Luís Filipe Antunes

Abstract
The proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades has resulted in a considerable fragmentation within health information technology (IT), with a strong political interference. The problem regarding this issue became twofold: 1) there are considerable flaws regarding interoperability and security involving patient data; and 2) it is difficult even for an experienced company to enter the Brazilian health IT market. In this article, the authors aim to assess the current state of IT interoperability and security in hospitals in Brazil and evaluate the best business strategy for an IT company to enter this difficult but very promising health IT market. A face-to-face questionnaire was conducted among 11 hospital units to assess their current status regarding IT interoperability and security aspects. Global Brazilian socio-economic data was also collected, and helped to not only identify areas of investment regarding health IT security and interoperability, but also to derive a business strategy, composed out of recommendations listed in the paper. Copyright © 2020, IGI Global.

Abstract
The heart-rate dynamics are one of the most analyzed physiological interactions. Many mathematical methods were proposed to evaluate heart-rate variability. These methods have been successfully applied in research to expand knowledge concerning the cardiovascular dynamics in healthy as well as in pathological conditions. Notwithstanding, they are still far from clinical practice. In this paper, we aim to review the nonlinear methods most used to assess heart-rate dynamics. We focused on methods based on concepts of chaos, fractality, and complexity: Poincaré plot, recurrence plot analysis, fractal dimension (and the correlation dimension), detrended fluctuation analysis, Hurst exponent, Lyapunov exponent entropies (Shannon, conditional, approximate, sample entropy, and multiscale entropy), and symbolic dynamics. We present the description of the methods along with their most notable applications.

Abstract
PurposeThe aim of this paper is to evaluate the use of blockchain for identity management (IdM) in the context of the Internet of things (IoT) while focusing on privacy-preserving approaches and its applications to healthcare scenarios.Design/methodology/approachThe paper describes the most relevant IdM systems focusing on privacy preserving with or without blockchain and evaluates them against ten selected features grouped into three categories: privacy, usability and IoT. Then, it is important to analyze whether blockchain should be used in all scenarios, according to the importance of each feature for different use cases.FindingsBased on analysis of existing systems, Sovrin is the IdM system that covers more features and is based on blockchain. For each of the evaluated use cases, Sovrin and UniquID were the chosen systems.Research limitations/implicationsThis paper opens new lines of research for IdM systems in IoT, including challenges related to device identity definition, privacy preserving and new security mechanisms.Originality/valueThis paper contributes to the ongoing research in IdM systems for IoT. The adequacy of blockchain is not only analyzed considering the technology; instead the authors analyze its application to real environments considering the required features for each use case.

Abstract

Abstract
Background: Concerns about privacy and personal data protection resulted in reforms of the existing legislation in the European Union (EU). The General Data Protection Regulation (GDPR) aims to reform the existing directive on the topic of personal data protection of EU citizens with a strong emphasis on more control of the citizens over their data and in the establishment of rules for the processing of personal data. OpenEHR is a standard that embodies many principles of interoperable and secure software for electronic health records (EHRs) and has been advocated as the best approach for the development of hospital information systems. Objective: This study aimed to understand to what extent the openEHR standard can help in the compliance of EHR systems to the GDPR requirements. Methods: A list of requirements for an EHR to support GDPR compliance and also a list of the openEHR design principles were made. The requirements were categorized and compared with the principles by experts on openEHR and GDPR. Results: A total of 50 GDPR requirements and 8 openEHR design principles were identified. The openEHR principles conformed to 30% (15/50) of GDPR requirements. All the openEHR principles were aligned with GDPR requirements. Conclusions: This study showed that the openEHR principles conform well to GDPR, underlining the common wisdom that truly realizing security and privacy requires it to be built in from the start. By using an openEHR-based EHR, the institutions are closer to becoming compliant with GDPR while safeguarding the medical data.