ELECTRONIC HEALTH RECORD (EHR) ENCRYPTION SYSTEM FOR FEDERAL MEDICAL CENTER MAKURDI, BENUE STATE
ABSTRACT
In the 21st century, every aspect of life has become digitalized, virtually everything is been done through the use of computers. In the medical sector the record system has upgraded from contemporary paper file record system to the electronic record system which most times runs on the open internet a web where cyber crime and information theft is on the increase daily. It will be of great importance to protect the privacy of patience and protect sensitive medical electronic information at different unit in the federal hospital running an online hospital management or online hospital portal. Cryptography seems to be the best way where this sensitive information can be protected by combining cryptography and the logged in credentials of the logged in user. Scrambling and making them human unreadable until the right key combination for the logged in user is been used to decrypt where the key will be managed solely by the owner of the information.
TABLE OF CONTENT
CHAPTER ONE
INTRODUCTION
Background of Study
Statement of The Problem
Objectives of The Study
Scope of The Study
Significance of The Study
Limitation of The study
CHAPTER TWO
LITERATURE REVIEW
Overview of Electronic Health Record
2.1.1                                                      Electronic Health Record System: Past, Present and Future
Types of Health Information/ Record Systems
Paper-Based
Electronic Device-Based
Web-Based
History of Medical Records
Paper Medical Records
The Users of EHR
Patients
Health Worker
Insurance
Relations and Demands on EHR
Content of the EHR
Personal Overview
Patient Part
Storage
Central Database
Chipcard
Online Storage
Decentral Storage
Patient Privacy and Security in Electronic Health Records
Privacy and Confidentiality
Privacy-Enhancing Technologies
Privacy-respecting security technologies
Controlling who can learn what
Personal Health Records
Controlling who owns what
Information Security
Security Requirements
Confidentiality
Integrity
Availability
Authenticity
Non-repudiation
Rights of Patient
An Overview of Cryptography
Cryptographic Functions
Authentication
Non-Repudiation
Confidentiality
Integrity
Cryptographic Algorithms
Symmetric Cryptography
Symmetric-Key Cryptography
Asymmetric Cryptography
Asymmetric-Key Cryptography
Hash Functions
Encryption and Cryptography
Cryptographic Security Technologies in EHR
Public Key Infrastructure
Privilege Management Infrastructure
Pseudonymization
CHAPTER THREE
SYSTEM ANALYSIS AND METHODOLOGY
Methodology
Structured System Analysis and Design Methodology (SSADM)
 Object-Oriented Analysis and Design Methodology (OOADM
Prototyping
Expert Systems Methodology
Selecting a Design Methodology
The Hospital and Its Environment
Demographic Variable
System Analysis
Analysis of the Present System
Weakness of the Present System
Exiting Cryptographic System (Smartcard Cryptographic System).
Setbacks of Exiting Cryptographic System
High Level Model for the Proposed System
CHAPTER FOUR
SYSTEM DESIGN AND IMPLEMENTATION
The Objective of the Design
Encryption Flowchart
Decryption Flowchart
Control Center
Patient’s Unit
Card/Record Unit
Consultant Unit
Pharmacy Unit
Laboratory Unit
Bursary Unit
Admin Unit
Database Specification
Bursary Unit
Card Unit
Consultancy Unit
Patient Unit
Pharmacy Unit
Staff_account Unit
Lab_Unit
Data Dictionary
Implementation and Testing
Parallel adoption
How it Works
System Specification
Server Side System Specification
Client Side System Requirements
Input/ Output Specification
Patient’s Registration Area
Staff Registration Form
Login Form
Pharmacy Unit Stock Form
Pharmacy unit Drugs Table
Bursary / Accountancy unit Pay slip Form
Patient Consultation Sheet
Patient Lab Form
Prescription Sheet Pharmacy Unit
Card Unit
Bursary Unit Staff List and Monthly Salary
Choice and Justification of Programming Language
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Summary
Conculsion
Recommendation
REFERENCE
CHAPTER ONE
1.0     INTRODUCTION
1.1            Background of The Study
Paper-based health records are rapidly becoming outdated. They are easily lost, are subject to wear and tear, are costly to handle, cannot be transferred electronically, may be difficult to interpret, and are inefficient. These fundamental drawbacks are driving a transition across the globe towards Electronic Health Records (EHRs).
