt-in approach for patient
The risk that large numbers of patients would refuse to opt in had been an issue in other countries (e g. the United
Following extensive discussion within the MAEHC€ s own privacy and security committee, with the communities,
convenience and data security. Instead of making security concerns the main feature of the patient brochures, the MAEHC placed these issues in a familiar context,
by comparing HIE security provisions to what banking institutions have in place today (Tripathi et al. 2009
110 †CHAPTER 4. ENABLING A SECURE EXCHANGE OF INFORMATION IMPROVING HEALTH SECTOR EFFICIENCY: THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES  OECD 2010
•Privacy and security measures •Adoption and use of standards for interoperability •Adoption of organisational change management initiatives
Institute of Medicine (2006), Hospital-Based Emergency Care: At the Breaking point, National Academy Press, Washington, D c
•Reduction in the risk of clinical errors through improved legibility and reduced double-entry of patient information
and security and ii) on clinical protocols Governance The GSMHN is a not for profit collaboration between GSGPN and the
Addressing privacy and security concerns A dedicated privacy and security committee worked in conjunction with communities
and consumer councils to make final determinations for privacy and security policies. A global opt-in approach was used in
which patients are asked specifically to agree to as needed electronic exchange of their clinical data between clinical sites (however, no
HIE participation were touted to encourage patient participation rather than making security a major concern Background and benefits
the risk of death and severe disability Determinants of success Government leadership and strong political commitment to widespread
Convenience, enhanced security in the dispensing process, and timesavings are the features most appreciated by users today
and security measures to allow access to certain national databases e g. National Pharmacy Register •Progress in hospital deployment has been limited due to competing
Robust privacy and security frameworks In The netherlands individuals are able to exercise, to a significant degree, control over
accessed in an emergency. They can also request the provider to conceal or mask discrete
The identifier is identical to the â€oesocial security numberâ€. This number does not provide any information and vest any right.
run the risk of a loss A migration to an ASP was recommended, therefore Use of the WDH,
and security requirements and to keep records in accordance with the ADEMD guidelines. All these tasks are considered
systems, yet achieves greater security and cost savings through decentralisation ANNEX B. PROJECT BACKGROUND AND METHODOLOGY †153
Privacy and security are crucial References Aligning Incentives with Health System Priorities Introduction A range of financial incentive programmes have emerged to accelerate ICT adoption
Addressing the challenges with the implementation of privacy and security requirements References Using Benchmarking to Support Continuous Improvement
role as visionary risk-taking and demanding reference customers. By taking these roles, these organisations can stimulate innovation through
information symmetries and risk assessment tools and systems are examples of government initiatives that can stimulate private initiatives
as visionary risk-taking and demanding reference customers and stimulate innovation through innovative demand side measures, such as public
that reduces risks and improves innovation management skills •Complement procurement processes with funding support that accelerates the scaling and
potential risk (they are vulnerable to loss of staff and knowledge and quality is based often
Without change, Australia risks being competed out in the world market, resulting in fewer jobs and lower economic growth.
•Accept international standards and risk assessments for certain product approvals Proposal 1, page 31 •Enhance the 457 and investor visa programmes (Proposal 11, page 55 and Proposal
approved under a trusted international standard or risk assessment, Australian regulators should not impose any additional requirements
All Commonwealth Government regulatory standards and risk assessment processes will be reviewed against this principle TPO00007 An action plan for a stronger Australia
and move to a more-effective risk-based approach for compliance and monitoring •The Government will improve the Significant Investor visa programme,
and take their own risks The Government is also acting to better translate Australia†s good ideas into commercial success
and risk assessments. VR Space has signed recently a three year partnership agreement with Simtars, a
efficiently manages risk and channels savings to the highest return investments •Stable, broadly based and efficient taxes that raise revenue while minimising market
•Risk-based regulation making and enforcement systems that target market failures and support relevant social, environmental or economic protections at the lowest
To achieve this, we must also promote a culture of entrepreneurialism and responsible risk taking by business.
