A Consent-based Workflow System for Healthcare Systems

In this paper, we describe a new framework for healthcare systems where patients are able to control the disclosure of their medical data. In our framework, the patient's consent has a pivotal role in granting or removing access rights to subjects accessing patient's medical data. Depending on the context in which the access is being executed, different consent policies can be applied. Context is expressed in terms of workflows. The execution of a task in a given workflow carries the necessary information to infer whether the consent can be implicitly retrieved or should be explicitly requested from a patient. However, patients are always able to enforce their own decisions and withdraw consent if necessary. Additionally, the use of workflows enables us to apply the need-to-know principle. Even when the patient's consent is obtained, a subject should access medical data only if it is required by the actual situation. For example, if the subject is assigned to the execution of a medical diagnosis workflow requiring access to the patient's medical record. We also provide a complex medical case study to highlight the design principles behind our framework. Finally, the implementation of the framework is outlined

An Access Control Model to Facilitate Healthcare Information Access in Context of Team Collaboration

The delivery of healthcare relies on the sharing of patients information among a group of healthcare professionals (so-called multidisciplinary teams (MDTs)). At present, electronic health records (EHRs) are widely utilized system to create, manage and share patient healthcare information among MDTs. While it is necessary to provide healthcare professionals with privileges to access patient health information, providing too many privileges may backfire when healthcare professionals accidentally or intentionally abuse their privileges. Hence, finding a middle ground, where the necessary privileges are provided and malicious usage are avoided, is necessary. This thesis highlights the access control matters in collaborative healthcare domain. Focus is mainly on the collaborative activities that are best accomplished by organized MDTs within or among healthcare organizations with an objective of accomplishing a specific task (patient treatment). Initially, we investigate the importance and challenges of effective MDTs treatment, the sharing of patient healthcare records in healthcare delivery, patient data confidentiality and the need for flexible access of the MDTs corresponding to the requirements to fulfill their duties. Also, we discuss access control requirements in the collaborative environment with respect to EHRs and usage scenario of MDTs collaboration. Additionally, we provide summary of existing access control models along with their pros and cons pertaining to collaborative health systems. Second, we present a detailed description of the proposed access control model. In this model, the MDTs is classified based on Belbin’s team role theory to ensure that privileges are provided to the actual needs of healthcare professionals and to guarantee confidentiality as well as protect the privacy of sensitive patient information. Finally, evaluation indicates that our access control model has a number of advantages including flexibility in terms of permission management, since roles and team roles can be updated without updating privilege for every user. Moreover, the level of fine-grained control of access to patient EHRs that can be authorized to healthcare providers is managed and controlled based on the job required to meet the minimum necessary standard and need-to-know principle. Additionally, the model does not add significant administrative and performance overhead.publishedVersio

How Registries Can Help Performance Measurement Improve Care

Suggests ways to better utilize databases of clinical information to evaluate care processes and outcomes and improve measurements of healthcare quality and costs, comparative clinical effectiveness research, and medical product safety surveillance