White Paper: Building a Patient-Driven Web-Based Healthcare Community Around an Emerging Personal He

White Paper: Building a Patient-Driven Web-Based Healthcare Community Around an Emerging Personal He

Steve Chi-Hung Lu, Ph.D.
CCR Exchange, Inc.

Abstract. This document demonstrates how we use open source software
in building an Internet healthcare community around an emerging
Personal Health Record standard called Continuity of Care Record (CCR)
format, and how members of the community can share healthcare
information securely and efficiently while retaining total privacy.

Keywords. Continuity of Care Record, Personal Health Record, Web
Community, Open Source Software, Public Key Infrastructure, Key
Management, Key Recovery, Two-Factor Authentication, XMLSignature,
XMLEncryption

Introduction

The Continuity of Care Record (CCR) is an XML-based electronic health
record format that is quickly gaining acceptance in the Healthcare
industry as a vehicle for exchanging clinical information among
providers, institutions, or other entities. Because of the platform-
agnostic property of XML, CCR is an ideal format for a patient to keep
either as a brief summary of recent care or as a life-long record of
medical history. Furthermore, because of XML is a well-supported
format by database vendors, importing into existing EMR systems
involves only simple XML transformations (XSLT) for converting CCR
into native schema.

CCR Exchange Network is a web-based infrastructure that provides
patients, physicians, and clinicians a secure environment to share
CCRs over public network. By taking advantage of the recent advent on
information and security technologies and standards, CCR Exchange was
built with special attention to security both in its design and
implementation. A list of security services that CCR Exchange Network
offers includes:

· Strong Two-Factor Authentication,
· Data Integrity and Confidentiality,
· Patient-Centric Discretionary Access Control,
· CCR Document Revision Control,
· Integrated Key Management,
· Facility for Key Backup and Recovery,
· Security Audit and Data Access Monitoring,
· Secure Messaging and Conferencing.

In the remainder of this document, we will show how CCR Exchange
implements these services using technologies freely available on the
Internet. At the end of this document, we will demonstrate a scenario
whereby a patient consults with his primary care provider and the
provider in turn refers him to a specialist.

1. A Brief Introduction to CCR

Continuity of Care Record...

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