Protecting the Exchange of Medical Images in Healthcare Process Integration with Web Services. Introduction. Medical images exist in electronic format for easy storage and maintenance promote high quality healthcare services for patients a picture is worth a thousand words - PowerPoint PPT Presentation
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Protecting the Exchange of Medical Images in Healthcare Process Integration with Web Services Patrick C. K. HUNG Faculty of Business and Information Technology, University of Ontario Institute of Technology [email protected]Eleanna Kafeza Department of Marketing and Communications, Athens University of Economics and Business [email protected]Dickson K. W. CHIU Senior Member, IEEE Dickson Computer Systems Hong Kong [email protected], [email protected]Vivying S.Y. Cheng Dept. of Computer Science Hong Kong University of Science & Technology [email protected]
Transcript
Protecting the Exchange of Medical Images in Healthcare Process Integration with Web Services
Patrick C. K. HUNGFaculty of Business and Information Technology,
Introduction Medical images exist in electronic format
for easy storage and maintenance promote high quality healthcare services for patients a picture is worth a thousand words
Problem: uncontrolled exchange of medical images Human initiated: emails, fax, ad hoc file transfer, … Software initiated or software-to-software Cross-institutional healthcare processes integration
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Proposed Approach Medical Image Exchange Platform (MIEP) Layered approach Contemporary information technologies
Web services for the information transport Role based access control (RBAC) Watermarking for the integrity and privacy protection
Single-point border check
MIEP HICSS40 - 4
Protocol and Architecture Summary
Health Institution
B
Health Institution
A
F
C
Medical Image
Web Service B Web Service A
Privacy Preferences
Privacy Policy
Verify Health Institute A’s Privacy Preferences with Health Institute B’s Privacy Policy
Send the medical image
1
2
MIEP HICSS40 - 5
Layered Architecture
Audit Application
Watermarked Images
Ontology
Web Services
Secured transport
Privacy + Access Control Rules
Enterprise Process
Protection Policy and Rules
Monitoring
Medical Partner
Internet SSL and PKI
WSDL
EPAL / P3P & APPEL
Medical Partner
OWL / DAML
Watermarking Protocol
BPEL
Laws / Regulation / Standards
Audit Application
Watermarked Images
Ontology
Web Services
Secured transport
Privacy + Access Control Rules
Enterprise Process
Protection Policy and Rules
MIEP HICSS40 - 6
Development Methodology - Overview
Policies Rules Technical Auditing
MIEP HICSS40 - 7
Development Methodology - Policies
Protection policies should comply with requirements in laws, regulations, and code of practices.
Healthcare process integration should comply with the protection policies - privacy and access control requirements should be specified explicitly.
Existing protection policy guarding internal operations may serve as basic hints for external partners.
MIEP HICSS40 - 8
Development Methodology - Rules
RBAC for employees of internal and external parties
Need-to-know principle - consider: the access need of each task of each process for each
role sensitivity of the image content contingencies and necessary override mechanisms
=> avoid ad hoc decisions. Make sure that medical partners understand
not only the protection policies but also the ontology based on which these rules are defined
MIEP HICSS40 - 9
Development Methodology - Technical
Express these rules in a high level language such as EPAL, P3P, and APPEL.
Ensure document images are exchanged via only the pre-defined MIEP Web service calls and from authenticated partners.
Firewall and email filters may be implemented to scan for and stop uncontrolled image traffic.
Watermark (containing protection information) is inserted into each image sent or received via the MIEP Web services.
Validation of document access against the access information embedded in the image watermark.
MIEP HICSS40 - 10
Development Methodology - Auditing
Auditing application may use existing in-house software as a blue-print, but now stricter.
Monitor actively all document image access to ensure
security and privacy constraints are met the integrity of image data otherwise, alerts should be sent to the management.
