# Record Level Data Security; storage plus fixed and mobile transmission **Category:** [Technical (archive)](https://discourse.openehr.org/c/technical-archive/156) **Created:** 2003-05-02 20:43 UTC **Views:** 1 **Replies:** 4 **URL:** https://discourse.openehr.org/t/record-level-data-security-storage-plus-fixed-and-mobile-transmission/15742 --- ## Post #1 by @lakewood Security begins at the data storage level\. Unless it can be protected at this level more sophisticated techniques applied to transmission and content will not be as effective as desired\. Three common approaches are: 1\)Data security 2\)Data management and 3\)Access to storage media\-resident data, e\.g\., somebody's disk drive These can occur long before access security is needed in a Healthcare environment, but are also appropriate for data storage and access within a Healthcare environment\. DATA SECURITY Good example is the CDSA project gratis from Intel: http://www.intel.com/labs/archive/cdsa.htm http://www.opengroup.org/security/l2-cdsa.htm which relieves upon: 1\)digital certificates and 2\)portable digital tokens Neat stuff since already the Healthcare Computer System Administrator has capable security tools\. The Secure Data Store Admin should have these available as well\. Target systems include Windows and Linux and security adaptability is supported\. Fixed data transmission environment have multiple techniques for securing data during transmission, e\.g\., SSL, HTTPS and these work well between fixed Healthcare environments, e\.g\., Hospital\-Clinic\. Mobile applications are crucial\. Mobile Healthcare applications are not exempt from data security requirements\. Data transmission security mechanisms for fixed environments do not work well in mobile environments and hence new techniques have been developed\. The following link covers Java in a mobile environment: http://www.javaworld.com/javaworld/jw-12-2002/jw-1220-wireless.html Presuming that the data is now available at a Healthcare environment the following may apply: 1\)data storage, management, handling and transmission can be similar to that described previously 2\)Healthcare\-specific systems \(e\.g\., GNUmed: http://www.gnumed.org/development/home.html and OpenEHR\) can be interfaced to the data obtained from external sources 3\)Bi\-directional record translations are possible \(may be required\) 4\)Data security and privacy issues remain COMMENTS 1\)A single Healthcare facility complete with a familiar set of EHR/EPR software, process, procedures, techniques and trained personnel may represent a single intelligent node existing in a 'fabric' containing Patients, related services, non\-conforming practitioners and other similarly intelligent node\. 2\)The intelligent nodes are not likely to be exact copies\. 3\)The processes, procedures, technologies, etc that have been used to interface perhaps dissimilar intelligent nodes in other environments apply 4\)Content is important to a Practitioner where it is "relevant"/"germane" 5\)The goal is to provide the Practitioner with "relevant"/"germane" information and nothing else SUGGESTIONS 1\)Develop a secure data storage, management, handling, transmission system that delivers secured data to a systems available to a Practitioner 2\)Develop applications that perform similar activities within a Healthcare environment 3\)Develop security applications that will access\. manage, handle and filter the data for the practitioner\. exercising control over disposition, e\.g\., spawning copies/partial copies/forwarding/audits/time\-limit functions, communicating with external users, etc\. 4\)Add new facility\-unique security that will precisely identify content, e\.g\., digital watermarks\. 5\)Handle redundant data and secure data destruction\. 6\)Security plug\-ins for practitioner\- and facility\-specific data security Lots of stuff available\! \-Thomas Clark --- ## Post #2 by @system You leave out completely the legal, social control and organisational aspects\. Technology isn't a silver bullet\. Gerard \-\- <private> \-\- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands \+31 252 544896 \+31 654 792800 --- ## Post #3 by @lakewood Hi Gerard, Record Level Data Security has little to do with legal, social control and organizational aspects\. I agree that these are important, and in many cases more important, than record level data security\. They are more complex issues that are dependent upon factors varying from culture to informal/private business arrangements\. To be complete others would have to be added\. The approach taken was to start at a level where secure global electronic data interchange of healthcare records is possible, a possible model being the "Association For Payment Clearing Services"\. http://www.apacs.org.uk/downloads/List%20of%20Standards5.pdf The perceived need is secure, standard record formats so that information can be accessed even though it was created under a system using a different record format\. The goal is access to all "relevant"/"germane" information\. Hence, interchangeability is crucial\. I admit that 'legal, social control and organizational' issues are much harder to solve which is why, in the short term, I am staying away from them\. \-Thomas Clark --- ## Post #4 by @system Dear Thomas, At OpenEHR there is an emphasis on the exchange of documents but also on storage of objects in systems\. What you are referring to is the first