Technical Design Project:

Biometric Health Card

BTEC 227

Centennial College

Submitted by:

November 27, 2019

 Table of Contents

Abstract............................................................................................................................................1
Introduction......................................................................................................................................2
Statement of Problem.......................................................................................................................3
Goals and Objectives.......................................................................................................................3
Literature Review.............................................................................................................................5
Scope................................................................................................................................................7
Cost Estimation................................................................................................................................9
Time Management.........................................................................................................................10
Risk Management...........................................................................................................................15
Conclusion......................................................................................................................................16
References......................................................................................................................................17

List of Figures and Tables

Figure 1 – Health Card Layout and Features…...............................................................................8

Figure 2 – Schematic of the Biometric Health Card........................................................................9
Figure 3 – Network Diagram….....................................................................................................12

Table 1 – Project Schedule............................................................................................................11

Table 2 – Work Breakdown Structure...........................................................................................13
Table 3 – Gantt Chart….................................................................................................................14
Table 4 – Quantitative Risk Analysis............................................................................................15
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Abstract

The safety and security of personal information is of the utmost concern advancing in the

digital age. The ease-of-unauthorized access associated with the Cloud has deterred the storing,

and therefore, the instant accessibility of medical information that is becoming a necessity for

healthcare workers[8][12]. Furthermore, with the accelerated evolution of technology, security

measures are not being kept up to date regarding personal information stored digitally[3][9][11].

Yang, et al. have proposed the inclusion of prescription data directly onto a smart card with the

protection of a personal identification number (PIN) [5]. Taherdoost, et al. identifies the growing

need for remembering multiple different PIN codes which can result in the necessity of the card

holder to write the PIN directly onto the card to avoid incorrectly inputting the PIN upon use [1].

This proposal identifies the overwhelming necessity of instant access to personal and

prescription information for patients and the importance of swift acceptance into an emergency

room triage all within the safety of a biometric health card. The biometric health card described

herein utilizes a fingerprint authentication in combination with a radio frequency identification

(RFID) device to provide a secure method of storing data within the device, as well as

preventing unauthorized access by illegitimate users. This device will provide an advantageous

method for quick access to medical information and prescription data, while alleviating the

pressure and complexity of emergency room registration and triage queues, in a unique and cost-

efficient manner that is beneficial to the health care industry.

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Introduction

The use of smart cards for a variety of applications is becoming prominent world-wide

from banking transactions to access control[1][9]. Digitalization of information from all facets

of life have led to the necessary adoption of on-the-go access to details through the Internet of

Things (IOT)[2]. The inclusion of more personal and varied information that a smart card can

access through digitalization has led to increased concern, and ultimately, demand for security

and privacy protection when sensitive material is being integrated onto these devices[1]. The

sensitivity of the material accessible through healthcare facilities produces the highest financial

value with an estimated $363 for a single stolen record[3]. The breaches of security incited by

the potential financial gain associated with them have long-term detrimental effects on a person’s

life, including loss of dignity and stigmatization[10]. The acceptance of digital technology has

quickly surpassed the application of suitable security and privacy measures escalating

opportunities for hackers to illegally obtain and utilize private personal information[3][9][11].

Drug prescriptions, in particular, benefit greatly from the frequency of medical information

access required by a doctor; therefore, the need for quick access to digital information must be

available to increase the efficiency and quality of health care[5]. The interpretation and legibility

of handwritten prescriptions, specifically the use of unrecognizable abbreviations and doses, has

become an increased preventable risk in health care[4]. As a result of the illegibility of written

prescription notes, more than 7000 people are killed annually by incorrectly read dosages and

drug identification upon dispensing[4]. An undesirable, preventable consequence of e-

prescriptions involves negligence from doctors whom disregard investigating patient history,

which has led to double prescribing medication and unintentionally issuing drugs that cause

adverse effects with a patient’s current medication[7]. The need for immediate simultaneous
 3

access to patient information and prescription data, digitally, and in a safe manner, is of the

utmost concern for determining the efficiency and quality of end-user health care practices in the

future[5][9].

Statement of Problem

Illegal access to medical information has led to increased theft and misuse of patient data

for personal coverage, fraud, or personal profit[3]. Access to this data can be attributed to the

accelerated advancements in digital accessibility, while neglecting the importance of security and

safety of the sensitive information stored by digitalization[3]. This has led to an increased need

for developing a safe and secure method of retaining and accessing patient's health information

and prescription data in the digital age.