MIEP HICSS40 - 11
MIEP Concept Model
Healthcare Process
Personnel
Healthcare Record
Role
Healthcare Task
peform
access
Access Log
MIEP Web Service
call
store
Auditing Taskcheck
check
Watermarkcheck
Medical Imageaccess
contains
Patient
owns
Access+Privacy Specification
authorize
+purpose
specifycontrol control
User Profile
conforms
MIEP HICSS40 - 12
Some Technical Details Outgoing Images Incoming Images Image Pickup Service Privacy Policies and Rules
MIEP HICSS40 - 13
Outgoing Images Routed through the outgoing proxy Web service
SendDocumentImage (S) - parameters: destination Web service to receive the images, purpose,
sender, and target information (such as task, application, personnel, and/or role), image format descriptions, …
S calls the enterprise image exchange auditing Web service AuditSend
Existing watermark (if any) analyzed for validity and protection policies
sender & receiver are indeed legible the exchange does not violate any protection policies
Watermark insertion: vital information such as the purpose, sender and target information (such as task, application, personnel, and/or role).
Such transactions are logged.
MIEP HICSS40 - 14
Incoming Images Routed through the incoming proxy Web service
ReceiveDocumentImage (R) - parameters: destination to receive the images (Web service URL,
port and operation), the user id, purpose, sender and target information (such as task, application, personnel, and/or role), image format descriptions, …
R call the enterprise image exchange auditing Web service AuditReceive for validation.
Compliant watermark from partner’s MIEP (if any) can be extracted for addition validation.
Similar watermark insertion for tracking. Such transactions are logged.
MIEP HICSS40 - 15
Image Pickup Service Not every business partner could immediately
switch to a MIEP platform. Initially allow a “pick up” service to cater for
manual retrieval of the image in case the partner is not fully automated.
Used in a call back mode to further enhance the security for program-to-program interaction.
Pre-registration required for auditing and protection.
MIEP HICSS40 - 16
Privacy Policies and Rules P3P - user agents allow users to automatically be informed
of site practices and to facilitate decision-making based on the Web sites’ privacy practices.
APPEL for expressing users’ preferences of making automated or semi-automated decisions regarding the acceptability of machine-readable privacy policies from P3P enabled Web sites.
Matching mechanism A’s preferences (in APPEL) of vs. B’s P3P policies in Step 1.
Health Institution
B
Health Institution
A
F
C
Medical Image
Web Service B Web Service A
Privacy Preferences
Privacy Policy
Verify Health Institute A’s Privacy Preferences with Health Institute B’s Privacy Policy
Send the medical image
1
2
MIEP HICSS40 - 17
Validation with HIPAA rules The right to view and make a copy of a patients own medical
records, and the right to request PHI to be shared with the patient in a particular way.
Patients can readily request their own medical images through the MIEP image pick up services
The right to find out where PHI has been shared for purposes other than care, payment, or healthcare operations
MIEP tracks and logs all cross-institutional exchange of medical image.
The right to request special restrictions on the use or disclosure of PHI.
MIEP maintains the patients’ profiles regarding their privacy preferences
The right to file complaints. MIEP can provide exchange records and evidence.
MIEP HICSS40 - 18
Summary Replace ad hoc and manual image exchange procedures with a
unified Medical Image Exchange Platform (MIEP) Layered MIEP architecture Design and implementation methodology Image exchange protocol Application of Web services and watermarking technologies
Embedded watermark ensure integrity, privacy, and access control
Advantages of Web service / SOA Legacy systems and existing practices corrected with MIEP Reusability of MIEP => streamlines the development, deployment,
and maintenance of software components for image exchange Single border check for all the protection policies and auditing
procedures => adequate control and auditing Expandability For future tracking and auditing purposes
MIEP HICSS40 - 19
Future Work Exploration of any potential usability and performance
issues. Mechanisms and tools for managing the interactions taking
place between different layers in the proposed framework. Further requirements engineering for privacy and security. Application of ontologies
role classifications terms used to present a domain of knowledge
Representation of the privacy access control policy in EPAL and the compliance of EPAL to the Web services.
Adoption issues Application in other professional business domains:
