Digitally Sustainable Information Systems in Axiomatic Design
Abstract
:1. Introduction
2. Axiomatic Design Approach: Background
3. Case Study: Integrated Health and Social Care Record
- the primary care record managed by the general practitioner who is in charge with the patient (electronic health record, EHR),
- the specialist record managed by the secondary care center placed in the hospital (hospital information system, HIS),
- the social record managed by the social worker and team placed in the referring territorial municipality (social record, SR).
- Illegitimate access to data (),
- Unwanted data changes (),
- Loss of data ().
4. Privacy Impact Assessment in Axiomatic Design
- At the “Previous decomposition level”, the functional robust solution of the previous level is considered.
- At the “Axiomatic decomposition” step, we functionally decompose the robust solution of previous level, based on an inter-domain mapping process called zigzagging (Figure 1).
- At the “Apply independence axiom” step, only admissible solutions (S) are selected. They correspond to decoupled or uncoupled design matrices.
- At the “Apply the information axiom” step, the robust solution is selected. It corresponds to the solution with the best PIA evaluation.
- At the “Select another design solution” step, the robust solution of the previous level is replaced by another solution of the same level. This condition occurs if none of the decomposed solutions satisfies the independence axiom or if the impact assessment of the identified admissible solutions is not deemed acceptable.
- At “Go to the next decomposition level” step, the selected robust solution is subjected to further functional decomposition. This process is iterative and is continued at the level of detail deemed necessary.
4.1. Application of Privacy Impact Assessment to the Case Study
- GP1: represents the set activities performed by the family doctor to store the patient’s health data in the his/her record (EHR),
- HP1: represents the option that the family doctor can access (in a read mode) all of the patient’s medical information produced by the specialized hospital centre and stored in the relevant system (HIS),
- Soc1: represents the option that the family doctor can access (in a read mode) all of the patient’s social care information produced by the social worker and stored in the relevant system (SR).
- Illegitimate access to data: consists of the prohibition for the data controller to access information that is unrelated to the correct performance of its activities. This situation would be a violation of the provisions of art. 18 of the GDPR [15]. In our case, the holder of the treatment is the family doctor. He is entitled to view all of the patient’s health data, including those produced at the Specialized Hospital Centre, but the family doctor has no title to fully access to his patients’ social record (SR). For this reason, the design matrix j = 1 of Figure 3 would lead to the establishment of an integrated file that could allow the family doctor to access data for which the treatment is not legitimate (i.e., social care data). Empirically, a significant level of risk (i.e., score 3) has been attributed to a possible violation of this type.
- Unwanted data changes: the constraint concerns the possibility that the family doctor carelessly modifies the system data. This risk is very low in an integrated EHR considering its efficient data backup and recovery mechanisms. On the other hand, the family doctor cannot carry out any operation that involves writing data in the specialist centre’s folder (HIS) as well as in the social folder (SR) [28]. The data visualization alone excludes any possible hazards of this type. A score of 1 is therefore attributed.
- Loss of data: the constraint represents the possibility that operations performed by the general practitioner lead to the loss of data in the system. This risk is very low in an integrated EHR. In fact, in this case, the family doctor cannot carry out any operation that involves writing data in the specialist centre’s record (HIS) and in the social record (SR). Thus, data visualization alone excludes any problems of this type. A score of 1 is therefore attributed.
- Illegitimate access to data: the integrated EHR allows the family doctor to access data relating to the patient’s medical record. Therefore, the likelihood of accessing this data is set to 3,
- Unwanted data changes: the overall likelihood of careless modification of system data is considered to be very low. Therefore, it arises as a negligible level of occurrence (i.e., 1),
- Loss of data: the likelihood of data processing associated with that results in data loss is considered to be very low and is rated 1.
4.2. Consecutive Decompositions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Score | Description | Assessment |
---|---|---|
1 | Negligible | The event did not cause any damage or caused minor inconveniences, such as the recompilation of some forms by the user. |
2 | Limited | The event caused temporary harm to the patient and necessitated additional interventions (additional costs, stress, temporary suspension of social services...). |
3 | Significant | The event caused temporary damage to the patient, which he/she should be able to overcome even if with serious difficulties (extension of hospitalization, withdrawal of social services...). |
4 | Maximum | The event caused permanent harm to the patient (permanent disability, long-term psychological or physical ailments, death). |
Score | Description | Assessment |
---|---|---|
1 | Negligible | There are no known events |
2 | Limited | Documented but not frequent |
3 | Significant | Documented and frequent |
4 | Maximum | Documented and very frequent |
3 | 1 | 1 | |
3 | 2 | 2 | |
2 | 2 | 2 | |
3 | 1 | 1 | |
3 | 2 | 2 | |
2 | 2 | 2 | |
1 | 1 | 1 | |
1 | 1 | 1 | |
2 | 2 | 2 |
1 | 1 | 1 | |
3 | 1 | 1 | |
2 | 1 | 1 | |
1 | 1 | 1 | |
1 | 1 | 1 | |
2 | 1 | 1 | |
1 | 1 | 1 | |
3 | 1 | 1 | |
2 | 1 | 1 |
Score | ||||
---|---|---|---|---|
3 | 1 | 1 | 26 | |
9 | 2 | 2 | ||
4 | 2 | 2 | ||
3 | 1 | 1 | 20 | |
3 | 2 | 2 | ||
4 | 2 | 2 | ||
1 | 1 | 1 | 16 | |
3 | 1 | 1 | ||
4 | 2 | 2 |
Level of Decomposition | ||
---|---|---|
First Level | Second Level | Third Level |
Primary care visit (GP3) | General practitioner visit (A) | General practitioner visit (1) |
Referral (B) | Send Referral to EHR (2) | |
Send Referral to LEHR (2.1) | ||
Send Referral stored to EHR (2.2) | ||
Send Referral stored to General practitioner (2.3) | ||
Specialist care visit (HP3) | Specialist Patient Info (C) | Get Patient Info from HIS (3) |
Send Patient Info HIS to Specialist (3.1) | ||
Get Patient Info from LEHR (4) | ||
Send Patient Info LEHR to Specialist (4.1) | ||
Specialist visit (D) | Specialist visit (5) | |
Specialist Referral (E) | Send Specialist Referral to HIS (6) | |
Send Specialist Referral to LEHR (6.1) | ||
Send Specialist Referral stored to HIS (6.2) | ||
Send Specialist Referral stored to Neurologist (6.3) |
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Pecoraro, F.; Pourabbas, E.; Rolli, F.; Parretti, C. Digitally Sustainable Information Systems in Axiomatic Design. Sustainability 2022, 14, 2598. https://doi.org/10.3390/su14052598
Pecoraro F, Pourabbas E, Rolli F, Parretti C. Digitally Sustainable Information Systems in Axiomatic Design. Sustainability. 2022; 14(5):2598. https://doi.org/10.3390/su14052598
Chicago/Turabian StylePecoraro, Fabrizio, Elaheh Pourabbas, Fernando Rolli, and Chiara Parretti. 2022. "Digitally Sustainable Information Systems in Axiomatic Design" Sustainability 14, no. 5: 2598. https://doi.org/10.3390/su14052598