Goals and Objectives

This project identifies the increased need for developing a safe and secure solution to

patients' health information breaches, while reducing hospital wait-times, and increasing the end-

user accessibility of prescription information. Biometric debit cards currently in use within the

United Kingdom have shown considerable success in preventing unauthorized transactions and

preventing the illegitimate access of information due to the storage of the fingerprint information

directly on the card[6], but the application of a biometric health card has not been utilized within

the health care industry. Fingerprint technology is the most accepted form of biometrics due to

its non-invasive nature and unique permanent properties[14]. Fingerprint technology accounts

for more than 50% of biometric revenue according to market reports conducted by an

International Biometric group from 2004-2007, proving its acceptance and potential to develop
 4

into the future[14]. There are several ways to capture a biometric fingerprint signal, however the

most commonly used is the capacitive fingerprint scanner[15]. It is considered the most secure

and relabel due to its simplicity[15]. This type of scanner has a big range of applications and it is

commonly used to safeguard personal information in smartphone technology today[15]. It works

by using an array of tiny capacitors fixed on a conductive plate to collect data about the finger,

storing an electrical charge that is unique to the individual due to the ridges on the

fingerprint[15]. In addition, the utilization of cloud technology to store private and essential

information has been met with resistance due to the increasing number of highly publicized data

breaches of major worldwide entities, such as Facebook and Equifax[8][12]. The production of a

tangible biometric-secured card that stores information will reduce the stigma associated with

digitally-stored sensitive data.

This project has been devised to meet the following objectives:

 Integrate biometric technology with a smart card in the form of a fingerprint sensor

to prevent unauthorized access to medical information.

 Implement a method of improving digital health care that can safely store

sensitive medical information

 Promote self-service kiosk accessibility for registration and personal information

amendments.

 Provide immediate access to prescribed medications at any pharmacy supporting the

technology.

 Eliminate redundant documentation that request repetitive information upon each visit

to a health facility.

 Present a solution for reducing medication issuing errors at the pharmaceutical and
 5

healthcare professional levels.

Literature Review

Filkins, et al. identifies the potential for digitalization in all aspects of our lives, providing

extraordinary opportunities, but bringing with it unique challenges[3]. Filkins, et al. determines

that the coupling of medical care data, with financial information, social behaviour patterns, and

genomic information is becoming more valuable to illegitimate commercial entities, for criminal

profiting and fraud worth millions of dollars[3]. The article diagnoses specific avenues that must

be investigated when dealing with hackers, as well as the importance for not taking cyber-

security for granted. Conclusively, “Privacy and security in the era of digital health: what should

transitional researchers know and do about it?” examines the consequences of information theft

through the internet, as well as what techniques should be utilized to minimize unauthorized

access but does not clearly identify a solution to the problem relating to safety and security of

personal information.

Yang, et al. explores the possibilities relating e-prescription data being utilized through

smart-card technologies and the consequences that it instills for patients and doctors. This paper,

“A Smart-Card-Enabled Privacy Preserving E-Prescription System”, acknowledges the need for

special treatment when dealing with patient health care information due to the involvement of

non-medical parties, doctors and patients, and the privacy stakes that are associated with this

data[5]. Yang, et al. further explain their proposed interest in a smart-card that contains

prescription and medical information utilizing an electronic signature to release, or access, the

patient's secure records for the purpose of accepting a prescription[5]. In addition to the

electronic signature for security purposes, this paper identifies the concern for a delegation of

signing capability for other people, such as caregivers, to receive the owner's prescription due to
 6

the inability to attend the pharmacy in-person[5]. Yang, et al. propose a viable solution for

instant-access to medical information required by pharmacists and doctors, but the security

feature still contains a number of potential flaws due to identify theft and improper access to

pharmaceuticals.

Brits, et al. provides a valid investigation into the illegibility of handwriting and the

errors associated with improper issuing of pharmaceuticals, which leads to a large number of

avoidable deaths annually[4]. The objectives of the study included: assessing the readability of

doctors' handwriting on prescriptions, determining which group of health care workers could

read the prescriptions the best, identifying other factors on prescriptions that could contribute to

dispensing errors, and determining whether utilizing an IntelliPen® would increase the

readability of doctors' handwriting. A result of the study concluded that aspects of the

prescriptions within the test do not meet the legal requirements for prescriptions[4]; therefore,

reinforcing the need for e-prescriptions and an appropriate medium for accessing the information

in a fast and safe manner.

