<s>
In	O
Electronic	B-Application
Health	I-Application
Records	I-Application
(	O
EHR	B-Application
’s	O
)	O
data	B-General_Concept
masking	I-General_Concept
,	O
or	O
controlled	O
access	O
,	O
is	O
the	O
process	O
of	O
concealing	O
patient	O
health	O
data	O
from	O
certain	O
healthcare	O
providers	O
.	O
</s>
<s>
Patients	B-Application
have	O
the	O
right	O
to	O
request	O
the	O
masking	B-Application
of	O
their	O
personal	O
information	O
,	O
making	O
it	O
inaccessible	O
to	O
any	O
physician	O
,	O
or	O
a	O
particular	O
physician	O
,	O
unless	O
a	O
specific	O
reason	O
is	O
provided	O
.	O
</s>
<s>
Data	B-General_Concept
masking	I-General_Concept
is	O
also	O
performed	O
by	O
healthcare	O
agencies	O
to	O
restrict	O
the	O
amount	O
of	O
information	O
that	O
can	O
be	O
accessed	O
by	O
external	O
bodies	O
such	O
as	O
researchers	O
,	O
health	O
insurance	O
agencies	O
and	O
unauthorised	O
individuals	O
.	O
</s>
<s>
It	O
is	O
a	O
method	O
used	O
to	O
protect	O
patients’	O
sensitive	O
information	O
so	O
that	O
privacy	O
and	O
confidentiality	O
are	O
less	O
of	O
a	O
concern	O
.	O
</s>
<s>
Techniques	O
used	O
to	O
alter	O
information	O
within	O
a	O
patient	O
’s	O
EHR	B-Application
include	O
data	O
encryption	O
,	O
obfuscation	O
,	O
hashing	B-Algorithm
,	O
exclusion	O
and	O
perturbation	O
.	O
</s>
<s>
The	O
increased	O
access	O
that	O
transpires	O
from	O
introducing	O
EHR	B-Application
's	O
is	O
seen	O
as	O
a	O
large	O
concern	O
to	O
some	O
patients	B-Application
.	O
</s>
<s>
Masking	B-Application
information	O
is	O
a	O
technique	O
that	O
contributes	O
to	O
establishing	O
the	O
confidentiality	O
of	O
EHR	B-Application
's	O
,	O
as	O
a	O
large	O
amount	O
of	O
sensitive	O
information	O
is	O
contained	O
within	O
these	O
records	O
.	O
</s>
<s>
History	O
of	O
health	O
outcomes	O
such	O
as	O
drug/alcohol	O
abuse	O
,	O
sexually	O
transmitted	O
infections	O
or	O
abortion	O
during	O
pregnancy	O
are	O
known	O
to	O
lead	O
to	O
social	O
discrimination	O
and	O
cause	O
social	O
harm	O
to	O
the	O
patient	O
,	O
hence	O
the	O
importance	O
of	O
protecting	O
the	O
content	O
within	O
EHR	B-Application
's	O
.	O
</s>
<s>
Masking	B-Application
limits	O
the	O
access	O
that	O
internal	O
and	O
external	O
individuals	O
can	O
have	O
to	O
a	O
particular	O
record	O
,	O
increasing	O
the	O
protection	O
of	O
its	O
contents	O
.	O
</s>
<s>
When	O
patients	B-Application
apply	O
for	O
masking	B-Application
of	O
their	O
EHR	B-Application
,	O
health	O
services	O
must	O
meet	O
their	O
needs	O
and	O
alter	O
the	O
system	O
accordingly	O
so	O
that	O
unauthorised	O
individuals	O
ca	O
n't	O
gain	O
access	O
.	O
</s>
<s>
To	O
increase	O
security	O
of	O
their	O
EHR	B-Application
's	O
,	O
patients	B-Application
can	O
elect	O
to	O
mask	O
their	O
information	O
by	O
signing	O
a	O
form	O
provided	O
by	O
the	O
health	O
service	O
.	O
</s>
<s>
It	O
is	O
necessary	O
that	O
health	O
services	O
with	O
EHR	B-Application
software	O
notify	O
and	O
educate	O
their	O
patients	B-Application
of	O
