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126-413: "Cloud computing is a paradigm for enabling network access to a scalable and elastic pool of shareable physical or virtual resources with self-service provisioning and administration on-demand." according to ISO . In 2011, the National Institute of Standards and Technology (NIST) identified five "essential characteristics" for cloud systems. Below are the exact definitions according to NIST: By 2023,

252-465: A business the potential to reduce IT operational costs by outsourcing hardware and software maintenance and support to the cloud provider. This enables the business to reallocate IT operations costs away from hardware/software spending and from personnel expenses, towards meeting other goals. In addition, with applications hosted centrally, updates can be released without the need for users to install new software. One drawback of SaaS comes with storing

378-467: A business plan for future computing and the Internet . The company's ambition was to supercharge sales with "cloud computing-enabled applications". The business plan foresaw that online consumer file storage would likely be commercially successful. As a result, Compaq decided to sell server hardware to internet service providers . In the 2000s, the application of cloud computing began to take shape with

504-698: A Privacy Official and a contact person responsible for receiving complaints and train all members of their workforce in procedures regarding PHI. An individual who believes that the Privacy Rule is not being upheld can file a complaint with the Department of Health and Human Services Office for Civil Rights (OCR). In 2006 the Wall Street Journal reported that the OCR had a long backlog and ignores most complaints. "Complaints of privacy violations have been piling up at

630-455: A Service" , "Communications as a Service", "Compute as a Service", and " Data Storage as a Service" . Infrastructure as a service (IaaS) refers to online services that provide high-level APIs used to abstract various low-level details of underlying network infrastructure like physical computing resources, location, data partitioning, scaling, security, backup, etc. A hypervisor runs the virtual machines as guests. Pools of hypervisors within

756-461: A Service) and dPaaS (Data Platform as a Service) . iPaaS enables customers to develop, execute and govern integration flows. Under the iPaaS integration model, customers drive the development and deployment of integrations without installing or managing any hardware or middleware. dPaaS delivers integration—and data-management—products as a fully managed service. Under the dPaaS model, the PaaS provider, not

882-449: A cloud platform instead of directly buying and managing the underlying hardware and software layers. With some PaaS, the underlying computer and storage resources scale automatically to match application demand so that the cloud user does not have to allocate resources manually. Some integration and data management providers also use specialized applications of PaaS as delivery models for data. Examples include iPaaS (Integration Platform as

1008-432: A collaboration agreement that allow "key industry players to negotiate in an open workshop environment" outside of ISO in a way that may eventually lead to development of an ISO standard. HIPAA The act consists of 5 titles: There are five sections to the act, known as titles. Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended

1134-405: A development environment to application developers. The provider typically develops toolkit and standards for development and channels for distribution and payment. In the PaaS models, cloud providers deliver a computing platform , typically including an operating system, programming-language execution environment, database, and the web server. Application developers develop and run their software on

1260-419: A distributed set of machines in different locations, connected to a single network or hub service. It is possible to distinguish between two types of distributed clouds: public-resource computing and volunteer cloud. According to ISO /IEC 22123-1: "multi-cloud is a cloud deployment model in which a customer uses public cloud services provided by two or more cloud service providers".   Poly cloud refers to

1386-533: A document is submitted directly for approval as a draft International Standard (DIS) to the ISO member bodies or as a final draft International Standard (FDIS), if the document was developed by an international standardizing body recognized by the ISO Council. The first step, a proposal of work (New Proposal), is approved at the relevant subcommittee or technical committee (e.g., SC 29 and JTC 1 respectively in

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1512-556: A form of virtualized computing." according to ISO . Function as a service is a form of serverless computing. The deployment of services to the cloud is referred to as cloud migration. Reverse cloud migration, also known as cloud repatriation, refers to moving cloud-based workloads back to on-premises infrastructures including enterprise data centers, colocation providers, and managed service providers. Cloud repatriation occurs due to security concerns, costs, performance issues, compatibility problems, and uptime concerns. Private cloud

1638-701: A health insurer to a health care provider either directly or via a financial institution. The EDI Benefit Enrollment and Maintenance Set (834) can be used by employers, unions, government agencies, associations or insurance agencies to enroll members to a payer. The payer is a healthcare organization that pays claims, administers insurance or benefit or product. Examples of payers include an insurance company, healthcare professional (HMO), preferred provider organization (PPO), government agency (Medicaid, Medicare etc.) or any organization that may be contracted by one of these former groups. EDI Payroll Deducted , and another group, Premium Payment for Insurance Products (820),

1764-442: A long process that commonly starts with the proposal of new work within a committee. Some abbreviations used for marking a standard with its status are: Abbreviations used for amendments are: Other abbreviations are: International Standards are developed by ISO technical committees (TC) and subcommittees (SC) by a process with six steps: The TC/SC may set up working groups  (WG) of experts for

1890-620: A one-year extension for certain "small plans". By regulation, the HHS extended the HIPAA privacy rule to independent contractors of covered entities who fit within the definition of "business associates". PHI is any information that is held by a covered entity regarding health status, provision of health care, or health care payment that can be linked to any individual. This is interpreted rather broadly and includes any part of an individual's medical record or payment history. Covered entities must disclose PHI to

2016-487: A one-year extension to all parties. On January 1, 2012, newer versions, ASC X12 005010 and NCPDP D.0 become effective, replacing the previous ASC X12 004010 and NCPDP 5.1 mandate. The ASC X12 005010 version provides a mechanism allowing the use of ICD-10-CM as well as other improvements. Under HIPAA, HIPAA-covered health plans are now required to use standardized HIPAA electronic transactions. See, 42 USC § 1320d-2 and 45 CFR Part 162. Information about this can be found in

