Document Confidentiality PPT

Document Confidentiality
Milan Petkovic, Ray Krasinski
Structured Documents / Security WGs
HL-7 Cambridge Meeting
October, 2010
The Problem
• Lack of persistent end-to-end encryption for CDA documents
– Distributed heterogeneous environments with multiple
– Encryption currently at transport level (e.g. TLS)
– Certain transports lack standard solutions (e.g. USB drive)
– Open document-level standard for encryption fosters interoperability
– Similar document-level encryption already defined for imaging
• Need for enabling technology towards addressing meaningful use
(HITECH), privacy legislation…
• Continua Health Alliance, national health networks, etc. foreseen as
possible adopters
Use case
Third party opinion in tele-monitoring
DMO transfers encrypted CDA document to hospital in different affinity domain
Hospital GP accesses the document
GP forwards encrypted CDA document to expert specialist
Expert specialist accesses document for 2nd opinion
Exchanging health records using USB drives
1. Doctor E-mails record summary to patient as encrypted CDA document
2. Patient detaches document and saves it on his USB drive
3. Patient shares encrypted CDA document with healthcare providers
• Document-level-encryption under discussion in IHE for
– Document encryption
– Key management
• Potential involvement of HL-7 for CDA document encryption
– Encryption at the CDA level (XML Encryption to encrypt body
and selected header fields)
– Advantage: fine-grained protection (selectively protect
metadata and content, …) which allows for routing,
searching, de-identification, etc.

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