topic \(messages\)\. Gerard > Hi Gerard, > > Record Level Data Security has little to do with legal, social control and > organizational aspects\. > > I agree that these are important, and in many cases more important, than > record level data security\. They are more complex issues that are dependent > upon factors varying from culture to informal/private business arrangements\. > To be complete others would have to be added\. > > The approach taken was to start at a level where secure global electronic > data interchange of healthcare records is possible, a possible model being > the "Association For Payment Clearing Services"\. > > http://www.apacs.org.uk/downloads/List%20of%20Standards5.pdf > > The perceived need is secure, standard record formats so that information > can be accessed even though it was created under a system using a different > record format\. > > \-Thomas Clark > > From: "Gerard Freriks" <gfrer@luna\.nl> > To: <lakewood@copper\.net>; <openehr\-technical@openehr\.org> > Sent: Saturday, May 03, 2003 2:40 AM > Subject: Re: Record Level Data Security; storage plus fixed and > mobiletransmission > >>> Security begins at the data storage level\. Unless it can be protected at >>> this level more sophisticated techniques applied to transmission and > > content >>> will not be as effective as desired\. >>> >>> Three common approaches are: >>> 1\)Data security >>> 2\)Data management and >>> 3\)Access to storage media\-resident data, e\.g\., somebody's disk drive >>> >> You leave out completely the legal, social control and organisational >> aspects\. >> Technology isn't a silver bullet\. >> >> Gerard >> >> \-\- <private> \-\- >> Gerard Freriks, arts >> Huigsloterdijk 378 >> 2158 LR Buitenkaag >> The Netherlands >> >> \+31 252 544896 >> \+31 654 792800 >> \-\- <private> \-\- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands \+31 252 544896 \+31 654 792800 --- ## Post #5 by @lakewood Hi Gerard, There has to be medical/Patient/healthcare records and related documents but they must be linked\. Storage must be provided for the above, permanent, temporary and intermediary \(e\.g\., dialog between practitioners\)\. Event\-based entries into medical/Patient/healthcare records would be structured and most likely result in modifications of permanent records\. 'related documents' may become part of a permanent record, e\.g\., commentary on the Patient \(object\)\. They may, however, contain information transitory information useless in a permanent healthcare record, e\.g\., scheduling, but significant during a course of treatment\. There is another type of information related to administrative activities that would be attached to the permanent record\. Billing, insurance, etc has to be accommodated\. This would be little interest to practitioners and can reside in a separate database \(e\.g\., relational\)\. Must be linked\. Both the medical/Patient/healthcare records and documents are subject to the same security requirements and both can be transmitted using the same network services\. For example, both can be served from a secure, XML\-based application server\. The secure transmission of a 'record' can be discussed separately from the content of other records that are encapsulated within it\. The naming might be confusing here\. The 'record' is likely to be a sequence of 'blocks' of information of whatever structure and format, e\.g\., FibreChannel protocol \(frame\-based transmission of blocks of information\)\. Looking at the content of the information received that structure could include healthcare records of any defined type\. An advantage of this approach is the simplicity of appending additional record\-based information to the end of the received file\. Two disadvantages: 1\)it has to be stored someplace 2\)multiple users would require additional structure and processing to keep things in order Neither of these are major\. To this point it is mechanistic and transparent to a Practitioner\. One should be able to access the received data and all additions\. Whether the Practitioner can edit the appended data is a separate issue\. This 'interface' can be common; beyond this things get more involved since other factors are operative\. > > Record Level Data Security has little to do with legal, social control and > > organizational aspects These aspects change things\. Everything from a facility security policy to what the staff does regarding record operations can change between facilities\. Importantly different facilities can interact uniquely with the information available for inclusion and modification\. Related problems have to be resolved between Practitioners, legal jurisdictions and human organizations\. Apart and separate from the records\-based issues, there can be a significant need for systems that support communications between practitioners, e\.g\., secure Chat and document transmission\. Something of value arising from this type communication could be included in the permanent record by a practitioner\. Solving the 'social control and organizational' problems will take considerably more time and is likely to require continual attention thereafter\. \-Thomas Clark --- **Canonical:** https://discourse.openehr.org/t/record-level-data-security-storage-plus-fixed-and-mobile-transmission/15742 **Original content:** https://discourse.openehr.org/t/record-level-data-security-storage-plus-fixed-and-mobile-transmission/15742