2142-533: A proposal to form a new global standards body. In October 1946, ISA and UNSCC delegates from 25 countries met in London and agreed to join forces to create the International Organization for Standardization. The organization officially began operations on 23 February 1947. ISO Standards were originally known as ISO Recommendations ( ISO/R ), e.g., " ISO 1 " was issued in 1951 as "ISO/R 1". ISO

2268-618: A provider, recipient or authorized agent regarding the status of a health care claim or encounter, or to request additional information from the provider regarding a health care claim or encounter. This transaction set is not intended to replace the Health Care Claim Payment/Advice Transaction Set (835) and therefore, is not used for account payment posting. The notification is at a summary or service line detail level. The notification may be solicited or unsolicited. EDI Health Care Service Review Information (278)

2394-668: A reasonable effort to disclose only the minimum necessary information required to achieve its purpose. The Privacy Rule gives individuals the right to request a covered entity to correct any inaccurate PHI. Also, it requires covered entities to take some reasonable steps on ensuring the confidentiality of communications with individuals. For example, an individual can ask to be called at their work number instead of home or cell phone numbers. The Privacy Rule requires covered entities to notify individuals of uses of their PHI. Covered entities must also keep track of disclosures of PHI and document privacy policies and procedures. They must appoint

2520-436: A relatively small number of standards, ISO standards are not available free of charge, but rather for a purchase fee, which has been seen by some as unaffordable for small open-source projects. The process of developing standards within ISO was criticized around 2007 as being too difficult for timely completion of large and complex standards, and some members were failing to respond to ballots, causing problems in completing

2646-528: A result, if a patient is unconscious or otherwise unable to choose to be included in the directory, relatives and friends might not be able to find them, Goldman said. HIPAA was intended to make the health care system in the United States more efficient by standardizing health care transactions. HIPAA added a new Part C titled "Administrative Simplification" to Title XI of the Social Security Act. This

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2772-482: A set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. Although it's not specifically named in the HIPAA Legislation or Final Rule, it's necessary for X12 transaction set processing. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. This standard doesn't cover

2898-508: A significant physical footprint, requiring allocations of space, hardware, and environmental controls. These assets have to be refreshed periodically, resulting in additional capital expenditures. They have attracted criticism because users "still have to buy, build, and manage them" and thus do not benefit from less hands-on management, essentially "[lacking] the economic model that makes cloud computing such an intriguing concept". Cloud services are considered "public" when they are delivered over

3024-531: A single attack—a process he called "hyperjacking". Some examples of this include the Dropbox security breach, and iCloud 2014 leak. Dropbox had been breached in October 2014, having over seven million of its users passwords stolen by hackers in an effort to get monetary value from it by Bitcoins (BTC). By having these passwords, they are able to read private data as well as have this data be indexed by search engines (making

3150-453: A single new NPI. The NPI replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs. However, the NPI does not replace a provider's DEA number, state license number, or tax identification number. The NPI is 10 digits (may be alphanumeric), with the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply

3276-421: A specific community with common concerns (security, compliance, jurisdiction, etc.), whether it is managed internally or by a third-party, and hosted internally or externally, the costs are distributed among fewer users compared to a public cloud (but more than a private cloud). As a result, only a portion of the potential cost savings of cloud computing is achieved. A cloud computing platform can be assembled from

3402-423: A suspect, a fugitive, a material witness, or a missing person. A covered entity may disclose PHI to certain parties to facilitate treatment, payment, or health care operations without a patient's express written authorization. Any other disclosures of PHI require the covered entity to obtain written authorization from the individual for disclosure. In any case, when a covered entity discloses any PHI, it must make

3528-487: A thin client interface, such as a web browser (e.g., web-based email), or a program interface. The consumer does not manage or control the underlying cloud infrastructure including network, servers, operating systems, storage, or even individual application capabilities, with the possible exception of limited user-specific application configuration settings. In the software as a service (SaaS) model, users gain access to application software and databases . Cloud providers manage

3654-922: A way regulated by HIPAA. Per the requirements of Title II, the HHS has promulgated five rules regarding Administrative Simplification: the Privacy Rule, the Transactions and Code Sets Rule, the Security Rule, the Unique Identifiers Rule, and the Enforcement Rule. The HIPAA Privacy Rule is composed of national regulations for the use and disclosure of Protected Health Information (PHI) in healthcare treatment, payment and operations by "covered entities" (generally, health care clearinghouses, employer-sponsored health plans, health insurers, and medical service providers that engage in certain transactions). The Privacy Rule came into effect on April 14, 2003, with

3780-637: Is "to develop worldwide Information and Communication Technology (ICT) standards for business and consumer applications." There was previously also a JTC 2 that was created in 2009 for a joint project to establish common terminology for "standardization in the field of energy efficiency and renewable energy sources". It was later disbanded. As of 2022 , there are 167 national members representing ISO in their country, with each country having only one member. ISO has three membership categories, Participating members are called "P" members, as opposed to observing members, who are called "O" members. ISO

3906-537: Is a need for understanding complex technologies and their interconnections to have power and agency within them. The metaphor of the cloud can be seen as problematic as cloud computing retains the aura of something noumenal and numinous ; it is something experienced without precisely understanding what it is or how it works. Additionally, cloud migration is a significant challenge. This process involves transferring data, applications, or workloads from one cloud environment to another, or from on-premises infrastructure to