Dyb & Warth support the need for a change in work practices and professional

knowledge-sharing in resolving the issue of medication errors[7]. The paper examines the

increasing need for a solution specifically in Norway, but the application of their findings can be

applied on a world-wide scale. A key point of their investigation states that e-prescriptions are

an excellent asset to doctors for accessing patient information across various institutions and

levels of care in their health and care services, but there is still a failure to utilize this

information[7]. Doctors continue to disregard patient medical history resulting in continued

double prescriptions, incompatibility of medications, and incorrect dosages, all of which the

implementation of e-prescriptions was meant to correct[7]. Dyb & Warth conclude that digital
 7

technologies are helpful, but the underlying factor is that routines and work practices must be

altered to provide a substantial change to medication errors[7].

Taherdoost, Sahibuddin, & Jalaliyoon express the importance of smart cards for use in a

multitude of daily applications, such as banking, identification, and access control[1]. The study

explains that a smart card adoption is being stymied by inadequate security features[1].

Taherdoost, et al. declare that Personal Identification Numbers (PIN) are becoming inadequate

due to the reluctance of users to memorize passwords and PIN numbers[1]. The uniqueness of a

fingerprint ensures the secure identity of the cardholder[1]. Taherdoost, et al. surmise that the

security of a device directly impacts its acceptance, and in turn, the degree of sensitive material

that can be stored on it[1].

Jain, Ross, & Pankanti indicate the need for a reliable means for authenticating users due

to the rapid advancements in networking, communication, and mobility[9]. The journal article

emphasizes the need for a reliable method to replace password-based authentication resulting in

their recommendation for using biometrics[9]. Further, Jain, et al. identify the advantages and

disadvantages of several different forms of biometrics, ranging from facial to voice

recognition[9]. The inability to share or misplace biometrics, in addition to the arduous task of

potentially forging biometrics, enhances the level of security of smart cards eliminating the need

for a standard password system[9]. Jain, et al. conclude that biometric-based recognition

methods will effectively support the linking of people to their records by ensuring information

security[9].

Scope

This project is the implementation of a dual-access security health card, an upgrade to the
 8

existing Ontario Health Card. It will have the name, ID number and a digital picture of the

patient (See Figure 1). The design of the dual-access process comprises a fingerprint sensor and

a powerful programmable minicomputer(chip) that can store and access data using a radio

frequency identification (RFID) device. The 'tap' functionality will be similar to the technology

already implemented on debit and credit cards. All the aforementioned information will be

embedded in the health card, which will provide security and accurate identification of the

patient. The ‘tap’ in conjunction with the patient's unique fingerprint, will allow the embedded

information to become accessible to health care providers for the purpose of: demographics,

medical history and prescription accessibility.

Figure 1 - Health Card Layout and Features

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Figure 2. Schematic of the Biometric Health Card. Adapted from Smart Cards and Smart
Card Programmer, by Kanda Electronics, November 16, 2012, retrieved from
[Link]
This card will be an innovative solution to medical errors with an emphasis on improper

prescriptions, wait times in the admission process of hospitals, alleviating the high administrative

cost for medical facilities and diminishing medical identity theft. The utilization of scholarly

journals and articles will reinforce the relevance and stance undertaken within this project.

Cost Estimation

Technological advancements have made it possible to perform transactions in a secure

platform. Miniaturizing computing power has allowed for the development of many systems that

are employed to make our lives more convenient. Having the banking sector pave the way into

secure transactions with smart credit and debit cards, as well as their version of self-serving
 10

kiosks, the ATM, we can gain access to our monies anytime and anywhere the technology exists.

The trend for smart card accessibility is growing and benefiting all the sectors where this

technology is employed. It is only natural that the healthcare industry looks at and takes

advantage of the technological advancements involving instant access to information. Our

product will enable access to your medical information on the spot in a secure platform using

biometrics for an added layer of security. This development will be beneficial to all the

stakeholders of the medical industry.

