Quantin Catherine, Fassa Maniane, Coatrieux Gouenou, Breton Vincent, Boire Jean Yves, Allaert François André
Dpt. of Biostatistics & Medical Informatics, Inserm U866, CHU de Dijon.
Stud Health Technol Inform. 2008;137:61-7.
The main problem for the patient who wants to have access to all of the information about his health is that this information is very often spread over many medical records. Therefore, it would be convenient for the patient, after being identified and authenticated, to use a kind of specific medical search engine as one part of the solution to this main problem. The principal objective is for the patient to have access to his or her medical information at anytime and wherever it has been stored. This proposal for secure "Google Like" access requires the addition of different conditions: very strict identity checks using cryptographic techniques such as those planned for the electronic signature, which will not only ensure authentication of the patient and integrity of the file, but also protection of the confidentiality and access follow-up. The electronic medical record must also be electronically signed by the practitioner in order to provide evidence that he has given his agreement and accepted responsibility for the content. This electronic signature also prevents any kind of post-transmission falsification. New advances in technology make it possible to envisage access to medical records anywhere and anytime, thanks to Grid and watermarking methodologies.
对于希望获取自己所有健康信息的患者来说,主要问题在于这些信息常常分散在许多医疗记录中。因此,在患者经过身份识别和认证后,使用一种特定的医学搜索引擎作为解决这一主要问题的方案之一,对患者而言会很方便。主要目标是让患者能够在任何时间、任何存储其医疗信息的地方获取这些信息。这种实现安全的“类谷歌”访问的提议需要附加不同条件:使用诸如电子签名计划采用的加密技术进行非常严格的身份检查,这不仅能确保患者身份认证和文件完整性,还能保护信息机密性并跟踪访问情况。电子病历还必须由从业者进行电子签名,以证明他已同意并对内容负责。这种电子签名还能防止任何形式的传输后篡改。由于网格和水印方法,技术上的新进展使得设想随时随地访问医疗记录成为可能。