Gritzalis Dimitris, Lambrinoudakis Costas
Department of Informatics, Athens University of Economics and Business, 76 Patission Street, Athens GR-10434, Greece.
Int J Med Inform. 2004 Mar 31;73(3):305-9. doi: 10.1016/j.ijmedinf.2003.12.011.
Several hereditary and other chronic diseases necessitate continuous and complicated health care procedures, typically offered in different, often distant, health care units. Inevitably, the medical records of patients suffering from such diseases become complex, grow in size very fast and are scattered all over the units involved in the care process, hindering communication of information between health care professionals. Web-based electronic medical records have been recently proposed as the solution to the above problem, facilitating the interconnection of the health care units in the sense that health care professionals can now access the complete medical record of the patient, even if it is distributed in several remote units. However, by allowing users to access information from virtually anywhere, the universe of ineligible people who may attempt to harm the system is dramatically expanded, thus severely complicating the design and implementation of a secure environment. This paper presents a security architecture that has been mainly designed for providing authentication and authorization services in web-based distributed systems. The architecture has been based on a role-based access scheme and on the implementation of an intelligent security agent per site (i.e. health care unit). This intelligent security agent: (a). authenticates the users, local or remote, that can access the local resources; (b). assigns, through temporary certificates, access privileges to the authenticated users in accordance to their role; and (c). communicates to other sites (through the respective security agents) information about the local users that may need to access information stored in other sites, as well as about local resources that can be accessed remotely.
几种遗传性疾病和其他慢性疾病需要持续且复杂的医疗保健程序，这些程序通常由不同的、往往距离较远的医疗保健单位提供。不可避免地，患有此类疾病的患者的病历变得复杂，规模增长迅速，且分散在参与护理过程的各个单位，这阻碍了医疗保健专业人员之间的信息交流。基于网络的电子病历最近被提议作为解决上述问题的方案，从医疗保健单位相互连接的意义上来说，它便于医疗保健专业人员现在能够访问患者的完整病历，即使该病历分布在几个远程单位。然而，通过允许用户几乎在任何地方访问信息，可能试图破坏系统的不合格人员范围大幅扩大，从而使安全环境的设计和实施严重复杂化。本文提出了一种主要为基于网络的分布式系统提供认证和授权服务而设计的安全架构。该架构基于基于角色的访问方案，并在每个站点（即医疗保健单位）实施智能安全代理。这种智能安全代理：(a). 对可以访问本地资源的本地或远程用户进行认证；(b). 通过临时证书根据认证用户的角色为其分配访问权限；以及(c). 向其他站点（通过各自的安全代理）传达有关可能需要访问存储在其他站点的信息的本地用户以及可以远程访问的本地资源的信息。
