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

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          Summary

          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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          Most cited references116

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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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              Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

              This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers.
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                Author and article information

                Journal
                Yearb Med Inform
                Yearb Med Inform
                10.1055/s-00034612
                Yearbook of Medical Informatics
                Georg Thieme Verlag KG (Stuttgart )
                0943-4747
                2364-0502
                August 2020
                21 August 2020
                : 29
                : 1
                : 32-43
                Affiliations
                [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
                Article
                galvin
                10.1055/s-0040-1701987
                7442507
                32823298
                acbdd1be-7eb0-4203-b590-d6077291838a

                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.

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                Categories
                Special Section: Ethics in Health Informatics
                Survey

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

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