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      Developments in Privacy and Data Ownership in Mobile Health Technologies, 2016-2019


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          Objectives : To survey international regulatory frameworks that serve to protect privacy of personal data as a human right as well as to review the literature regarding privacy protections and data ownership in mobile health (mHealth) technologies between January 1, 2016 and June 1, 2019 in order to identify common themes.

          Methods : We performed a review of relevant literature available in English published between January 1, 2016 and June 1, 2019 from databases including PubMed, Google Scholar, and Web of Science, as well as relevant legislative background material. Articles out of scope (as detailed below) were eliminated. We categorized the remaining pool of articles and discrete themes were identified, specifically: concerns around data transmission and storage, including data ownership and the ability to re-identify previously de-identified data; issues with user consent (including the availability of appropriate privacy policies) and access control; and the changing culture and variable global attitudes toward privacy of health data.

          Results : Recent literature demonstrates that the security of mHealth data storage and transmission remains of wide concern, and aggregated data that were previously considered “de-identified” have now been demonstrated to be re-identifiable. Consumer-informed consent may be lacking with regard to mHealth applications due to the absence of a privacy policy and/or to text that is too complex and lengthy for most users to comprehend. The literature surveyed emphasizes improved access control strategies. This survey also illustrates a wide variety of global user perceptions regarding health data privacy.

          Conclusion : The international regulatory framework that serves to protect privacy of personal data as a human right is diverse. Given the challenges legislators face to keep up with rapidly advancing technology, we introduce the concept of a “healthcare fiduciary” to serve the best interest of data subjects in the current environment.

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          Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements

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            Personal Sensing: Understanding Mental Health Using Ubiquitous Sensors and Machine Learning.

            Sensors in everyday devices, such as our phones, wearables, and computers, leave a stream of digital traces. Personal sensing refers to collecting and analyzing data from sensors embedded in the context of daily life with the aim of identifying human behaviors, thoughts, feelings, and traits. This article provides a critical review of personal sensing research related to mental health, focused principally on smartphones, but also including studies of wearables, social media, and computers. We provide a layered, hierarchical model for translating raw sensor data into markers of behaviors and states related to mental health. Also discussed are research methods as well as challenges, including privacy and problems of dimensionality. Although personal sensing is still in its infancy, it holds great promise as a method for conducting mental health research and as a clinical tool for monitoring at-risk populations and providing the foundation for the next generation of mobile health (or mHealth) interventions.
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              Assessment of the Data Sharing and Privacy Practices of Smartphone Apps for Depression and Smoking Cessation

              Key Points Question Do the privacy policies of popular smartphone applications (apps) for depression and smoking cessation describe accurately whether data will be processed by commercial third parties? Findings In this cross-sectional study of 36 top-ranked apps for depression and smoking cessation available in public app stores, 29 transmitted data to services provided by Facebook or Google, but only 12 accurately disclosed this in a privacy policy. Meaning Health care professionals prescribing apps should not rely on disclosures about data sharing in health app privacy policies but should reasonably assume that data will be shared with commercial entities whose own privacy practices have been questioned and, if possible, should consider only apps with data transmission behaviors that have been subject to direct scrutiny.

                Author and article information

                Yearb Med Inform
                Yearb Med Inform
                Yearbook of Medical Informatics
                Georg Thieme Verlag KG (Stuttgart )
                August 2020
                21 August 2020
                : 29
                : 1
                : 32-43
                [1 ]Cambridge Health Alliance, Cambridge, MA, USA
                [2 ]Tufts University School of Medicine, Boston, MA, USA
                [3 ]Chief Legal Officer Health and Wellness, Royal Palm Companies, Miami, Florida
                Author notes
                Correspondence to Hannah K. Galvin, MD, FAAP, ABPM-CI Tufts University School of Medicine 145 Harrison Ave, Boston, MA 02111USA hgalvinmd@ 123456gmail.com

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                Special Section: Ethics in Health Informatics

                privacy,confidentiality,telemedicine,health insurance portability and accountability act,international law


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