Ruotsalainen Pekka
National Research and Development Centre for Welfare and Health (Stakes), Centre of Excellence for ICT, Helsinki, Finland.
Int J Med Inform. 2004 Mar 31;73(3):291-5. doi: 10.1016/j.ijmedinf.2003.12.012.
During the past decade, there have been many regional, national and European projects focused on the development of platforms for secure access and sharing of distributed patient information. A platform is needed because present local or enterprise-wide information systems are typically not intended for cross-organisational secure access of patient data. Most of the present secure platforms are local or regional. Commonly used platform types in the health care environment vary from secure point-to-point communication systems to internet-based portals. This paper defines an enhanced cross-security platform which makes it possible for different kinds of local, regional, and national health information systems to communicate in a secure way. The proposed evolutionary way interconnects regional or national security domains with the help of a cross-platform zone. A more revolutionary model based on peer-to-peer Grid like networks and dynamic security credentials is also discussed. The proposed evolutionary model uses cross-domain security and interoperability services to ensure secure communication and interoperability between different security domains. The platform supports both communication defined beforehand and adhoc dynamic access to distributed electronic health records (EHRs). The internet is proposed as the "glue" between different regional or national security domains.
在过去十年中，有许多地区、国家和欧洲项目致力于开发用于安全访问和共享分布式患者信息的平台。之所以需要这样一个平台，是因为目前的本地或企业级信息系统通常并非用于跨组织安全访问患者数据。当前大多数安全平台都是本地或区域性的。医疗保健环境中常用的平台类型从安全的点对点通信系统到基于互联网的门户不等。本文定义了一个增强型跨安全平台，它使不同类型的本地、区域和国家卫生信息系统能够以安全的方式进行通信。所提出的演进方式借助跨平台区域将区域或国家安全域互连起来。还讨论了一种基于对等网格状网络和动态安全凭证的更具革命性的模型。所提出的演进模型使用跨域安全和互操作性服务来确保不同安全域之间的安全通信和互操作性。该平台既支持预先定义的通信，也支持对分布式电子健康记录（EHR）的临时动态访问。互联网被提议作为不同区域或国家安全域之间的“粘合剂”。