We target our product to the residents of Ontario with the cost of its initial development

estimated at $482 Canadian dollars. This cost includes a universal software development kit

(SDK) for smart cards with available encryption priced at $400, an Arduino microcontroller

starter kit priced at $35.00, which includes a breadboard and cables to connect the IO pins and

power supply, a fingerprint reader for biometrics security at $9.00, an RFID reader (MFRC-522)

valued at $10.00, a 64GB MicroSDXC memory card with adapter for storing information valued

at $16.00, and a Micro SD storage board module for Arduino valued at $12.00.

The project utilizes a Microprocessor operating system technology with advanced

password security and advanced encryption standards. This will enable the programing portion

of our development. The implementation of biometrics as a layer of security will safeguard the

contents of the smart card to safely secure the sensitive information encrypted on the card.

Time Management

Project time management provides a clear understanding of the time required to complete

each process of the project without violating its schedule. A good project time management

allows a project to be delivered as planned with no need to expedite any one specific process.

Our project contains eight processes as shown in Table 1. In a series PND, the processes are
 11

sequential, but our project uses a series/parallel PND which allows tasks B&C and D&E to be

completed in parallel, meaning that they work on during the same time frame disturbance to the

project schedule. The summation of these processes ensures the completion of the project’s final

proposal.

Table 1. – Project Schedule

The table above is represented in the Project Network Diagram (PND). The PND, using

landscape format with inscription inside (see Legend), allows for visualization of the project
 12

during time. The numbers inside the box are calculated using time estimation formula from a

Beta (ß) skewed distribution. The diagram also display that task D and E can be completed in

parallel with task B and C. These two tasks, D and E, compile a slack time of two and one week

respectively. The critical path which has the longest path and the shortest time for the project

completion is shown in red on the diagram and comprises task A-B-C-F-G-H. Its duration is 14

weeks, whereas the duration for the other path (A-D-E-F-G-H), is 13 weeks.

2 B 4 4 C 8
0 Res1 0 Draft
2 2 4 4 4 8

8 F 10 10 G 12 12 H 14
0 A 2 0 Feas. P.
0 Final P. 0 Present.
0 Top. Sel
8 2 10 10 2 12 12 2 14
0 2 2

2 D 5 5 E 7
1 Editing Early Start Identifier Letter Early Finish
2 Res2
4 3 7 6 2 8

Figure 3 – Network Diagram Slack Time Activity Description

Late Start Activity Duration Late Finish

Legend

The work will be shared among the 3 members of the group. Each member will need to

be productive for the project to be successful. Responsibility will be assigned to each member

and a deadline will be provided as well to get the task done. The tasks include, but are not

limited to, topic selection, research, drafting proposals, formatting the document and redacting a

feasibility plan. The work will be shared equally among us. The Work Breakdown Structure

(WBS) provides a detailed map of the task to be completed and to whom they are assigned.
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Process Activities Responsibility 1 2 3 4 5 6 7 8 9 10 11 12 13 14

A Topic Selection Brainstorming to find a topic Everyone
Preliminary Literature Review Jeff and Michel
Related Works Review Carlos
B Research 1 Literature Review Jeff and Michel
Needs Analysis Carlos
Conceptualization Everyone
C Draft Proposals Introduction Jeff
Scope Management Jeff
Time Management Michel
Technical Details Michel
Risk Management Carlos
Cost Estimation Carlos
Literature Review Results Everyone
D Research 2 Technical R.- CHIP Michel
Technical R.- Fingerprint Sensor Carlos
Technical R.- Software Jeff
Technical R.- Comm. Protocol Michel
Technical R.- Circuitry Everyone
E Editing Proposal Expand Technical Details Carlos
Use of Graphics Jeff
Revising Details Michel
F Final Proposal Formatting Carlos
Error detection Michel
Final Editing Jeff
G Presentation Slides Creation Everyone
In Class Presentation Everyone
H Feasibility plan Validation of Technical Details Refer to Section D
Application of Validation’s Results Refer to Section D
Preparation for Project’s Execution Everyone
Table 2 – Work Breakdown Structure
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E1 Ed F,j Screen Mode g E) [Gantt Chart ;

