Video calls from lay bystanders to dispatch centers - risk assessment of information security

Stein R Bolle, Per Hasvold, Eva Henriksen, Stein R Bolle, Per Hasvold, Eva Henriksen

Abstract

Background: Video calls from mobile phones can improve communication during medical emergencies. Lay bystanders can be instructed and supervised by health professionals at Emergency Medical Communication Centers. Before implementation of video mobile calls in emergencies, issues of information security should be addressed.

Methods: Information security was assessed for risk, based on the information security standard ISO/IEC 27005:2008. A multi-professional team used structured brainstorming to find threats to the information security aspects confidentiality, quality, integrity, and availability.

Results: Twenty security threats of different risk levels were identified and analyzed. Solutions were proposed to reduce the risk level.

Conclusions: Given proper implementation, we found no risks to information security that would advocate against the use of video calls between lay bystanders and Emergency Medical Communication Centers. The identified threats should be used as input to formal requirements when planning and implementing video calls from mobile phones for these call centers.

Figures

Figure 1
Figure 1
The workflow of risk assessment according to the information security standard ISO/IEC 27005:2008.
Figure 2
Figure 2
Risk matrix presenting the identified threats with identifier and short description. Darker shades of grey indicates higher level of risk: light grey low risk, medium grey moderate risk and darkest grey severe risk. White background is used for threats with unknown risk.

References

    1. World Health Organization. Global health risks. 2009.
    1. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997;349(9061):1269–1276. doi: 10.1016/S0140-6736(96)07493-4.
    1. Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000;90(4):523–526. doi: 10.2105/AJPH.90.4.523.
    1. Tjora A. Calls for Care Coordination, compentence, and computers in medical emergency call centres. VDM Verlag Dr. Müller; 2009.
    1. Heward A, Damiani M, Hartley-Sharpe C. Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J. 2004;21:115–118. doi: 10.1136/emj.2003.006940.
    1. Forslund K, Kihlgren A, Kihlgren M. Operators' experiences of emergency calls. J Telemed Telecare. 2004;10(5):290–297. doi: 10.1258/1357633042026323.
    1. Johnsen E, Bolle SR. To see or not to see - Better dispatcher-assisted CPR with video-calls? A qualitative study based on simulated trials. Resuscitation. 2008;78(3):320–326. doi: 10.1016/j.resuscitation.2008.04.024.
    1. Morley P. Video instruction for dispatch-assisted cardiopulmonary resuscitation: two steps forward and one step back! Crit Care Med. 2009;37(2):753–754. doi: 10.1097/CCM.0b013e318194d2e1.
    1. Bolle SR, Johnsen E, Gilbert M. Video calls for dispatcher-assisted cardiopulmonary resuscitation can improve the confidence of lay rescuers-surveys after simulated cardiac arrest. J Telemed Telecare. 2011;17(2):88–92. doi: 10.1258/jtt.2010.100605.
    1. Yang CW, Wang HC, Chiang WC, Chang WT, Yen ZS, Chen SY, Ko PCI, Ma MHM, Chen SC, Chang SC, Lin FY. Impact of adding video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests-a randomized controlled study. Resuscitation. 2008;78(3):327–332. doi: 10.1016/j.resuscitation.2008.03.232.
    1. Yang CW, Wang HC, Chiang WC, Hsu CW, Chang WT, Yen ZS, Ko PCI, Ma MHM, Chen SC, Chang SC. Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests. Crit Care Med. 2009;37(2):490–495. doi: 10.1097/CCM.0b013e31819573a5.
    1. Federal Communications Commission. Chairman Genachowski Announces Steps to Bring 9-1-1 into 21st Century.
    1. International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC) ISO/IEC 27005:2008, Information Technology - Security Techniques - Information Security Risk Management. 2008. [1st edition 2008-06-15.]
    1. Bolle SR, Scholl J, Gilbert M. Can video mobile phones improve CPR quality when used for dispatcher assistance during simulated cardiac arrest? Acta Anaesthesiol Scand. 2009;53:116–120. doi: 10.1111/j.1399-6576.2008.01779.x.
    1. Norwegian Act of 14 April 2000 no. 31 relating to the processing of personal data [Personal Data Act]
    1. Norwegian Act of 18 May 2001 no 24 on personal health data filing systems and the processing of personal health data [Personal Health Data Filing System Act]
    1. European Parliament and Council of the European Union. Directive 95/46/EC on the protection of individuals with regard to the processing of personal data and on the free movement of such data. 1995.
    1. Kang S, Watt J, Ala S. Social copresence in anonymous social interactions using a mobile video telephone. Proceeding of the twenty-sixth annual SIGCHI conference on Human factors in computing systems, ACM. 2008. pp. 1535–1544.
    1. Cheung S, Deakin CD, Hsu R, Petley GW, Clewlow F. A prospective manikin-based observational study of telephone-directed cardiopulmonary resuscitation. Resuscitation. 2007;72(3):425–435. doi: 10.1016/j.resuscitation.2006.07.025.
    1. Roppolo LP, Pepe PE, Cimon N, Gay M, Patterson B, Yancey A, Clawson JJ. Council of Standards Pre-Arrival Instruction Committee NAoEDwg. Modified cardiopulmonary resuscitation (CPR) instruction protocols for emergency medical dispatchers: rationale and recommendations. Resuscitation. 2005;65(2):203–210. doi: 10.1016/j.resuscitation.2004.11.025.
    1. The Laerdal Foundation for Acute Medicine. Den norske lægeforening. 2. Stavanger; 1999. Norsk indeks for medisinsk nødhjelp.
    1. Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inform. 2001;64(2-3):143–156. doi: 10.1016/S1386-5056(01)00200-3.
    1. Parker J, Coiera E. Improving clinical communication: a view from psychology. J Am Med Inform Assoc. 2000;7(5):453–461. doi: 10.1136/jamia.2000.0070453.
    1. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–488. doi: 10.1016/S0140-6736(01)05627-6.
    1. Malterud K. The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet. 2001;358(9279):397–400. doi: 10.1016/S0140-6736(01)05548-9.
    1. Aven T. Risk analysis: assessing uncertainties beyond expected values and probabilities, chap Risk analysis methods. Wiley; 2008. pp. 57–84.
    1. Smith A, Boult M, Woods I, Johnson S. Promoting patient safety through prospective risk identification: example from peri-operative care. Qual Saf Health Care. 2010;19:69–73. doi: 10.1136/qshc.2008.028050.
    1. Tränkler U, Hagen O, Horsch A. Video quality of 3G videophones for telephone cardiopulmonary resuscitation. J Telemed Telecare. 2008;14(7):396–400. doi: 10.1258/jtt.2008.007017.
    1. Eisenberg MS, Hallstrom AP, Carter WB, Cummins RO, Bergner L, Pierce J. Emergency CPR instruction via telephone. Am J Public Health. 1985;75:47–50. doi: 10.2105/AJPH.75.1.47.

Source: PubMed

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