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4032-534: Is a relatively recent model in cloud computing, with most BaaS startups dating from 2011 or later but trends indicate that these services are gaining significant mainstream traction with enterprise consumers. "Serverless computing is a cloud service category in which the customer can use different cloud capabilities types without the customer having to provision, deploy and manage either hardware or software resources, other than providing customer application code or providing customer data. Serverless computing represents

4158-415: Is a transaction set for making a premium payment for insurance products. It can be used to order a financial institution to make a payment to a payee. EDI Health Care Eligibility/Benefit Inquiry (270) is used to inquire about the health care benefits and eligibility associated with a subscriber or dependent. EDI Health Care Eligibility/Benefit Response (271) is used to respond to a request inquiry about

4284-414: Is a transaction set that can be used to transmit health care service information, such as subscriber, patient, demographic, diagnosis or treatment data for the purpose of the request for review, certification, notification or reporting the outcome of a health care services review. EDI Functional Acknowledgement Transaction Set (997) is a transaction set that can be used to define the control structures for

4410-462: Is a voluntary organization whose members are recognized authorities on standards, each one representing one country. Members meet annually at a General Assembly to discuss the strategic objectives of ISO. The organization is coordinated by a central secretariat based in Geneva . A council with a rotating membership of 20 member bodies provides guidance and governance, including setting the annual budget of

4536-464: Is abused, ISO should halt the process... ISO is an engineering old boys club and these things are boring so you have to have a lot of passion ... then suddenly you have an investment of a lot of money and lobbying and you get artificial results. The process is not set up to deal with intensive corporate lobbying and so you end up with something being a standard that is not clear. International Workshop Agreements (IWAs) are documents that establish

4662-508: Is an abbreviation for "International Standardization Organization" or a similar title in another language, the letters do not officially represent an acronym or initialism . The organization provides this explanation of the name: Because 'International Organization for Standardization' would have different acronyms in different languages (IOS in English, OIN in French), our founders decided to give it

4788-512: Is approved as an International Standard (IS) if a two-thirds majority of the P-members of the TC/SC is in favour and not more than one-quarter of the total number of votes cast are negative. After approval, the document is published by the ISO central secretariat , with only minor editorial changes introduced in the publication process before the publication as an International Standard. Except for

4914-550: Is cloud infrastructure operated solely for a single organization, whether managed internally or by a third party, and hosted either internally or externally. Undertaking a private cloud project requires significant engagement to virtualize the business environment, and requires the organization to reevaluate decisions about existing resources. It can improve business, but every step in the project raises security issues that must be addressed to prevent serious vulnerabilities. Self-run data centers are generally capital intensive. They have

5040-536: Is delivered to a designated third party such as a family care provider. An individual may also request (in writing) that the provider send PHI to a designated service used to collect or manage their records, such as a Personal Health Record application. For example, a patient can request in writing that her ob-gyn provider digitally transmit records of her latest prenatal visit to a pregnancy self-care app that she has on her mobile phone. According to their interpretations of HIPAA, hospitals will not reveal information over

5166-522: Is funded by a combination of: International standards are the main products of ISO. It also publishes technical reports, technical specifications, publicly available specifications, technical corrigenda (corrections), and guides. International standards Technical reports For example: Technical and publicly available specifications For example: Technical corrigenda ISO guides For example: ISO documents have strict copyright restrictions and ISO charges for most copies. As of 2020 ,

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5292-426: Is in the cloud at any time. It could accidentally or deliberately alter or delete information. Many cloud providers can share information with third parties if necessary for purposes of law and order without a warrant. That is permitted in their privacy policies, which users must agree to before they start using cloud services. Solutions to privacy include policy and legislation as well as end-users' choices for how data

5418-489: Is more secure for them to use a public cloud. There is the risk that end users do not understand the issues involved when signing on to a cloud service (persons sometimes do not read the many pages of the terms of service agreement, and just click "Accept" without reading). This is important now that cloud computing is common and required for some services to work, for example for an intelligent personal assistant (Apple's Siri or Google Assistant ). Fundamentally, private cloud

5544-495: Is no hypervisor overhead. IaaS clouds often offer additional resources such as a virtual-machine disk-image library, raw block storage , file or object storage , firewalls, load balancers , IP addresses , virtual local area networks (VLANs), and software bundles. The NIST 's definition of cloud computing describes IaaS as "where the consumer is able to deploy and run arbitrary software, which can include operating systems and applications. The consumer does not manage or control

5670-425: Is produced, for example, for audio and video coding standards is called a verification model (VM) (previously also called a "simulation and test model"). When a sufficient confidence in the stability of the standard under development is reached, a working draft (WD) is produced. This is in the form of a standard, but is kept internal to working group for revision. When a working draft is sufficiently mature and

5796-453: Is reduced visibility and control. Cloud users may not have full insight into how their cloud resources are managed, configured, or optimized by their providers. They may also have limited ability to customize or modify their cloud services according to their specific needs or preferences. Complete understanding of all technology may be impossible, especially given the scale, complexity, and deliberate opacity of contemporary systems; however, there

5922-489: Is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of health care services within a specific health care/insurance industry segment. For example, a state mental health agency may mandate all healthcare claims, Providers and health plans who trade professional (medical) health care claims electronically must use the 837 Health Care Claim: Professional standard to send in claims. As there are many different business applications for

6048-449: Is required or between payers and regulatory agencies to monitor the rendering, billing, and/or payment of retail pharmacy services within the pharmacy health care/insurance industry segment. The EDI Health Care Claim Payment/Advice Transaction Set (835) can be used to make a payment, send an Explanation of Benefits (EOB), send an Explanation of Payments (EOP) remittance advice , or make a payment and send an EOP remittance advice only from