ProJect Plan 365- [Link]
Task Name Duration Start finish '191ep01 '191ep03 '191ep15 '19Sep22 '191ep29 '190ct06 '190ct1J '190ct10 '190ct27 '19Nov0 '19Nov1 '19Nov1 '19Nov2 '19Dec01 '19
1 [Link] 70 days Tue19-09-03B:00 Mon19-12-09s:oo
2 TOPIC SELECTION 10 days Tue19-09-03 8:00 Mon19-09-16 5:00
3 Brainstorming 3 days Tue 19-09-038:00 Thu 19-09-05 5:00 f Jeff, Carlos, Michel • Jeff,Carlos,Michel
4 Relatedwork 3 days Fri 19-09-06 8:00, Tue19-09-10 5:00 F Carlos
5 [Link] 4days Wed19-09-118:01Mon19-09-165:00 Jeff, Michel
6 RESEARCH! 10 days Tue19-09-17 8:00 Mon19-09-30 5:00
7 Literature Review 3days Tue 19-09-17 8:00 Thu 19-09-19 5:00 f Jeff, Michel
8 Need Analysis 3 days Fri 19-09-20 8:00, Tue19-09-24 5:00 F Carlos
9 Conceptual isati□n 4days Wed19-09-25 8:01Mon19-09-305:00 Jeff, Michel,
Carias
10 DRAFT PROPOSALS 20 days Tue19-10-018:00 Mon19-10-28 5:00
11 Introduction 2 days Tue 19-10-018:00 Wed 19-10-02 5:00 Jeff Jeff
12 ScopeManagement 3 days Thu19-10-038:00 Mon19-10-07 5:00 Jeff Michel
13 TimeManagement 3days Tue 19-10-088:00 Thu19-10-105:00f Michel
14 TechnicalDetails 2 days Fri 19-10-118:00I Mon19-10-145:00 Michel
- Michel
15 Aisk Management 3 days Mon19-10-14 8:01Wed 19-10-16 5:00 Carlos Carlos
16 cost Estimation 2 days Thu19-10-17 8:00 Fri19-10-18 5:00 Pl Carlos ■ Carlos
17 [Link] 5 days Man19-10-218:01 Fn19-10-25 5:00 Pl Jeff, Michel, Carlos [Link]
18 RES£ARCH2 15 days Mon 19-09-30 8:01Fri19-10-18 5:00 Pl
19 TechnicalR. CHIP 3 days Mon19-09-308:01 Wed19-10-02 5:00 Michel
20 TechnicalR. Sensor 3 days Thu19-10-03 8:00Mon19-10-075:00 Carlos
21 TechnicalR. 3 days Tue 19-10-088:00 Thu 19-10-105:00f Jeff
22 TechnicalR. comm. 3days Fri 19-10-118:00ITue19-10-155:00 F
Michel Protocol
23 TechnicalR. Circuitry 3 days Wed19-10-168:01Fri19-10-18 5:00 Pl Jeff, Michel, Carlos
24 EDITING PROPOSAL 11days Mon 19-10-14 8:0I Mon19-10-28 S:DD
25 Use of Graphics 5 days Man19-10-148:01Fri19-10-18 5:00 Pl Jeff
- Jeff
26 Revisingdetails 5 days Mon19-10-218:0r Fri19-10-25 5:00 Pl Michel, Carlos [Link]
FINAL PROPOSAL 10 days Tue19-10-298:00 Mon19-11-11S:OO
Formattingand 10 days Tue 19-10-298:00 Mon19-11-115:00 Jeff, Michel, Carlos Jeff,Michel,Carlos
PRESENTATION 10 days Tue19-11-128:00 Mon19-11-2SS:OO
Slides Creation and 10 days Wed19-11-06 8:01Tue19-11-195:00F Jeff, Michel, Carlos Jeff,Michel,Carlos
presentation
31 FfASIBILITY PLAN 10 days Tue19-11-268:00 Mon19-12-09S:OD Jeff, Michel, Carlos

Table 3 - Gannt Chart

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Risk Management

The risks associated with our project include:

Receiving the wrong component (microcontroller)
 Damaging specialized components during the build
 Sick days
 Debugging code problems
 Needing to change specification
 Time management
 Cost
 Weather

Table 4 - Quantitative Risk Analysis

To mitigate our two biggest probabilities of failure, we need to be able to source out

components locally when possible due to the possibility of delays relating to the acquisition of our

parts. In the debugging portion of our project, we need to establish experienced programming contacts

that we can consult for assistance if we experience problems. There are very skilled tutors in the

learning centre that we could approach to help if the need arises. The remaining potential risks turned

out to be on the medium to low end, with little impact on the timeline of our projections.
 16

