Integrated Access Control for Health Care Information Systems

Transkript

1 iaccess Integrated Access Control for Health Care Information Systems Øystein Nytrø Institutt for Datateknikk og Informasjonsvitenskap/NTNU og Nasjonalt Senter for EPJ-forskning/DMF/NTNU Both prohibited and mandatory access Prohibited Generally irrelevant Neccessary Depending upon role (relation to patient), situation which is dynamic Too much information hides necessary information 2

2 Everything is so difficult Huge number of overlapping laws and regulations, with wide room for interpretation Direct consequence for implementation and daily clinical work situation A hospital may have hundreds of clinical information systems, each with different access control. Information must flow between different health service organizations and caregivers Emergencies are normal, planned behaviour is not The industry will listen to the customer, not the regulations. 3 The Record in the Care Chain Kommunehelsetjenesten Journal 4 Primærlege Journal Lab Journal 3 Regionsykehus Journal 2 Lokalsykehus 4 Lånt av Torbjørn Nystadnes,

3 Patient and information flow Reason for encounter: Bladder pain Cystitis Blood in urine Evaluation Bladder cancer Patient Primary doctor Outpatient clinic Inpatient ward Surgery X-ray Laboratory Weeks Anders Grimsmo An example challenge Everyone providing healthcare must make a record (hpl 39-40) Care institutions (on the lowest level) must appoint a record responsible who decides what the record should contain (hpl 39) Including the right to edit signed information And decide upon correction and deletion according to hpl The record responsible is often a clinically active person having an own record. And is thus in a position to edit her own record Which is illegal 6

4 Principles of access control There must be an active decision about performing a legal care act before access to relevant information can be given. A decided act defines the objective of access and delimits the relevant information. The role of the caregiver further delimits the relevant information Roles are governed by service organizations Some care acts can only be performed as a succession of other care acts. 7 Registrer t i EPJ: Per Spellmans journal Per Spellmann, pasient Kan komme med Har Inneholder Informasjo n S a m t y k k e k r a v Medfører behov for Ola Normann Opptrer som Tjenesteyter: Ola Normann. lege, Kirurgisk avdeling Utfører Tjenesteytelse: år oppfølging Principles for access control Har Rolle: lege, Kirurgisk avdeling Basert på Rollemal: Lege ved Org. enhet: Kirurgisk avd. Gir tilgang til Opptre r som Besluttet tiltak: år oppfølging Utfører Basert på Tiltaksmal: år oppfølging Har tilknyttet 8 Kari Ås Tjenesteyter: Kari Ås, kirurg Kirurgisk avdeling Lånt av Torbjørn Nystadnes, Har beslutte t Dokumentmaler år oppfølging Prosedyrebeskr. etc. Oppfølgingsprogram

5 Goals: Both theory and effect Study principles and develop a model for integrated access control for health care information systems, thereby contributing to the access control research field and enabling more efficient and secure information dissemination in future health care services and healthcare research. Develop an access control model specifically tailored for information integration and distributed, user-centered, administration and management. Propose a method for integration of existing access control models and policies, in information systems, including integration and propagation of existing rights and statements of consent. Identify premises dictated by the Norwegian privacy legislation and propose methods for efficient sharing of sensitive health care information within the legislative privacy framework. Premises will be analysed and summarized in publications. 9 Project overview and structure SINTEF (Meland): Develop a handbook for surveying implemented or planned access control integration efforts and comparing these to best-practices and legislative requirements. Doing two-stage surveys NTNU-IDI (Nytrø - PhD): Develop theoretical models of policies and access control in complex scenarios of distributed and integrated ICT systems. The models must take into consideration both legacy and future health care information systems. UIO-AFIN (Schartum PhD2): Analyse and survey formal and legal regulations for sharing information, investigate how statutory provisions for health care have changed recently, investigate the total use of policy instruments for safe and secure access to health information International guest researchers Helse Midt-Norge/HEMIT and Rikshospitalet/CSAM Be subject for analysis and survey according Validate results from SINTEF-work Others (NSEP): Serve as experiment platform through current research projects for shared core record, medication plans, computer supported cooperative care and mobility. 0

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