data	B-General_Concept
masking	I-General_Concept
capabilities	O
and	O
the	O
advantages	O
and	O
disadvantages	O
of	O
the	O
process	O
.	O
</s>
<s>
In	O
submitting	O
a	O
request	O
,	O
patients	B-Application
are	O
given	O
the	O
control	O
to	O
specify	O
the	O
physicians	O
and	O
health	O
service	O
staff	O
members	O
that	O
are	O
provided	O
with	O
consent	O
and	O
the	O
right	O
to	O
access	O
their	O
record	O
.	O
</s>
<s>
Health	O
services	O
must	O
abide	O
by	O
patient	O
masking	B-Application
requests	O
under	O
the	O
Health	O
Records	O
Act	O
and	O
implement	O
data	B-General_Concept
masking	I-General_Concept
techniques	O
within	O
the	O
EHR	B-Application
technology	O
,	O
otherwise	O
major	O
consequences	O
can	O
result	O
.	O
</s>
<s>
In	O
addition	O
,	O
audit	O
trails	O
can	O
be	O
implemented	O
by	O
health	O
services	O
to	O
track	O
and	O
identify	O
which	O
individuals	O
have	O
accessed	O
a	O
patients	B-Application
EHR	B-Application
over	O
a	O
certain	O
time	O
period	O
.	O
</s>
<s>
In	O
patient	O
care	O
,	O
authorised	O
users	O
have	O
the	O
ability	O
to	O
override	O
masking	B-Application
and	O
access	O
restrictions	O
under	O
emergency	O
circumstances	O
.	O
</s>
<s>
If	O
a	O
patient	O
is	O
in	O
a	O
critical	O
health	O
state	O
and	O
treatment	O
is	O
urgently	O
required	O
,	O
physicians	O
are	O
provided	O
with	O
the	O
right	O
to	O
access	O
all	O
required	O
information	O
within	O
the	O
EHR	B-Application
.	O
</s>
<s>
Any	O
unmasking	O
of	O
a	O
patient	O
's	O
EHR	B-Application
is	O
audited	O
,	O
and	O
a	O
sufficient	O
reason	O
for	O
access	O
is	O
generally	O
required	O
.	O
</s>
<s>
Masking	B-Application
refers	O
to	O
sets	O
of	O
alterations	O
and	O
changes	O
made	O
to	O
protect	O
information	O
within	O
the	O
confines	O
of	O
Electronic	B-Application
health	I-Application
records	I-Application
.	O
</s>
<s>
Not	O
only	O
is	O
masking	B-Application
performed	O
at	O
a	O
patients	B-Application
request	O
,	O
it	O
is	O
a	O
common	O
method	O
used	O
to	O
assist	O
in	O
the	O
conduction	O
of	O
clinical	O
and	O
epidemiological	O
research	O
.	O
</s>
<s>
In	O
general	O
,	O
direct	O
identifiers	O
are	O
removed	O
from	O
the	O
dataset	O
,	O
replaced	O
with	O
random	O
values	O
,	O
changed	O
using	O
the	O
hashing	B-Algorithm
function	O
,	O
or	O
restored	O
with	O
a	O
unique	O
key	B-Application
.	O
</s>
<s>
Encryption	O
is	O
often	O
the	O
most	O
complex	O
form	O
of	O
data	B-General_Concept
masking	I-General_Concept
,	O
although	O
it	O
is	O
a	O
relatively	O
safe	O
and	O
secure	O
method	O
.	O
</s>
<s>
It	O
involves	O
inserting	O
a	O
password	B-Application
or	O
key	B-Application
to	O
grant	O
an	O
individual	O
access	O
to	O
view	O
certain	O
data	O
.	O
</s>
<s>
Only	O
permitted	O
users	O
are	O
provided	O
with	O
a	O
password	B-Application
and	O
therefore	O
have	O
the	O
capacity	O
to	O
recover	O
sensitive	O
information	O
included	O
within	O
an	O
EHR	B-Application
.	O
</s>
<s>
When	O
the	O
system	O
requests	O
data	B-General_Concept
masking	I-General_Concept