risk taking behaviour. This is why the Government is laying the groundwork for Australian businesses to embrace structural economic changes,
and risks and to decide whether, and in which areas, to invest their capital. Government subsidies and other policies that have distorted
competitiveness and policies to ensure our economic security into the future. The study Building Australia†s Comparative Advantages, makes an important contribution to the
industry, government assistance to these industries still risks †crowding out†other productive industries, as the exchange rate and other economic variables adjust.
best placed to assess commercial prospects and risks, to foresee and take advantage of changing market conditions,
society function and manage risks. At the same time, regulations impose costs and reduce the flexibility of businesses and individuals to adapt to changing economic conditions
to standards and risk assessments of some highly regarded regulators in other advanced economies not being recognised in Australia.
example is that the Australian industrial chemical risk assessment system makes insufficient use of assessments and determinations conducted by highly-regarded overseas regulatory
Regulators will adopt a risk based approach, for example, by focusing on businesses and activities that are higher-risk,
and lowering compliance costs for lower-risk businesses. We are also continuing the roll out of Standard Business Reporting,
to provide quicker and more accurate reporting across government agencies, and reduce the cost of regulatory reporting
Accept trusted international standards and risk assessments To reduce duplicative domestic regulation, the Government will adopt the principle that if
risk assessment, then Australian regulators should not impose any additional requirements unless there is a good and demonstrable reason to do so.
The Government will review all Commonwealth Government standards and risk assessment processes in each ministerial portfolio and objectively assess whether unique Australian
standards or risk assessments are needed •As a first step, the Government will enable Australian manufacturers of medical
international risk assessments materials from trusted overseas regulators. This will be part of broader reform to introduce a graduated, risk-based approach to the
regulation of industrial chemicals that will streamline (and, in the case of low-risk chemicals, remove the need for) the pre market assessment of chemicals already
authorised for use in comparable countries Portfolio Ministers will conduct consultations as part of existing deregulation commitments
take a risk-based approach, and are consistent and accountable The Framework will apply to Commonwealth regulators that administer, monitor or
As not all employers are able to cover risks themselves, an alternative may be to allow other private employers to access cover under the Commonwealth laws as
and importers who have strong security practices and a history of compliant behaviour with access to streamlined custom procedures.
Mint, and the registry services of the Australian Securities and Investment Commission. The Government†s Asset Recycling Initiative will provide incentive payments to the States to privatise
new risk based model with improved information and education services, better recognition and greater autonomy for highly compliant providers and a more
on low-risk activities. For example, from 1 july this year, ASQA has been automatically updating the scope of courses a registered training organisation (RTO) can offer when a
risk-factors to reward low-risk applicants and re-focus compliance and monitoring activities on high-risk applicants
and information-gathering powers modelled on those available to the Australian Securities and Investments Commission. The Registered Organisations Commission will have the power to
dams to ensure water security for communities and industries. A Ministerial working group has been established to identify priorities for fast-tracking investment in water infrastructure
reduce risk. Among other things, the Centres will encourage businesses in these industries to form commercial research and development partnerships with each other, and with the
of success and well understood risk How a growth Centre could assist the food industry
is a risk that the employee will forfeit the shares, in which case taxation is deferred
The Australian Securities and Investment Commission will also be consulted, given its oversight of disclosure documents involving the offer of financial
and assuming there is no risk of forfeiting the options, if the employees accept the options then they will have to pay tax on the free options in the income year they are provided
schemes where there is a risk of the employee forfeiting the shares or options, and schemes provided
risk of forfeiture or when any restrictions on the sale or exercise of the options are lifted (vesting
options necessarily being at risk of forfeiture Further, for options, the deferred taxing point at vesting will be
Small businesses have the advantage of being adaptable and flexible, able to exploit niche markets, develop
carry and spread risks themselves, they can find it more difficult to attract and retain
risk assessments The Parliamentary Secretary to the Prime minister will continue consultations with industry and Ministers on opportunities to
) Opportunity at risk: regaining our competitive edge in minerals resources. Sydney: Minerals Council of Australia National Science Board.
•Page 43 †Australian Securities Exchange (ASX)- istock •Page 47 †Students reading-istock
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