6174-590: Is restricted. The organization that is known today as ISO began in 1926 as the International Federation of the National Standardizing Associations ( ISA ), which primarily focused on mechanical engineering . The ISA was suspended in 1942 during World War II but, after the war, the ISA was approached by the recently-formed United Nations Standards Coordinating Committee (UNSCC) with

6300-478: Is seen as more secure with higher levels of control for the owner, however public cloud is seen to be more flexible and requires less time and money investment from the user. The attacks that can be made on cloud computing systems include man-in-the middle attacks, phishing attacks, authentication attacks, and malware attacks. One of the largest threats is considered to be malware attacks, such as Trojan horses . Recent research conducted in 2022 has revealed that

6426-484: Is stored. Users can encrypt data that is processed or stored within the cloud to prevent unauthorized access. Identity management systems can also provide practical solutions to privacy concerns in cloud computing. These systems distinguish between authorized and unauthorized users and determine the amount of data that is accessible to each entity. The systems work by creating and describing identities, recording activities, and getting rid of unused identities. According to

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6552-438: Is supposed to simplify healthcare transactions by requiring all health plans to engage in health care transactions in a standardized way. The HIPAA/EDI ( electronic data interchange ) provision was scheduled to take effect from October 16, 2003, with a one-year extension for certain "small plans". However, due to widespread confusion and difficulty in implementing the rule, Centers for Medicare & Medicaid Services (CMS) granted

6678-466: Is transparent to the cloud user, who sees only a single access-point. To accommodate a large number of cloud users, cloud applications can be multitenant , meaning that any machine may serve more than one cloud-user organization. The pricing model for SaaS applications is typically a monthly or yearly flat fee per user, so prices become scalable and adjustable if users are added or removed at any point. It may also be free. Proponents claim that SaaS gives

6804-508: The Department of Health and Human Services (HHS) to increase the efficiency of the health-care system by creating standards for the use and dissemination of health-care information. These rules apply to "covered entities", as defined by HIPAA and the HHS. Covered entities include health plans, health care clearinghouses (such as billing services and community health information systems), and health care providers that transmit health care data in

6930-971: The IBM SmartCloud framework in 2011, and Oracle announced the Oracle Cloud in 2012. In December 2019, Amazon launched AWS Outposts, a service that extends AWS infrastructure, services, APIs , and tools to customer data centers, co-location spaces, or on-premises facilities. Advocates of public and hybrid clouds claim that cloud computing allows companies to avoid or minimize up-front IT infrastructure costs. Proponents also claim that cloud computing allows enterprises to get their applications up and running faster, with improved manageability and less maintenance, and that it enables IT teams to more rapidly adjust resources to meet fluctuating and unpredictable demand, providing burst computing capability: high computing power at certain periods of peak demand. Additional value propositions of cloud computing include: One of

7056-630: The International Electrotechnical Commission . It is headquartered in Geneva , Switzerland. The three official languages of ISO are English , French , and Russian . The International Organization for Standardization in French is Organisation internationale de normalisation and in Russian, Международная организация по стандартизации ( Mezhdunarodnaya organizatsiya po standartizatsii ). Although one might think ISO

7182-598: The International Organization for Standardization (ISO) had expanded and refined the list. The history of cloud computing extends back to the 1960s, with the initial concepts of time-sharing becoming popularized via remote job entry (RJE). The "data center" model, where users submitted jobs to operators to run on mainframes, was predominantly used during this era. This was a time of exploration and experimentation with ways to make large-scale computing power available to more users through time-sharing , optimizing

7308-540: The Privacy section of the Health Information Technology for Economic and Clinical Health Act ( HITECH Act ). The Privacy Rule requires medical providers to give individuals access to their PHI. After an individual requests information in writing (typically using the provider's form for this purpose), a provider has up to 30 days to provide a copy of the information to the individual. An individual may request

7434-472: The "backend" as a service (m) model, also known as "mobile backend as a service" (MBaaS), web app and mobile app developers are provided with a way to link their applications to cloud storage and cloud computing services with application programming interfaces (APIs) exposed to their applications and custom software development kits (SDKs). Services include user management, push notifications , integration with social networking services and more. This

7560-502: The Cloud Security Alliance, the top three threats in the cloud are Insecure Interfaces and APIs , Data Loss & Leakage , and Hardware Failure —which accounted for 29%, 25% and 10% of all cloud security outages respectively. Together, these form shared technology vulnerabilities. In a cloud provider platform being shared by different users, there may be a possibility that information belonging to different customers resides on

7686-440: The Department of Health and Human Services. Between April of 2003 and November 2006, the agency fielded 23,886 complaints related to medical-privacy rules, but it has not yet taken any enforcement actions against hospitals, doctors, insurers or anyone else for rule violations. A spokesman for the agency says it has closed three-quarters of the complaints, typically because it found no violation or after it provided informal guidance to

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7812-690: The Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code. Furthermore, Title I addresses the issue of "job lock" which is the inability for an employee to leave their job because they would lose their health coverage. To combat the job lock issue, the Title protects health insurance coverage for workers and their families if they lose or change their jobs. Title I requires

7938-656: The Health Care claim, there can be slight derivations to cover off claims involving unique claims such as for institutions, professionals, chiropractors, dentists, etc. EDI Retail Pharmacy Claim Transaction ( NCPDP Telecommunications is used to submit retail pharmacy claims to payers by health care professionals who dispense medications, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit claims for retail pharmacy services and billing payment information between payers with different payment responsibilities where coordination of benefits

