Abstract
Within a hospital, the moving of medical information systems from retrospective data-gathering
methods to prospective clinical information systems raises the question of the confidentiality
of patient data. A method of improving the traditional matrix model usually used to
achieve access controls is described. The event-driven model refers to the way a security
system ensures that a given user has a valid »need-to« relationship to a given patient.
Events are defined as the occurrence of specific data that trigger the creation or
the updating of the relationship between the identity of a user and the identity of
a patient (e. g., admission, discharge, transfer, prescription, and report). The creation
and the deletion of the relationships between users and patients are based on numerous
repositories and working lists of patients. This implementation requires an organization
of the hospital activities which is able to manage, in a real-time manner, those repositories
as closely as possible to the steps occurring during the patient’s care process. Although
this approach seems to reasonably fit the dynamic of the care process, it adds significant
organizational constraints.
Keywords
Confidentiality - Privacy - Medical Records Systems - Computerised Patient Records
- Patient-centered Care
