title: A systematic literature review on security and privacy of electronic health record systems: technical perspectives.
abstract: BACKGROUND
  Even though many safeguards and policies for electronic health record (EHR) security have been implemented, barriers to the privacy and security protection of EHR systems persist.
  
  
  OBJECTIVE
  This article presents the results of a systematic literature review regarding frequently adopted security and privacy technical features of EHR systems.
  
  
  METHODS
  Our inclusion criteria were full articles that dealt with the security and privacy of technical implementations of EHR systems published in English in peer-reviewed journals and conference proceedings between 1998 and 2013; 55 selected studies were reviewed in detail. We analysed the review results using two International Organization for Standardization (ISO) standards (29100 and 27002) in order to consolidate the study findings.
  
  
  RESULTS
  Using this process, we identified 13 features that are essential to security and privacy in EHRs. These included system and application access control, compliance with security requirements, interoperability, integration and sharing, consent and choice mechanism, policies and regulation, applicability and scalability and cryptography techniques.
  
  
  CONCLUSIONS
  This review highlights the importance of technical features, including mandated access control policies and consent mechanisms, to provide patients' consent, scalability through proper architecture and frameworks, and interoperability of health information systems, to EHR security and privacy requirements.
authors.affiliation: University of Wollongong, NSW, Australia.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Rezaeibagha
authors.affiliation: University of Wollongong, NSW, Australia.
authors.forename: Khin Than
authors.initials: KT
authors.lastname: Win
authors.affiliation: University of Wollongong, NSW, Australia.
authors.forename: Willy
authors.initials: W
authors.lastname: Susilo
mesh_terms: D022126:Access to Information; D016494:Computer Security / Q000592:standards; D003219:Confidentiality; D057286:Electronic Health Records / Q000592:standards; D019983:Guideline Adherence; D006801:Humans