Bandar Alhaqbani

Access control requirements for processing electronic health records

There is currently a strong focus worldwide on the potential of large-scale Electronic Health Record systems to cut costs and improve patient outcomes through increased efficiency. A number of countries are developing nationwide EHR systems to aggregate services currently provided by isolated Electronic Medical Record databases. However, such aggregation introduces new risks for patient privacy and data security, both by linking previously-separate pieces of information about an individual, and by creating single access points to a wide range of personal data. It is thus essential that new access control policies and mechanisms are devised for federated Electronic Health Record systems, to ensure not only that sensitive patient data is accessible by authorized personnel only, but also that it is available when needed in life-critical situations. Here we review the traditional security models for access control, Discretionary Access Control, Mandatory Access Control and Role-Based Access Control, and use a case study to demonstrate that no single one of them is sufficient in a federated healthcare environment. We then show how the required level of data security can be achieved through a judicious combination of all three mechanisms.

Privacy-preserving electronic health record linkage using pseudonym identifiers

Accurate and reliable information sharing is essential in the healthcare domain. Currently, however, information about individual patients is held in isolated medical records maintained by numerous separate healthcare providers. Accurately linking this information is necessary for planned nationwide Electronic Health Record systems, but this must be done in a way that not only satisfies traditional data confidentiality requirements, but also meets patientspsila personal privacy needs. Here we present an architecture for linking electronic medical records in a way that gives patients control over what information is revealed about them. This is done through the use of indirect pseudonym identifiers. We then explain how this architecture can be implemented using existing technologies. A case study is used to show how our architecture satisfies data accuracy needs and patientspsila privacy requirements.

Privacy-aware workflow management

Information security policies play an important role in achieving information security. Confidentiality, Integrity, and Availability are classic information security goals attained by enforcing appropriate security policies. Workflow Management Systems (WfMSs) also benefit from inclusion of these policies to maintain the security of business-critical data. However, in typical WfMSs these policies are designed to enforce the organisation’s security requirements but do not consider those of other stakeholders. Privacy is an important security requirement that concerns the subject of data held by an organisation. WfMSs often process sensitive data about individuals and institutions who demand that their data is properly protected, but WfMSs fail to recognise and enforce privacy policies. In this paper, we illustrate existing WfMS privacy weaknesses and introduce WfMS extensions required to enforce data privacy. We have implemented these extensions in the YAWL system and present a case scenario to demonstrate how it can enforce a subject’s privacy policy.

A Time-Variant Medical Data Trustworthiness assessment model

Electronic Health Record (EHR) systems are being introduced to overcome the limitations associated with paper-based and isolated Electronic Medical Record (EMR) systems. This is accomplished by aggregating medical data and consolidating them in one digital repository. Though an EHR system provides obvious functional benefits, there is a growing concern about the privacy and reliability (trustworthiness) of Electronic Health Records. Security requirements such as confidentiality, integrity, and availability can be satisfied by traditional hard security mechanisms. However, measuring data trustworthiness from the perspective of data entry is an issue that cannot be solved with traditional mechanisms, especially since degrees of trust change over time. In this paper, we introduce a Time-variant Medical Data Trustworthiness (TMDT) assessment model to evaluate the trustworthiness of medical data by evaluating the trustworthiness of its sources, namely the healthcare organisation where the data was created and the medical practitioner who diagnosed the patient and authorised entry of this data into the patients medical record, with respect to a certain period of time. The result can then be used by the EHR system to manipulate health record metadata to alert medical practitioners relying on the information to possible reliability problems.