Patience in the hospital are been diagnosed and treated, this diagnostics and treatment are been recorded for future purposes in the electronic health record system (EHR) of the hospital. This record should be protected at all cost from a third party.
This master’s thesis offers a practical solution using cryptography to protect these sensitive electronic records of patients and staff in Federal Medical Center (FMC) Makurdi, Benue State and gives them privacy control over who views their treatment and symptoms, and every other sensitive information in other units of the hospital.
1.2            Statement of the Problem
Most people in the society, are been discriminated or been treated wrongly, in their various environment because of the nature of their ill health which was been exposed by the third party.
In the 21st century where most patient medical records are stored electronically and most medical institutions have their electronic health record system running on a network (local or internet), these network may not be fully secured for such sensitive medical information considering the increase rate of cyber crime and information theft.
It will be imperative to use a security measure where even if the third party get hold of these sensitive health record, the content especially the treatment and symptoms will be scrambled and unreadable. Using a cryptographic method to secure this patients electronic record will be best to achieve the desired result (i.e scrambled or unreadable) and will give the patient full privacy control over his/hers medical record with  a given key and decided who views their record.
Federal Medical Center (FMC) Makurdi needs to have a system that will secure not just patients sensitive data but also other very important data about various units and their staff in the hospital.
1.3.    Objectives of the Study
The general aims of this project work are to design a system that can:
1.     Authenticate and provide access to right users.
2.      Introduce a higher level of security (the use of a cryptographic “Secret Key”) where patients and medical staff are in charge of sensitive record in their unit rather than just the normal Login and Password.
3.     Add patient’s records and equally encrypt sensitive information about them.
4.     Append the diagnosis records and secure.
5.     Capture the basic data in the following basic unit of Federal Medical Center (FMC) Makurdi: card and record unit, consultant unit, pharmacy unit, laboratory unit, bursary /accounting unit and provide an area where patient can view their file.
6.     Protect sensitive information at the various unit using user login security and triple DES encryption method there by assigning unique decryption key for each user which works when there is a right login credential and secret key combination for that particular logged in person.
7.     Encrypting sensitive data by default using the logged in user’s secret key which is only known by the logged in user.
8.     Providing a flexible means of changing login password if it is been compromised.
9.     Providing a flexible means of allowing users to change their secret key, by providing a security question and answer which was provided when they created the account and the old key if key has been compromised.
10.   Providing  a security emergency  rule called “glass breaking rule” where only the admin staff can use patient id and his own secret key to get patient secret key to enable doctors see patient record.
11.   Finally, to design a system this will help to overcome the problem of stigmatization on patients living with a particular ailment.
1.4     Scope of the Study
The main focus of the project is the implementation of data encryption and decryption on patient’s privacy in E-records. The system will be secured in cases where only the authorized person has the needed cryptographic key to decipher the message. The system does not provide any security where an unauthorized user has knowledge of the encryption key.
 It also offers a practical solution to the sharing of medical data where privacy and security are robust and where the records can be trusted as being unaltered and unchanged as they pass between providers in the following units in the hospital, these include:
1.     Card and record unit
2.     Consultant unit
3.     Pharmacy unit
4.     Laboratory unit
5.     Bursary /accounting unit
 Federal Medical Center Makurdi, Benue State, will be used as case study for this work.
1.5     Significance of the Study
This project, allows patients have right over their secret key and allows them to give an authorization secret to any of the medical personnel through different communication channels (e.g. phone or as a paper code). This token allows them to access the patient's E-record data while the patient does not need to be present at the time of access as he does not need to enter a PIN for authorization.
This approach provides more flexibility and retains the security and privacy properties of patient-controlled E-record encryption.
 1.6     Limitations of the Study
This system applies to only hospitals where patient’s records are stored electronically. The project isn’t concern about building a full hospital management system but trying to demonstrate how encryption method of security can be combined with the normal logging in to protect sensitive information. Other cryptosystem weren’t used in this research due to its research nature and time, the algorithms used became limited. Also financial constraints and time, limited further research on this study.