Architecture of Secure Portable and Interoperable Electronic Health Records

Abstract

Electronic Health Records (EHR) are moving towards the core application of health information systems. Enabling informational interoperability of shared care environment including EHR, structure and function of components used have to follow open standards and publicly available specifications. This comprises includes also methods and tools applied. After shortly introducing general aspects of open interoperable component architectures, actual approaches for EHR systems are discussed distinguishing between the one-model and the dual-model paradigm. The emerging activities for a harmonised multi-model open EHR as well as its implementation are presented. Special attention is given to security requirements and solutions. Based on standardised Public Key Infrastructure (PKI) and security token such as Health Professional Cards (HPC), policy-defined application security services such as authorisation, access control, accountability, etc., of information recorded, stored and processed must be guaranteed. In that context, appropriate resource access decision services have to be established. As the European HARP project result, a component-based EHR architecture has been specified and demonstrated for enabling open, distributed, virtual, and portable EHR implementation with enforcing fine-grained security services by binding certificates to application components, by the way enforcing policies.