title: A conceptual framework and principles for trusted pervasive health.
abstract: BACKGROUND
  Ubiquitous computing technology, sensor networks, wireless communication and the latest developments of the Internet have enabled the rise of a new concept-pervasive health-which takes place in an open, unsecure, and highly dynamic environment (ie, in the information space). To be successful, pervasive health requires implementable principles for privacy and trustworthiness.
  
  
  OBJECTIVE
  This research has two interconnected objectives. The first is to define pervasive health as a system and to understand its trust and privacy challenges. The second goal is to build a conceptual model for pervasive health and use it to develop principles and policies which can make pervasive health trustworthy.
  
  
  METHODS
  In this study, a five-step system analysis method is used. Pervasive health is defined using a metaphor of digital bubbles. A conceptual framework model focused on trustworthiness and privacy is then developed for pervasive health. On that model, principles and rules for trusted information management in pervasive health are defined.
  
  
  RESULTS
  In the first phase of this study, a new definition of pervasive health was created. Using this model, differences between pervasive health and health care are stated. Reviewed publications demonstrate that the widely used principles of predefined and static trust cannot guarantee trustworthiness and privacy in pervasive health. Instead, such an environment requires personal dynamic and context-aware policies, awareness, and transparency. A conceptual framework model focused on information processing in pervasive health is developed. Using features of pervasive health and relations from the framework model, new principles for trusted pervasive health have been developed. The principles propose that personal health data should be under control of the data subject. The person shall have the right to verify the level of trust of any system which collects or processes his or her health information. Principles require that any stakeholder or system collecting or processing health data must support transparency and shall publish its trust and privacy attributes and even its domain specific policies.
  
  
  CONCLUSIONS
  The developed principles enable trustworthiness and guarantee privacy in pervasive health. The implementation of principles requires new infrastructural services such as trust verification and policy conflict resolution. After implementation, the accuracy and usability of principles should be analyzed.
authors.affiliation: National Instutute for Health and Welfare, Department of Information, Helsinki, Finland. pekka.ruotsalainen@thl.fi
authors.forename: Pekka Sakari
authors.initials: PS
authors.lastname: Ruotsalainen
authors.forename: Bernd Gerhard
authors.initials: BG
authors.lastname: Blobel
authors.forename: Antto Veikko
authors.initials: AV
authors.lastname: Seppälä
authors.forename: Hannu Olavi
authors.initials: HO
authors.lastname: Sorvari
authors.forename: Pirkko Anneli
authors.initials: PA
authors.lastname: Nykänen
mesh_terms: D006304:Health Status; D006801:Humans; D008962:Models, Theoretical; D018907:Privacy