8064-688: The ISO Statutes. ISO was founded on 23 February 1947, and (as of July 2024 ) it has published over 25,000 international standards covering almost all aspects of technology and manufacturing. It has over 800 technical committees (TCs) and subcommittees (SCs) to take care of standards development. The organization develops and publishes international standards in technical and nontechnical fields, including everything from manufactured products and technology to food safety, transport, IT, agriculture, and healthcare. More specialized topics like electrical and electronic engineering are instead handled by

8190-577: The Internet: Commercialization, privatization, broader access leads to the modern Internet: Examples of Internet services: The International Organization for Standardization ( ISO / ˈ aɪ s oʊ / ) is an independent, non-governmental , international standard development organization composed of representatives from the national standards organizations of member countries. Membership requirements are given in Article 3 of

8316-469: The Privacy Rule creates a right for any individual to refuse to disclose any health information (such as chronic conditions or immunization records) if requested by an employer or business. HIPAA Privacy Rule requirements merely place restrictions on disclosure by covered entities and their business associates without the consent of the individual whose records are being requested; they do not place any restrictions upon requesting health information directly from

8442-620: The Rule identifies various security standards, and for each standard, it names both required and addressable implementation specifications. Required specifications must be adopted and administered as dictated by the Rule. Addressable specifications are more flexible. Individual covered entities can evaluate their own situation and determine the best way to implement addressable specifications. Some privacy advocates have argued that this "flexibility" may provide too much latitude to covered entities. Software tools have been developed to assist covered entities in

8568-485: The Trojan horse injection method is a serious problem with harmful impacts on cloud computing systems. The National Institute of Standards and Technology recognized three cloud service models in 2011: Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS). The International Organization for Standardization (ISO) later identified additional models in 2023, including "Network as

8694-512: The advocacy group Health Privacy Project , said that some hospitals are being "overcautious" and misapplying the law, the Times reports. Suburban Hospital in Bethesda, Md., has interpreted a federal regulation that requires hospitals to allow patients to opt out of being included in the hospital directory as meaning that patients want to be kept out of the directory unless they specifically say otherwise. As

8820-425: The application runs. This eliminates the need to install and run the application on the cloud user's own computers, which simplifies maintenance and support. Cloud applications differ from other applications in their scalability—which can be achieved by cloning tasks onto multiple virtual machines at run-time to meet changing work demand. Load balancers distribute the work over the set of virtual machines. This process

8946-544: The benefits of multiple deployment models. Hybrid cloud can also mean the ability to connect collocation, managed and/or dedicated services with cloud resources. Gartner defines a hybrid cloud service as a cloud computing service that is composed of some combination of private, public and community cloud services, from different service providers. A hybrid cloud service crosses isolation and provider boundaries so that it cannot be simply put in one category of private, public, or community cloud service. It allows one to extend either

9072-482: The capabilities of the enterprise to deliver a specific business service through the addition of externally available public cloud services. Hybrid cloud adoption depends on a number of factors such as data security and compliance requirements, level of control needed over data, and the applications an organization uses. Another example of hybrid cloud is one where IT organizations use public cloud computing resources to meet temporary capacity needs that can not be met by

9198-440: The capacity or the capability of a cloud service, by aggregation, integration or customization with another cloud service. Varied use cases for hybrid cloud composition exist. For example, an organization may store sensitive client data in house on a private cloud application, but interconnect that application to a business intelligence application provided on a public cloud as a software service. This example of hybrid cloud extends

9324-479: The case of MPEG, the Moving Picture Experts Group ). A working group (WG) of experts is typically set up by the subcommittee for the preparation of a working draft (e.g., MPEG is a collection of seven working groups as of 2023). When the scope of a new work is sufficiently clarified, some of the working groups may make an open request for proposals—known as a "call for proposals". The first document that

9450-436: The case of electronic record requests. Individuals have the broad right to access their health-related information, including medical records, notes, images, lab results, and insurance and billing information. Explicitly excluded are the private psychotherapy notes of a provider, and information gathered by a provider to defend against a lawsuit. Providers can charge a reasonable amount that relates to their cost of providing

9576-418: The central secretariat. The technical management board is responsible for more than 250 technical committees , who develop the ISO standards. ISO has a joint technical committee (JTC) with the International Electrotechnical Commission (IEC) to develop standards relating to information technology (IT). Known as JTC 1 and entitled "Information technology", it was created in 1987 and its mission

9702-440: The cloud infrastructure consumer-created or acquired applications created using programming languages, libraries, services, and tools supported by the provider. The consumer does not manage or control the underlying cloud infrastructure including network, servers, operating systems, or storage, but has control over the deployed applications and possibly configuration settings for the application-hosting environment. PaaS vendors offer

9828-405: The cloud infrastructure. In this model, the cloud user patches and maintains the operating systems and the application software. Cloud providers typically bill IaaS services on a utility computing basis: cost reflects the number of resources allocated and consumed. The NIST 's definition of cloud computing defines Platform as a Service as: The capability provided to the consumer is to deploy onto

9954-495: The cloud operational system can support large numbers of virtual machines and the ability to scale services up and down according to customers' varying requirements. Linux containers run in isolated partitions of a single Linux kernel running directly on the physical hardware. Linux cgroups and namespaces are the underlying Linux kernel technologies used to isolate, secure and manage the containers. The use of containers offers higher performance than virtualization because there

