KEYWORDS: Computer security, Information security, Document imaging, Control systems, Databases, Computing systems, Network security, Medicine, System integration, Web services
The EHR is a secure, real-time, point-of-care, patient-centric information resource for healthcare providers. Many
countries and regional districts have set long-term goals to build EHRs, and most of EHRs are usually built based on the
integration of different information systems with different information models and platforms. A number of hospitals in
Shanghai are also piloting the development of an EHR solution based on IHE XDS/XDS-I profiles with a
service-oriented architecture (SOA). The first phase of the project targets the Diagnostic Imaging domain and allows
seamless sharing of images and reports across the multiple hospitals. To develop EHRs for regional coordinated
healthcare, some factors should be considered in designing architecture, one of which is security issue. In this paper, we
present some approaches and policies to improve and strengthen the security among the different hospitals' nodes, which
are compliant with the security requirements defined by IHE IT Infrastructure (ITI) Technical Framework. Our security
solution includes four components: Time Sync System (TSS), Digital Signature Manage System (DSMS), Data
Exchange Control Component (DECC) and Single Sign-On (SSO) System. We give a design method and
implementation strategy of these security components, and then evaluate the performance and overheads of the security
services or features by integrating the security components into an image-based EHR system.
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