Patient Summaries in Context of Large Scale EHR Networks with Fine Granular Access Control Restrictions

摘要

Background: Large Scale Electronic Health Record (EHR) systems tend to contain a significant higher amount of patient data compared to traditional local Electronic Medical Record (EMR) silos. This demands the requirement of providing a user context and role specific summary of the patient record. Security and Access Control systems are a crucial part of modern EHR systems controlling legal policies and patient consents. Goal of this paper is to elaborate a concept enhancing an already existing, commonly based on IHE XDS and XACML based, EHR systems with summarization functionalities. Methods: Using literature review and analysis of technical background of standards and currently running eHealth projects the state of the art is compiled. Based on this knowledge a workflow concept is derived and verified using a prototype based on an EHR product. Results: Using the IHE Profiles XDR and On-Demand a standard based connection to the EHR product is established. The data is extracted and stored with a link to the document reference it was contained in. With a standard based IHE ITI-18 transaction the query is filtered by the ACS of the domain. Using the resulting information a patient summary document can be compiled including only data which was gathered from documents the user has access to.