Conclusion

The utilization of biometrics to secure personal information is an advantageous solution to the

stigma associated with digitalized medical records. Further, a biometric health card will open the door

to future technological possibilities, such as instantaneous data accessibility, point-of-care decision

making, and innovating smart devices[13]. Yang, et al. have proposed the inclusion of prescription

data

directly onto a smart card; however, the security method suggested consisted of a PIN[5], which is not

as favourable of a method for protecting sensitive information as biometrics is, particularly with the

rapid acceleration of technology in combination with the difficulty in forging or imitating the biometric

data[9][14]. The adoption of a biometric health card will provide an essential advancement for

improving health care quality, while reducing the errors associated with both paper and e-prescriptions.
 17

References

[1] Taherdoost, H., Sahibuddin, S., & Jalaliyoon, N. (2011). Smart Card Technology; Technology
and Adoption. Retrieved 30 September 2019, from
[Link]

[Quote: “However smart card are currently used in many other applications such as health and
services cards, banking (such as auto-teller machine cards), network authentication, telephone (calling)
cards, identification (including government identity cards, employee ID badges and membership cards),
telecommunication (mobile phone subscriber identification and administration), transport ticketing and
tolling, electronic passports, and physical access control if having a look at the Iranian wallet, you will
find; notes, coins, driving license, library card, paper identity card and other cards.” (p. 74)]

[Quote: “More research on privacy and security is needed before such a card comes into being,
since the more personal and varied the information stored on an individual’s smart card, the greater
the potential for privacy loss when that card is accessed.” (p. 76)]

[Quote: “People are needed to remember more and more pin numbers remember [sic] 15_20
different pin codes are difficult for all people and it could causes [sic] that somebody write the pin
number on the card.” (p.78)]

[Quote: “The results of this study illustrate that security has an important and positive effect
on user satisfaction and consequently on user acceptance. It means that with increasing the level of
security, the level of user acceptance will be increased.” (p. 83)]

[Quote: “Users are reluctant to memorize passwords and pin numbers. This reluctance is one of
the driving forces behind the development of biometric [sic]. Also [sic] many people can share pin
numbers then it is not uniquely [sic] but biometrics can specify the real person because it is unique.”
(p.78)]

[2] Parida, V., Sjödin, D. and Reim, W. (2019). Reviewing Literature on Digitalization, Business
Model Innovation, and Sustainable Industry: Past Achievements and Future Promises. [online] MDPI.
Available at: [Link] [Accessed 31 Oct. 2019].

[Quote: “We are witnessing a new age, where industry is becoming increasingly ‘smart’ with
the use of the Internet of Things (IoT) technologies, intensive data exchange and predictive analytics.”
(p.1)]

[3] Filkins, B., Kim, J., Roberts, B., Armstrong, W., & Miller, M., Steinhubl, S., et al. (2019).
Privacy and security in the era of digital health: what should translational researchers know and do
about it?.
Retrieved 30 September 2019, from [Link]
[Quote: “Healthcare has the highest per capita cost for a stolen record ($363) of any industry.”
(p. 1563)]
[Quote: “Adoption of digital technologies has outpaced the implementation of appropriate
safeguards for privacy and security, as well as the ability to anticipate and respond to potential threats.”
(p. 1562)]
 18

[Quote: “Motivation for attack can range from financial gain: intent to commit fraud,
profiting from selling packaged identities; unauthorized hospital clerks (insider) idly viewing the
health record of a movie star; to just the challenge of defeating a security system.” (p. 1562)]

[4] Brits, H., Botha, A., Niksch, L., Terblanche, R., Venter, K., & Joubert, G. (2017). Illegible
handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein.
Retrieved 30 September 2019, from
[Link]
[Quote: “Preventable medication errors affect more than 1.5 million Americans annually. These
errors are caused by unclear abbreviations and doses, and illegible handwriting.” (para. 3)]
[Quote: “The following quote stresses the problem with illegible handwriting: ‘Doctors’ sloppy
handwriting kills more than 7000 people annually.’” (para. 1)]
[Quote: “It is a legal requirement according to the Medicines and Related Substances Act 101 of
1965 (amended) to ensure that the name is legible on all prescriptions.” (para. 30)]