of	O
an	O
EHR	B-Application
,	O
access	O
is	O
extremely	O
difficult	O
and	O
time-consuming	O
for	O
hackers	O
or	O
unauthorized	O
users	O
,	O
as	O
they	O
do	O
not	O
possess	O
the	O
unique	O
code	O
that	O
will	O
decrypt	O
the	O
data	O
.	O
</s>
<s>
Data	B-General_Concept
obfuscation	I-General_Concept
limits	O
the	O
sharing	O
of	O
highly	O
sensitive	O
health	O
information	O
within	O
an	O
Electronic	B-Application
health	I-Application
record	I-Application
by	O
scrambling	O
particular	O
data	O
elements	O
to	O
prevent	O
unauthorized	O
access	O
.	O
</s>
<s>
Data	B-General_Concept
obfuscation	I-General_Concept
is	O
commonly	O
used	O
as	O
it	O
increases	O
anonymity	O
and	O
preserves	O
relationships	O
within	O
a	O
dataset	O
that	O
would	O
often	O
be	O
destroyed	O
in	O
more	O
rigorous	O
forms	O
of	O
masking	B-Application
.	O
</s>
<s>
For	O
example	O
,	O
clinical	O
data	O
can	O
be	O
swapped	O
between	O
EHR	B-Application
's	O
,	O
preserving	O
the	O
existing	O
values	O
in	O
a	O
field	O
but	O
eliminating	O
the	O
specific	O
mapping	O
between	O
fields	O
of	O
a	O
record	O
.	O
</s>
<s>
Random	O
“	O
noise	O
”	O
can	O
also	O
be	O
added	O
the	O
data	O
,	O
maintaining	O
the	O
statistical	O
properties	O
of	O
a	O
field	O
while	O
randomly	O
altering	O
exact	O
values	O
within	O
a	O
particular	O
EHR	B-Application
.	O
</s>
<s>
The	O
process	O
involves	O
often	O
removing	O
an	O
EHR	B-Application
entirely	O
from	O
the	O
system	O
(	O
at	O
patients	B-Application
request	O
)	O
or	O
removing	O
specific	O
sections	O
of	O
a	O
patients	B-Application
record	O
.	O
</s>
<s>
This	O
method	O
of	O
masking	B-Application
provides	O
the	O
highest	O
level	O
of	O
confidentiality	O
;	O
however	O
,	O
continuity	O
of	O
care	O
can	O
be	O
significantly	O
affected	O
in	O
some	O
cases	O
.	O
</s>
<s>
In	O
addition	O
,	O
data	O
exclusion	O
from	O
EHR	B-Application
’s	O
is	O
most	O
commonly	O
applied	O
for	O
when	O
external	O
researchers	O
are	O
investigating	O
the	O
nature	O
of	O
patient	O
health	O
outcomes	O
.	O
</s>
<s>
To	O
protect	O
individual	O
privacy	O
,	O
patient	O
identifiers	O
and	O
demographics	O
such	O
as	O
name	O
,	O
date	O
of	O
birth	O
and	O
address	O
,	O
are	O
removed	O
from	O
the	O
copied	O
EHR	B-Application
's	O
,	O
whilst	O
researchers	O
evaluate	O
clinical	O
information	O
such	O
as	O
diagnoses	O
and	O
performed	O
procedures	O
.	O
</s>
<s>
The	O
process	O
ensures	O
that	O
patients’	O
sensitive	O
information	O
remains	O
anonymous	O
whilst	O
gains	O
in	O
research	O
can	O
still	O
be	O
made	O
.	O
</s>
<s>
Data	O
hashing	B-Algorithm
involves	O
blocking	O
and	O
de-identifying	O
certain	O
characters	O
within	O
strings	O
of	O
information	O
so	O
that	O
personal	O
information	O
is	O
no	O
longer	O
recognizable	O
to	O
its	O
original	O
form	O
.	O
</s>
<s>
The	O
fact	O
that	O
data	O
hashing	B-Algorithm
alters	O
the	O
data	O
itself	O
means	O
it	O
is	O
only	O
appropriate	O
when	O
applied	O
to	O
data	O
that	O
is	O
not	O
required	O
again	O
in	O
the	O
future	O
.	O
</s>
