Cross-domain data sharing in distributed electronic health record systems

Cross-organization or cross-domain cooperation takes place from time to time in Electronic Health Record (EHR) system for necessary and high-quality patient treatment. Cautious design of delegation mechanism must be in place as a building block of cross-domain cooperation, since the cooperation inevitably involves exchanging and sharing relevant patient data that are considered highly private and confidential. The delegation mechanism grants permission to and restricts access rights of a cooperating partner. Patients are unwilling to accept the EHR system unless their health data are guaranteed proper use and disclosure, which cannot be easily achieved without cross-domain authentication and fine-grained access control. In addition, revocation of the delegated rights should be possible at any time during the cooperation. In this paper, we propose a secure EHR system, based on cryptographic constructions, to enable secure sharing of sensitive patient data during cooperation and preserve patient data privacy. Our EHR system further incorporates advanced mechanisms for fine-grained access control, and on-demand revocation, as enhancements to the basic access control offered by the delegation mechanism, and the basic revocation mechanism, respectively. The proposed EHR system is demonstrated to fulfill objectives specific to the cross-domain delegation scenario of interest. © 2006 IEEE.