Peter Pharow

Electronic signatures for long-lasting storage purposes in electronic archives

Communication and co-operation in healthcare and welfare require a certain set of trusted third party (TTP) services describing both status and relation of communicating principals as well as their corresponding keys and attributes. Additional TTP services are needed to provide trustworthy information about dynamic issues of communication and co-operation such as time and location of processes, workflow relations, and system behaviour. Legal and ethical requirements demand securely stored patient information and well-defined access rights. Among others, electronic signatures based on asymmetric cryptography are important means for securing the integrity of a message or file as well as for accountability purposes including non-repudiation of both origin and receipt. Electronic signatures along with certified time stamps or time signatures are especially important for electronic archives in general, electronic health records (EHR) in particular, and especially for typical purposes of long-lasting storage. Apart from technical storage problems (e.g. lifetime of the storage devices, interoperability of retrieval and presentation software), this paper identifies mechanisms of e.g. re-signing and re-stamping of data items, files, messages, sets of archived items or documents, archive structures, and even whole archives.

Applications in health care using public-key certificates and attribute certificates

Security infrastructures are increasingly used in the health care and welfare sector, particularly for providing security such as confidentiality, authenticity, integrity, non-repudiation and auditing. Especially within the health care sector, there is a need for different kinds of certificates, namely public-key certificates and attribute certificates. This necessity is caused by the huge range of processes and procedures deriving front different application areas within the health care sector. This leads to a large amount of specific and different roles, rules, access rights, and permissions for each health professional. An important security token within health care is represented by a smart card, called the health professional card (HPC). Existing solutions e.g. the German HPC, prototypes and European as well as national projects, activities, and initiatives, show the state of the art with respect to certificates. Finally, we point out unsolved problems regarding security infrastructures, jurisdiction, data protection, and advertizing via the Internet.

Chipkarten als Sicherheitswerkzeug in einem regionalen klinischen Tumorregister

Die Implementierung einer verteilten elektronischen Krankenakte uber die Organisations-grenzen einer Leistungsstelle hinaus erfordert eine vertrauenswurdige Kommunikation und Kooperation, die durch rechtliche, organisatorische und technische Bedingungen und Masnahmen zu gewahrleisten sind. Dies gilt um so mehr fur onkologische Dokumentationssysteme mit ihren besonderen medizinischen, sozialen und ethischen Implikationen. Alle Dimensionen der Datensicherheit und des Datenschutzes sind dabei zu berucksichtigen, wobei kryptographische Techniken das Mittel der Wahl zur Realisierung der Sicherheitsanforderungen sind. Im regionalen klinischen Tumorregister Magdeburg/Sachsen-Anhalt wurden Chipkarten als Sicherheitswerkzeuge und eine entsprechende Sicherheitsinfrastruktur pilotierend eingefuhrt. Im vorliegenden Beitrag werden Bedrohungen, Sicherheitsanforderungen und Sicherheitslosungen in verteilten Informations- und Kommunikationssystemen diskutiert. Die Architektur der verwendeten Chipkarten und insbesondere die organisierte und implementierte TTP-Struktur werden vorgestellt. Aufgrund der Verallgemeinerung der Ergebnisse sind die Losungen sowohl fur das Gesundheitswesen als auch fur andere Bereiche von Interesse.

Wege zur elektronischen Patientenakte

ZusammenfassungDie elektronische Patientenakte ist die Kernapplikation jeder Gesundheitstelematik-Plattform. Was haben wir — was brauchen wir für e-Health Europe?

Onconet: A Telematics Applications Programme Project Result

Resulting from projects launched by the European Commission within the fifth framework such as ISHTAR, TrustHealth, Euromed-ETS or MERDSEC, a security infrastructure has been implemented for enabling trustworthy communication and co-operation between healthcare applications. This security infrastructure consists of Health Professional Cards (HPC) as security tokens and a Trusted Third Party (TTP) providing the Public Key Infrastructure needed for the asymmetric kryptographic algorithms used for security services based on digital signatures such as strong authentication, integrity check, accountability but also for session key exchange. The solutions implemented are solely based on international standards. The generic security solution has been applied to establish a trustworthy healthcare network for seamless care of cancer patients. This shared care application enables the exchange of partial or complete Electronic Healthcare Records (EHCR) in oncology but also queries and statistical analysis about entities etc. The solution is used to support administration of cancer patients, clinical studies, education, research and development, but also quality assurance and optimisation of diagnosis and treatment.

Sicherheitsumgebung für chipkartenbasierte Informationssysteme im Gesundheitswesen

Im heutigen Gesundheitswesen spielen chipkartenbasierte Informationssysteme eine immer grosere Rolle. Patientendatenkarten (PDC) erlauben einerseits dem Patienten sein Recht auf informationelle Selbstbestimmung und Mobilitat umzusetzen, und erhohen gleichzeitig Qualitat, Verbindlichkeit, Integritat und Verfugbarkeit der in der Karte gespeicherten Informationen im Sinne des „Shared Care“ Paradigmas. Unter Berucksichtigung der besonders sensitiven medizinischen Informationen mussen diese Shared Care Informationssysteme adaquate Sicherheitsdienste zur Verfugung stellen, so das nur autorisierten Personen ein beschrankter und protokollierter Zugang zu den Patientendaten in Ubereinstimmung mit dem “Need to know”-Prinzip gewahrleistet ist.