10080-448: The cloud provider, the company typically does not offer monetary compensation. Instead, eligible users may receive credits as outlined in the corresponding SLA. Cloud computing abstractions aim to simplify resource management, but leaky abstractions can expose underlying complexities. These variations in abstraction quality depend on the cloud vendor, service and architecture . Mitigating leaky abstractions requires users to understand

10206-458: The cloud. Cloud migration can be complicated, time-consuming, and expensive, particularly when there are compatibility issues between different cloud platforms or architectures. If not carefully planned and executed, cloud migration can lead to downtime, reduced performance, or even data loss. According to the 2024 State of the Cloud Report by Flexera , approximately 50% of respondents identified

10332-421: The confidence people have in the standards setting process", and alleged that ISO did not carry out its responsibility. He also said that Microsoft had intensely lobbied many countries that traditionally had not participated in ISO and stacked technical committees with Microsoft employees, solution providers, and resellers sympathetic to Office Open XML: When you have a process built on trust and when that trust

10458-454: The copy, however, no charge is allowable when providing data electronically from a certified EHR using the "view, download, and transfer" feature which is required for certification. When delivered to the individual in electronic form, the individual may authorize delivery using either encrypted or unencrypted email, delivery using media (USB drive, CD, etc., which may involve a charge), direct messaging (a secure email technology in common use in

10584-448: The coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits in relation to preexisting conditions for either 12 months following enrollment in the plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they have had "creditable coverage" before enrolling in

10710-442: The customer, manages the development and execution of programs by building data applications for the customer. dPaaS users access data through data-visualization tools. The NIST 's definition of cloud computing defines Software as a Service as: The capability provided to the consumer is to use the provider's applications running on a cloud infrastructure . The applications are accessible from various client devices through either

10836-406: The data is in the cloud initially hampered adoption of cloud for big data , but now that much data originates in the cloud and with the advent of bare-metal servers , the cloud has become a solution for use cases including business analytics and geospatial analysis . International Organization for Standardization Early research and development: Merging the networks and creating

10962-639: The definition of "significant harm" to an individual in the analysis of a breach was updated to provide more scrutiny to covered entities with the intent of disclosing breaches that previously were unreported. Previously, an organization needed proof that harm had occurred whereas now organizations must prove that harm had not occurred. Protection of PHI was changed from indefinite to 50 years after death. More severe penalties for violation of PHI privacy requirements were also approved. The HIPAA Privacy rule may be waived during disasters. Limited waivers have been issued in cases such as Hurricane Harvey in 2017. See

11088-413: The document, the draft is then approved for submission as a Final Draft International Standard (FDIS) if a two-thirds majority of the P-members of the TC/SC are in favour and if not more than one-quarter of the total number of votes cast are negative. ISO will then hold a ballot among the national bodies where no technical changes are allowed (a yes/no final approval ballot), within a period of two months. It

11214-644: The establishment of Amazon Web Services (AWS) in 2002, which allowed developers to build applications independently. In 2006 Amazon Simple Storage Service, known as Amazon S3 , and the Amazon Elastic Compute Cloud (EC2) were released. In 2008 NASA 's development of the first open-source software for deploying private and hybrid clouds. The following decade saw the launch of various cloud services. In 2010, Microsoft launched Microsoft Azure , and Rackspace Hosting and NASA initiated an open-source cloud-software project, OpenStack . IBM introduced

11340-788: The final rule for HIPAA electronic transaction standards (74 Fed. Reg. 3296, published in the Federal Register on January 16, 2009), and on the CMS website. The EDI Health Care Claim Transaction Set (837) is used to submit health care claim billing information, encounter information, or both, except for retail pharmacy claims (see EDI Retail Pharmacy Claim Transaction). It can be sent from providers of health care services to payers, either directly or via intermediary billers and claims clearinghouses. It can also be used to transmit health care claims and billing payment information between payers with different payment responsibilities where coordination of benefits

11466-996: The following top challenges when migrating workloads to public clouds : Applications hosted in the cloud are susceptible to the fallacies of distributed computing , a series of misconceptions that can lead to significant issues in software development and deployment. In a report by Gartner , a survey of 200 IT leaders revealed that 69% experienced budget overruns in their organizations' cloud expenditures during 2023. Conversely, 31% of IT leaders whose organizations stayed within budget attributed their success to accurate forecasting and budgeting, proactive monitoring of spending, and effective optimization. Typically, cloud providers' Service Level Agreements (SLAs) do not encompass all forms of service interruptions. Exclusions typically include planned maintenance, downtime resulting from external factors such as network issues, human errors , like misconfigurations, natural disasters , force majeure events, or security breaches . Typically, customers bear

11592-427: The functionality of the solutions, cost , integrational and organizational aspects as well as safety & security are influencing the decision of enterprises and organizations to choose a public cloud or on-premises solution. Hybrid cloud is a composition of a public cloud and a private environment, such as a private cloud or on-premises resources, that remain distinct entities but are bound together, offering

11718-551: The general calculation (e.g., the beneficiary may be counted with 18 months of general coverage, but only 6 months of dental coverage, because the beneficiary did not have a general health plan that covered dental until 6 months prior to the application date). Since limited-coverage plans are exempt from HIPAA requirements, the odd case exists in which the applicant to a general group health plan cannot obtain certificates of creditable continuous coverage for independent limited-scope plans, such as dental to apply towards exclusion periods of

11844-443: The health care benefits and eligibility associated with a subscriber or dependent. EDI Health Care Claim Status Request (276) is a transaction set that can be used by a provider, recipient of health care products or services or their authorized agent to request the status of a health care claim. EDI Health Care Claim Status Notification (277) is a transaction set that can be used by a healthcare payer or authorized agent to notify