[5] Yang, Y., Han, X., Bao, F., & Deng, R. (2004). A Smart-Card-Enabled Privacy Preserving E-
Prescription System. Retrieved 30 September 2019, from
[Link]
Prescription_System
[Quote: “Easy and instant access to electronically managed medical and insurance information
is now a key factor determining the efficiency and quality of health care provision.” (p. 47)]
[Quote: “Drug prescription is among the health care processes that frequently makes references
to patients’ medical and insurance information.” (p. 47)]
[Quote: “Apart from bringing the flexibility and convenience in accessing personal health and
insurance data, the adoption of smart cards in our system has many other advantages: the authenticity
of the patients is automatically ensured by holding the cards, so that many processes would be
automated and sped up, e.g., hospital admissions; it prevents patients from obtaining multiple
prescriptions from different practitioners; smart cards can be used as a tool for tracking public health
initiatives, e.g., vaccinations; with free access to the emergency data stored in the smart card,
emergency treatment would be instant; to name a few.” (p. 48)]
[Quote: “To make the system more realistic, we identify the needs for a patient to delegate his
signing capability to other people so as to protect the privacy of information housed on his card.” (p.
47)]
[Quote: “To be more specific, i) a number of parties get involved in the health care provision,
such as hospitals, clinics, general practitioners (GPs), and external business associates including
insurance companies, billing agencies, pharmacies, and so on, resulting in the heterogeneity of
information infrastructures and business patterns…” (p. 47)]
[Quote: “The area for consultation details and prescription information is writable under the
card holder’s PIN (CHN). With this, our system offers the flexibility that such information can be
added to the smart card under the authorization of the patient.” (p. 56)]
 19

[6] Perala, A. (2019). UK Bank Begins Trial of Biometric Credit Cards - Mobile ID World. Retrieved
6 November 2019, from [Link]
610071/
[Quote: “Perhaps offering some indication of the growing concern over data security, NatWest
took care to note in announcing the trial that users’ biometric data is never transmitted from the
payment card, and that no fingerprint data is stored on remote servers.”]

[7] Dyb, K., & Warth, LL. (2019). Implementing eHealth Technologies: The Need for Changed
Work Practices to Reduce Medication Errors. - PubMed - NCBI. Retrieved 6 November 2019, from
[Link]
[Quote: “Doctors continue prescribing medications, now digitally, without checking the
patient’s pharmaceutical history. Therefore, Norway still has medication errors, particularly related to
double prescriptions (Figure 1B).]
[Quote: “Taking the wrong medicine, an incorrect dosage or the wrong combinations of drugs
can lead to poor health outcomes, including premature death and reduced quality of life [3, 4].”]
[Quote: “Digital technologies are helpful in addressing the medication problem, but the main
challenge may be related to establishing new routine work practices among health professionals”]
[Quote: “E-prescription is a success as a digital system that provides doctors at various
institutions and level of care in Norwegian health and care services access to the same prescription
information.”]
[Quote: “However, medication errors are still a significant health problem and a serious threat to
patient safety.”]

[8] Schiff, G., Mirica, M., Dhavle, A., Galanter, W., Lambert, B., & Wright, A. (2018). A
Prescription For Enhancing Electronic Prescribing Safety | Health Affairs. Retrieved 7 November
2019, from [Link]
[Quote: “However, posting and sharing patients’ medication lists in a centralized site inevitably
raises privacy and security concerns. Such concerns have inhibited mainstream acceptance of this idea,
and highly publicized data breaches (for example, Facebook and Equifax) do little to reassure the
public.”]

[9] Jain, A., Ross, A., & Pankanti, S. (2006). Biometrics: A Tool for Information Security. IEEE
Transactions On Information Forensics And Security, 1(2), 125-143. doi:
10.1109/tifs.2006.873653
[Quote: “But it is certain that biometric-based recognition will have a profound influence on the
way we conduct our daily business because of the inherent potential for effectively linking people to
records, thereby ensuring information security.” (p. 141)]
[Quote: “The need for reliable user authentication techniques has increased in the wake of
heightened concerns about security and rapid advancements in networking, communication, and
mobility.” (p. 125)]
 20

