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E-grāmata: Ensuring the Integrity of Electronic Health Records: The Best Practices for E-records Compliance

  • Formāts: 340 pages
  • Izdošanas datums: 21-Dec-2020
  • Izdevniecība: CRC Press
  • ISBN-13: 9781000222999
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  • Formāts: 340 pages
  • Izdošanas datums: 21-Dec-2020
  • Izdevniecība: CRC Press
  • ISBN-13: 9781000222999
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Data integrity is a critical aspect to the design, implementation, and usage of any system which stores, processes, or retrieves data. The overall intent of any data integrity technique is the same: ensure data is recorded exactly as intended and, upon later retrieval, ensure the data is the same as it was when originally recorded. Any alternation to the data is then traced to the person who made the modification. The integrity of data in a patient’s electronic health record is critical to ensuring the safety of the patient.

This book is relevant to production systems and quality control systems associated with the manufacture of pharmaceuticals and medical device products and updates the practical information to enable better understanding of the controls applicable to e-records. The book highlights the e-records suitability implementation and associated risk-assessed controls, and e-records handling. The book also provides updated regulatory standards from global regulatory organizations such as MHRA, Medicines and Healthcare Products Regulatory Agency (UK); FDA, Food and Drug Administration (US); National Medical Products Association (China); TGA, Therapeutic Goods Administration (Australia); SIMGP, Russia State Institute of Medicines and Good Practices; and the World Health Organization, to name a few.