11970-533: The healthcare industry), or possibly other methods. When using unencrypted email, the individual must understand and accept the risks to privacy using this technology (the information may be intercepted and examined by others). Regardless of delivery technology, a provider must continue to fully secure the PHI while in their system and can deny the delivery method if it poses additional risk to PHI while in their system. An individual may also request (in writing) that their PHI

12096-405: The implementation details and limitations of the cloud services they utilize. Service lock-in within the same vendor occurs when a customer becomes dependent on specific services within a cloud vendor, making it challenging to switch to alternative services within the same vendor when their needs change. Cloud computing poses privacy concerns because the service provider can access the data that

12222-430: The individual within 30 days upon request. They must also disclose PHI when required to do so by law such as reporting suspected child abuse to state child welfare agencies. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; or to identify or locate

12348-421: The information in electronic form or hard-copy, and the provider is obligated to attempt to conform to the requested format. For providers using an electronic health record ( EHR ) system that is certified using CEHRT (Certified Electronic Health Record Technology) criteria, individuals must be allowed to obtain the PHI in electronic form. Providers are encouraged to provide the information expediently, especially in

12474-673: The information public). There is the problem of legal ownership of the data (If a user stores some data in the cloud, can the cloud provider profit from it?). Many Terms of Service agreements are silent on the question of ownership. Physical control of the computer equipment (private cloud) is more secure than having the equipment off-site and under someone else's control (public cloud). This delivers great incentive to public cloud computing service providers to prioritize building and maintaining strong management of secure services. Some small businesses that do not have expertise in IT security could find that it

12600-449: The infrastructure and platforms that run the applications. SaaS is sometimes referred to as "on-demand software" and is usually priced on a pay-per-use basis or using a subscription fee. In the SaaS model, cloud providers install and operate application software in the cloud and cloud users access the software from cloud clients. Cloud users do not manage the cloud infrastructure and platform where

12726-584: The infrastructure, platform, and applications, and increasing efficiency for end users. The "cloud" metaphor for virtualized services dates to 1994, when it was used by General Magic for the universe of "places" that mobile agents in the Telescript environment could "go". The metaphor is credited to David Hoffman, a General Magic communications specialist, based on its long-standing use in networking and telecom. The expression cloud computing became more widely known in 1996 when Compaq Computer Corporation drew up

12852-400: The insurer stays in the market without exclusion regardless of health condition. Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans like dental or vision plans offered separately from the general health plan. However, if such benefits are part of the general health plan, then HIPAA still applies to such benefits. For example, if

12978-479: The main challenges of cloud computing, in comparison to more traditional on-premises computing, is data security and privacy. Cloud users entrust their sensitive data to third-party providers, who may not have adequate measures to protect it from unauthorized access, breaches, or leaks. Cloud users also face compliance risks if they have to adhere to certain regulations or standards regarding data protection, such as GDPR or HIPAA . Another challenge of cloud computing

13104-708: The necessary steps within the prescribed time limits. In some cases, alternative processes have been used to develop standards outside of ISO and then submit them for its approval. A more rapid "fast-track" approval procedure was used in ISO/IEC JTC 1 for the standardization of Office Open XML (OOXML, ISO/IEC 29500, approved in April 2008), and another rapid alternative "publicly available specification" (PAS) process had been used by OASIS to obtain approval of OpenDocument as an ISO/IEC standard (ISO/IEC 26300, approved in May 2006). As

13230-441: The new plan offers dental benefits, then it must count creditable continuous coverage under the old health plan towards any of its exclusion periods for dental benefits. An alternate method of calculating creditable continuous coverage is available to the health plan under Title I. That is, 5 categories of health coverage can be considered separately, including dental and vision coverage. Anything not under those 5 categories must use

13356-433: The new plan that does include those coverages. Hidden exclusion periods are not valid under Title I (e.g., "The accident, to be covered, must have occurred while the beneficiary was covered under this exact same health insurance contract"). Such clauses must not be acted upon by the health plan. Also, they must be re-written so they can comply with HIPAA. Title II of HIPAA establishes policies and procedures for maintaining

13482-489: The next stage, called the "enquiry stage". After a consensus to proceed is established, the subcommittee will produce a draft international standard (DIS), and the text is submitted to national bodies for voting and comment within a period of five months. A document in the DIS stage is available to the public for purchase and may be referred to with its ISO DIS reference number. Following consideration of any comments and revision of

13608-518: The parties involved." However, in July 2011, the University of California, Los Angeles agreed to pay $ 865,500 in a settlement regarding potential HIPAA violations. An HHS Office for Civil Rights investigation showed that from 2005 to 2008, unauthorized employees repeatedly and without legitimate cause looked at the electronic protected health information of numerous UCLAHS patients. It is a misconception that

13734-587: The phone to relatives of admitted patients. This has, in some instances, impeded the location of missing persons. After the Asiana Airlines Flight 214 San Francisco crash, some hospitals were reluctant to disclose the identities of passengers that they were treating, making it difficult for Asiana and the relatives to locate them. In one instance, a man in Washington state was unable to obtain information about his injured mother. Janlori Goldman, director of

13860-744: The plan and after any "significant breaks" in coverage. "Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage is defined as any 63-day period without any creditable coverage. Along with an exception, it allows employers to tie premiums or co-payments to tobacco use, or body mass index. Title I mandates that insurance providers must issue policies without exclusions to individuals leaving group health plans, provided they have maintained continuous, credible coverage. (see above) exceeding 18 months, and renew individual policies for as long as they are offered or provide alternatives to discontinued plans for as long as

13986-411: The preparation of a working drafts. Subcommittees may have several working groups, which may have several Sub Groups (SG). It is possible to omit certain stages, if there is a document with a certain degree of maturity at the start of a standardization project, for example, a standard developed by another organization. ISO/IEC directives also allow the so-called "Fast-track procedure". In this procedure,

14112-401: The privacy and the security of individually identifiable health information, outlines numerous offenses relating to health care, and establishes civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health-care system. However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires

14238-729: The private cloud. This capability enables hybrid clouds to employ cloud bursting for scaling across clouds. Cloud bursting is an application deployment model in which an application runs in a private cloud or data center and "bursts" to a public cloud when the demand for computing capacity increases. A primary advantage of cloud bursting and a hybrid cloud model is that an organization pays for extra compute resources only when they are needed. Cloud bursting enables data centers to create an in-house IT infrastructure that supports average workloads, and use cloud resources from public or private clouds, during spikes in processing demands. Community cloud shares infrastructure between several organizations from

14364-498: The public Internet, and they may be offered as a paid subscription, or free of charge. Architecturally, there are few differences between public- and private-cloud services, but security concerns increase substantially when services (applications, storage, and other resources) are shared by multiple customers. Most public-cloud providers offer direct-connection services that allow customers to securely link their legacy data centers to their cloud-resident applications. Several factors like

14490-509: The responsibility of monitoring SLA compliance and must file claims for any unmet SLAs within a designated timeframe. Customers should be aware of how deviations from SLAs are calculated, as these parameters may vary by service. These requirements can place a considerable burden on customers. Additionally, SLA percentages and conditions can differ across various services within the same provider, with some services lacking any SLA altogether. In cases of service interruptions due to hardware failures in

14616-679: The risk analysis and remediation tracking. The standards and specifications are as follows: HIPAA covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans must use only the National Provider Identifier (NPI) to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. Effective from May 2006 (May 2007 for small health plans), all covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies, and so forth) must use

14742-490: The same data server. Additionally, Eugene Schultz , chief technology officer at Emagined Security, said that hackers are spending substantial time and effort looking for ways to penetrate the cloud. "There are some real Achilles' heels in the cloud infrastructure that are making big holes for the bad guys to get into". Because data from hundreds or thousands of companies can be stored on large cloud servers, hackers can theoretically gain control of huge stores of information through

14868-527: The semantic meaning of the information encoded in the transaction sets. The Final Rule on Security Standards was issued on February 20, 2003. The Security Rule complements the Privacy Rule. While the Privacy Rule pertains to all Protected Health Information (PHI) including paper and electronic, the Security Rule deals specifically with Electronic Protected Health Information (EPHI). It lays out three types of security safeguards required for compliance: administrative, physical, and technical. For each of these types,

14994-468: The short form ISO . ISO is derived from the Greek word isos ( ίσος , meaning "equal"). Whatever the country, whatever the language, the short form of our name is always ISO . During the founding meetings of the new organization, however, the Greek word explanation was not invoked, so this meaning may be a false etymology . Both the name ISO and the ISO logo are registered trademarks and their use

15120-501: The subcommittee is satisfied that it has developed an appropriate technical document for the problem being addressed, it becomes a committee draft (CD) and is sent to the P-member national bodies of the SC for the collection of formal comments. Revisions may be made in response to the comments, and successive committee drafts may be produced and circulated until consensus is reached to proceed to

15246-525: The subject of that information. In January 2013, HIPAA was updated via the Final Omnibus Rule. The updates included changes to the Security Rule and Breach Notification portions of the HITECH Act. The most significant changes related to the expansion of requirements to include business associates, where only covered entities had originally been held to uphold these sections of the law. In addition,

15372-414: The typical cost of a copy of an ISO standard is about US$ 120 or more (and electronic copies typically have a single-user license, so they cannot be shared among groups of people). Some standards by ISO and its official U.S. representative (and, via the U.S. National Committee, the International Electrotechnical Commission ) are made freely available. A standard published by ISO/IEC is the last stage of

15498-605: The underlying cloud infrastructure but has control over operating systems, storage, and deployed applications; and possibly limited control of select networking components (e.g., host firewalls)." IaaS-cloud providers supply these resources on-demand from their large pools of equipment installed in data centers . For wide-area connectivity, customers can use either the Internet or carrier clouds (dedicated virtual private networks ). To deploy their applications, cloud users install operating-system images and their application software on

15624-413: The use of multiple public clouds for the purpose of leveraging specific services that each provider offers. It differs from Multi cloud in that it is not designed to increase flexibility or mitigate against failures but is rather used to allow an organization to achieve more than could be done with a single provider. The issues of transferring large amounts of data to the cloud as well as data security once

15750-442: The users' data on the cloud provider's server. As a result, there could be unauthorized access to the data. Examples of applications offered as SaaS are games and productivity software like Google Docs and Office Online. SaaS applications may be integrated with cloud storage or File hosting services , which is the case with Google Docs being integrated with Google Drive , and Office Online being integrated with OneDrive . In

15876-513: Was suggested at the time by Martin Bryan, the outgoing convenor (chairman) of working group 1 (WG1) of ISO/IEC JTC 1/SC 34 , the rules of ISO were eventually tightened so that participating members that fail to respond to votes are demoted to observer status. The computer security entrepreneur and Ubuntu founder, Mark Shuttleworth , was quoted in a ZDNet blog article in 2008 about the process of standardization of OOXML as saying: "I think it de-values

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