[Quote: “Biometric systems offer several advantages over traditional authentication schemes.
They are inherently more reliable than password-based authentication as biometric trains cannot be lost
or forgotten (passwords can be lost or forgotten); biometric traits are difficult to copy, share, and
distribute (passwords can be announced in hacker websites); and they require the person being
authenticated to be present at the time and point of authentication (conniving users can deny that they
have the password).” (p. 125)]
[Quote: “Because biometrics cannot be easily shared, misplaced, or forged, the resultant
security is more reliable than current password systems and does not encumber the end user with
remembering long cryptographically strong passwords.” (p. 140)]

[10] Nass, S., Levit, L., & Gostin, L. (2009). Beyond the HIPAA privacy rule. Washington,
D.C.: National Academies Press.
[Quote: “Breaches of privacy and confidentiality not only may affect a person’s dignity, [sic]
but can cause harm. When personally identifiable health information, for example, is disclosed to an
employer, insurer, or family member, it can result in stigma, embarrassment, and discrimination. Thus,
without some assurance of privacy, people may be reluctant to provide candid and complete
disclosures of sensitive information even to their physicians.”]
[Quote: “However, several highly publicized examples of stolen or misplaced computers
containing health data have heightened the public’s concerns about the security of health data”]

[11] Kisku, Dakshina Ranjan. Advances in Biometrics for Secure Human Authentication
and Recognition. CRC Press, Taylor & Francis Group, 2016.
[Quote: “The need for reliable user authentication techniques has increased in the wake of
heightened concerns about security and rapid advancements in networking, communication, and
mobility.” (p. 123)]

[12] Schiff, Gordon, et al. "A prescription for enhancing electronic prescribing safety."
Health Affairs 37.11 (2018): 1877-1883.
[Quote: “While electronic prescribing has been shown to reduce medication errors and improve
prescribing safety, it is vulnerable to error-prone processes”]

[13] Wang, L., & Ann Alexander, C. (2018). Big Data Analytics in Biometrics and Healthcare.
Journal Of Computer Sciences And Applications, 6(1), 48-55. doi: 10.12691/jcsa-6-1-7
[Quote: “There are endless exciting opportunities for Big Data in the future of healthcare:
genome sequencing, innovative smart devices, accessing data anywhere, point-of-care decision-
making, and reducing readmissions.” (p.53)]

[14] Memon, S., Balachandran, W., & Sepasian, M. (2008). Review of finger print sensing technologies
- IEEE Conference Publication. Retrieved 20 November 2019, from
[Link]
 21

[Quote: “In comparison with other biometric technologies fingerprints are most universal,
unique and permanent biometrics. In addition, user acceptability is high when features can be obtained
in non-obtrusive way. Therefore, it is one of the best biometric identifiers in term of acceptability.
According to the Biometric, market reports by international biometric group from 2004–2007,
fingerprint-based biometric systems continue to be the leading biometric technology in terms of
market share, commanding more than 50% of non-AFIS biometric revenue and this will continue in
the foreseeable future.”]

[Quote: “Biometric technology is potentially hard to fraud and it uniquely identifies a person
and contemporary solution to eliminate the security vulnerability. Moreover [sic] biometric
technologies have the advantage that they are tightly bound to the individual and cannot be easily used
by a fraud. Using the fingerprint as security and identification is so popular today and almost become
the synonym for biometric systems.”]

[15] Triggs, R. (2019). How fingerprint scanners work: optical, capacitive, and ultrasonic variants
explained. Retrieved 13 November 2019, from [Link]
fingerprint- scanners-work-670934/

[Quote: “The most commonly found type of fingerprint scanner used today is the capacitive
scanner. You’ll find this type of scanner inside most smartphones these days, as it’s the most secure.
Again [sic} the name gives away the core component, providing you’re familiar with a little [sic]
electronics [sic], the capacitor.”]

[Quote: “Instead of creating a traditional image of a fingerprint, capacitive fingerprint scanners

use arrays tiny capacitor circuits to collect data about a fingerprint. As capacitors can store electrical
charge, connecting them up to conductive plates on the surface of the scanner allows them to be used
to track the details of a fingerprint. The charge stored in the capacitor will be changed slightly when a
finger’s ridge is placed over the conductive plates, while an air gap will leave the charge at the
capacitor relatively unchanged. An op-amp integrator circuit is used to track these changes, which can
then be recorded by an analogue-to-digital converter.”]

[16] Anonymous. (2019). Smart Cards and Smart Card Programmer. Retrieved 21 November
2019, from [Link]