An e-consent-based shared EHR system architecture for integrated healthcare networks

Bergmann, Joachim; Bott, Oliver J.; Pretschner, D. P.; Haux, Reinhold

doi:10.1016/j.ijmedinf.2006.07.013

Cited by 45 publications

(20 citation statements)

References 13 publications

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“…[5,6]) have been explicitly designed and geared towards dedicated settings. In contrast to those, our standards-based approach of COMS represents a universally deployable architecture which benefits from its flexibility and can hence be used in any setting where the management of patients' consents is required.…”

Section: Discussionmentioning

confidence: 99%

Architecture of a consent management suite and integration into IHE-based regional health information networks

Heinze

Birkle

Köster

et al. 2011

BMC Med Inform Decis Mak

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BackgroundThe University Hospital Heidelberg is implementing a Regional Health Information Network (RHIN) in the Rhine-Neckar-Region in order to establish a shared-care environment, which is based on established Health IT standards and in particular Integrating the Healthcare Enterprise (IHE). Similar to all other Electronic Health Record (EHR) and Personal Health Record (PHR) approaches the chosen Personal Electronic Health Record (PEHR) architecture relies on the patient's consent in order to share documents and medical data with other care delivery organizations, with the additional requirement that the German legislation explicitly demands a patients' opt-in and does not allow opt-out solutions. This creates two issues: firstly the current IHE consent profile does not address this approach properly and secondly none of the employed intra- and inter-institutional information systems, like almost all systems on the market, offers consent management solutions at all. Hence, the objective of our work is to develop and introduce an extensible architecture for creating, managing and querying patient consents in an IHE-based environment.MethodsBased on the features offered by the IHE profile Basic Patient Privacy Consent (BPPC) and literature, the functionalities and components to meet the requirements of a centralized opt-in consent management solution compliant with German legislation have been analyzed. Two services have been developed and integrated into the Heidelberg PEHR.ResultsThe standard-based Consent Management Suite consists of two services. The Consent Management Service is able to receive and store consent documents. It can receive queries concerning a dedicated patient consent, process it and return an answer. It represents a centralized policy enforcement point. The Consent Creator Service allows patients to create their consents electronically. Interfaces to a Master Patient Index (MPI) and a provider index allow to dynamically generate XACML-based policies which are stored in a CDA document to be transferred to the first service. Three workflows have to be considered to integrate the suite into the PEHR: recording the consent, publishing documents and viewing documents.ConclusionsOur approach solves the consent issue when using IHE profiles for regional health information networks. It is highly interoperable due to the use of international standards and can hence be used in any other region to leverage consent issues and substantially promote the use of IHE for regional health information networks in general.

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Section: Discussionmentioning

confidence: 99%

Architecture of a consent management suite and integration into IHE-based regional health information networks

Heinze

Birkle

Köster

et al. 2011

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

show abstract

“…Patient's access to their doctor's EHR system has been developed as a web-based service proposed by Cimino et al (2002), demonstrating that patients gain an improved understanding of their health and that such systems can have beneficial effects on health outcomes where patients and doctors can have a shared workload and a better communication. An e-consent based solution to share the EHR between the patient and health care personnel has been suggested by Bergmann et al (2007) as a virtual shared EHR and with the use of an e-consent object based on digital signatures for authorized access to the patient's shared her. However, the formal requirements can be difficult to implement in cross-border solutions.…”

Section: Different Approaches For Patients' Accessmentioning

confidence: 99%

Design Requirements for a Patient Administered Personal Electronic Health Record

Fensli¹,

Oleshchuk²,

O’Donoghue³

et al. 2011

Biomedical Engineering, Trends in Electronics, Communications and Software

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“…These e-consents are digitally signed certificates, authorizing the respective health professional for access to the shared health record for a limited time with individually parameterized access rights. Semantic interoperability is achieved by using the clinical document architecture (CDA) [24].…”

Section: A Telemedicine Architecturementioning

confidence: 99%

The INCA System: A Further Step Towards a Telemedical Artificial Pancreas

Gómez

Pérez

Vering³

et al. 2008

IEEE Trans. Inform. Technol. Biomed.

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An e-consent-based shared EHR system architecture for integrated healthcare networks

Cited by 45 publications

References 13 publications

Architecture of a consent management suite and integration into IHE-based regional health information networks

Architecture of a consent management suite and integration into IHE-based regional health information networks

Design Requirements for a Patient Administered Personal Electronic Health Record

The INCA System: A Further Step Towards a Telemedical Artificial Pancreas

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