Foreword xv
Preface xvii
1 Introduction
1(6)
References
5(1)
Additional Readings
5(2)
2 E-records Lifecycle Revisited
7(10)
Introduction
7(1)
E-records Lifecycle
8(6)
Records Identification Phase
9(1)
Records Standardization Phase
9(1)
Creation/Capture Phase
10(2)
Active Phase
12(1)
Inactive Phase
13(1)
Final Disposition Phase
13(1)
Regulatory Agencies' Expectations
14(1)
Summary
14(1)
References
14(1)
Additional Reading
15(2)
3 Data and E-records Lifecycles - A Comparison
17(8)
Introduction
17(1)
Data Lifecycle
18(2)
Record Lifecycle
20(3)
Correlation of Data and E-records Lifecycles
23(1)
References
23(2)
4 MHRA Guidance -- Revisited
25(16)
Brexit
25(1)
Introduction
25(2)
Data Governance
27(1)
Computer Systems Validation
28(1)
Requirements
29(10)
References
39(2)
5 E-records Integrity Expectations of EU GMP Inspectors
41(8)
Introduction
41(1)
EMA E-records Integrity Technical Requirements
42(1)
EU E-records Integrity Guidelines
43(1)
Expectations of EU GMP Inspectors
44(3)
Conclusion
47(1)
References
48(1)
6 Comparison of Health Authorities E-records Integrity Expectations
49(8)
Introduction
49(1)
Elements to Compare Guidance Documents
50(2)
Key Elements of Each Guidance Document
52(1)
Differences between Guidance Documents
52(2)
Consistencies between Guidance Documents
54(1)
Summary
55(1)
References
56(1)
7 Maxims of E-records Integrity
57(6)
Introduction
57(1)
Lifecycle
57(2)
A Measure of Validity
59(1)
Security
60(1)
References
61(2)
8 Vulnerabilities of E-records
63(14)
What Is Record Vulnerability?
63(1)
Protection and Security of Electronic Records
63(2)
Threats that Can Impact E-records
65(3)
Regulated Users
65(1)
Malware and Phishing Attempts
65(1)
Service Providers
65(1)
Unrestricted Access to Computers
66(1)
Inadequate Disposal of Old Hardware
67(1)
E-records Transfers
67(1)
E-records Storage
67(1)
Assessment of E-record Vulnerability, Risks, and Implementation of Control Measures
68(1)
Case Study
69(4)
Regulatory Agencies Expectations
73(1)
Summary
73(1)
References
74(3)
9 CGMP E-records Risk Management
77(6)
Introduction
77(2)
Risk Management
79(2)
Regulatory Agencies Expectations
81(1)
References
81(1)
Additional Reading
82(1)
10 CGMP E-records Risk Assessments
83(6)
Introduction
83(1)
How Can E-records Risk Be Assessed?
84(1)
Risk Assessment
85(2)
References
87(1)
Additional Reading
87(2)
11 Security Service
89(6)
Introduction
89(1)
Computer Access
89(2)
Password Policy
91(1)
Audit Trails
91(2)
Regulatory Agencies' Expectations
93(1)
References
93(2)
12 Defining and Managing Manufacturing Data
95(14)
Introduction
95(1)
Data Lifecycle
96(1)
Medicine Manufacturing Operations
96(1)
Identification of CGMP Record
97(1)
Exchange of Data
97(2)
Storage of Records
99(1)
Protection of Data and E-records
100(2)
Transient Data
101(1)
Raw Data
102(1)
Retrieval of E-records
102(1)
Retention Time
103(1)
Disposition of E-records
104(1)
Summary
105(1)
References
105(4)
13 Controls on Transient Data
109(6)
What Is Transient Data?
109(1)
Protection of Transient Data
110(2)
Regulatory Agencies' Expectations
112(1)
Summary
112(1)
References
113(2)
14 Digital Date and Timestamps
115(6)
Introduction
115(1)
System Clock
116(1)
Computer Clock Reliability
116(1)
Digital Time-Stamping Service
117(1)
Time Zone
118(1)
Computer Systems Not Networked
118(1)
Computer Clock Controls
118(1)
Regulatory Agencies' Expectations
119(1)
References
119(1)
Additional Readings
119(2)
15 E-records Migration and Its Integrity
121(4)
Introduction
121(1)
Migration Process
122(1)
Automated Migration
123(1)
Checklist for Data Migration
123(1)
Regulatory Agencies' Expectations
124(1)
References
124(1)
16 Ensuring E-records Integrity of Cloud Service Providers
125(12)
Introduction
125(1)
Cloud Service Requirements
126(4)
Selection of the Cloud Service Provider
130(1)
Service Level Agreement
131(2)
Periodic Audits
133(1)
E-records Migration
133(1)
E-records Accessibility
133(1)
Regulatory Agencies' Expectation
134(1)
Summary
134(1)
References
134(1)
Additional Readings
135(2)
17 E-records Integrity in Hybrid Systems
137(4)
Introduction
137(1)
E-records Signed with Handwritten Signatures
137(2)
Regulatory Agencies' Expectations
139(1)
References
139(2)
18 Technologies Supporting E-records Integrity
141(22)
Introduction
141(6)
Cryptographic Technologies
143(4)
Summary
147(3)
Cryptographic Technologies Apply to E-records Integrity
149(1)
E-records in Storage
150(7)
Access Controls and Authority Checks to Computer Resources
151(1)
Audit Trails Control
152(1)
Authentication
152(2)
Security of the Electronic Signatures
154(1)
Signature E-records Linkage
155(1)
Time Controls
156(1)
The Uniqueness of the Electronic Signatures
157(1)
E-records in Transit
157(2)
The Integrity of E-records in Transit
157(2)
Device Checks
159(1)
Summary
159(1)
Disclaimer
160(1)
References
161(2)
19 Integration Between Computer Systems and E-records Lifecycles
163(12)
Introduction
163(2)
Concept Period
165(1)
Project Period -- Risk Assessment
165(2)
Project Period -- Requirements
167(2)
Project Period -- Building, Testing, Documenting, and Installing
169(1)
Project Period -- E-records Migration and Computer Systems Release to Operations
170(1)
Operations Periods
170(1)
Computer System Retirement -- E-records Migration
171(1)
E-records Archiving
172(2)
E-records Final Disposition
174(1)
References
174(1)
20 Miscellaneous E-records Integrity Issues
175(16)
Introduction
175(1)
Backup as a Service
175(1)
Audit Trails Review
176(4)
Introduction
176(2)
Categories of Manufacturing-Related Audit Trails
178(1)
Product- or Batch-Specific Data
178(1)
Administration Events
179(1)
System Activities
179(1)
What Are We Looking for in an Audit Review?
179(1)
Review of Audit Trail Entries
179(1)
Guidance for "Regular Review" of Audit Trails
179(1)
What Are We Looking for in an Audit Review?
180(1)
Suspected Data Integrity Violation - What Do We Need to Do?
180(1)
Testing Audit Trails
180(1)
Databases Integrity
181(1)
Retention of E-records -- Verification
182(3)
Introduction
182(1)
Documentation
183(1)
Testing Required Concerning the Retention of E-records
184(1)
E-records Integrity in Wireless Environments
185(4)
Introduction to Wireless Environment
185(2)
Data Integrity in Wireless Environments
187(2)
References
189(2)
21 E-records Remediation Project Revisited - Medicine Manufacturing
191(10)
Introduction
191(1)
Remediation Project Fundamentals
192(1)
Evaluate E-records Controls
193(2)
Sample Project and the Evaluation of E-records Controls
195(1)
Corrective Actions Planning
195(2)
Sample Project and the Corrective Actions Planning
196(1)
Remediation
197(2)
Interpretation
197(1)
Training
197(1)
Remediation Execution
198(1)
New Applications and Application Upgrade Assessments
198(1)
Suppliers Qualification Program
198(1)
Sample Project and Remediation
199(1)
Remediation Project Report
199(1)
References
199(1)
Additional Reading
200(1)
22 Designing E-records Integrity into your Practices
201(18)
Introduction EU Annex 11
201(1)
EU Annex 11 as a Computer Data Integrity Compliance Model
202(2)
Supporting Processes Applicable to the Data Integrity Controls
204(4)
Categories of Data Integrity Controls
208(8)
Summary
216(1)
References
216(3)
23 Introduction to Data Quality
219(10)
Introduction
219(1)
Data Quality
220(1)
Data Accuracy
221(1)
Data Auditability
222(1)
Data Conformity
223(1)
Data Completeness
223(1)
Data Consistency
223(1)
Data Integrity
224(1)
Data Provenance
224(1)
Data Validity
225(1)
Data Quality Design
226(1)
Quality Control to Data
227(1)
Summary
227(1)
References
228(1)
Additional Reading
228(1)
24 Summary
229(2)
References
230(1)
Appendix I Glossary of Terms 231(38)
Appendix II Abbreviations and/or Acronyms 269(6)
Appendix III References 275(12)
Appendix IV Things That Can Go Wrong when Validating Big Data Environments 287(6)
Appendix V Data Integrity for Analytical Instruments connected to a LIMS 293(8)
Appendix VI Data Integrity -- EU Deviations 301(14)
Index 315
Orlando Lopez has significant understanding and experience with worldwide regulatory authorities regarding CSV, e-records integrity, and related requirements/guidelines related to Production Manufacturing Systems, IT Systems, Analytics, and Business Intelligence.

He has knowledge and experience in the development of governance and SLC deliverables. Wrote and deployed CSV methodology to computer infrastructure J&J worldwide. Several times he had re-engineered the computer validation methodology to regulated companies.

Orlando Lopez has experience with direct participation in FDA agency remedial action plans, regulatory inspections, response activities, and consent decree remediation related verifications.

He is published in the Encyclopedia of Pharmaceutical Science and Technology, 4th Edition - Chapter 56 Computer Systems Validation and has written 25+ publications, including 9 computer compliance related books - amazon.com/author/orlandolopez/ Familiar with gap assessment, remediation planning and remediation execution activities.