integrating the healthcare enterprise audit trail and node authentication profile name of presenter...

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

Audit Trail and Node Authentication Profile

Name of PresenterIHE affiliation

HIMSS Annual Conference 2004

Prof. Societies Sponsorship

Healthcare Providers & Vendors

Healthcare IT Standards HL7, DICOM, etc.

General IT Standards Internet, ISO, etc.

Interoperable Healthcare IT Solution Specifications

IHE Integration Profile Interoperable Healthcare IT

Solution Specifications IHE Integration Profile

Interoperable Healthcare IT Solution Specifications

IHE Integration Profile Interoperable Healthcare IT

Solution Specifications IHE Integration Profile

IHE Process

IHE drives healthcare standards based-integration IHE drives healthcare standards based-integration


IHE

EHR- Longitudinal Record

IHE Cardiology

IHE Laboratory

IHE Radiology

IHE

Future Domain

IHE

Future Domain

IHE

IT Infrastructure Intra-Enterprise

Cross-Enterprise

14 Integration Profiles

5 Integration Profile



IHE 2004 achievements and expanding scope IHE 2004 achievements and expanding scope

Over 80 vendors involved world-wide, 4 Technical Frameworks31 Integration Profiles, Testing at yearly Connectathons,

Demonstrations at major exhibitions world-wide

Provider-Vendor cooperation to accelerate standards adoption


IHE ProcessIHE Process Users and vendors work together to identify

and design solutions for integration problems

Intensive process with annual cycles:– Identify key healthcare workflows and integration

problems– Research & select standards to specify a solution– Write, review and publish IHE Technical Framework– Perform cross-testing at “Connectathon”– Demonstrations at tradeshows (HIMSS/RSNA…)


A Proven Standards Adoption ProcessA Proven Standards Adoption Process

IHEIntegrationProfiles B

IHEIntegrationProfile A

Easy toIntegrateProducts

IHEConnectathon

ProductWith IHE

IHEDemonstration

User Site

RFPRFP

Standards

IHETechnical

Framework

Product IHE IntegrationProduct IHE IntegrationStatementStatement

IHE IHE ConnectathonConnectathonResultsResults

IHE Integration Profiles at the heart of IHE :– Detailed selection of standards and options each solving a specific integration

problem– A growing set of effective provider/vendor agreed solutions– Vendors can implement with ROI– Providers can deploy with stability


More on IHE IT InfrastructureMore on IHE IT Infrastructure

To learn more about IHE IT Infrastructure

Integrating the Healthcare Enterprise:

www.himss.org/ihe

Read the IHE Brochurehttp://www.himss.org/content/files/IHE_newsletter_final.pdf


Audit Trail and Node Authentication Audit Trail and Node Authentication (ATNA) – Abstract/Scope(ATNA) – Abstract/Scope

HIPAA means more attention and care to protect Patient’s Privacy, and this requires Security.

In Healthcare we have Protected Health Information for patients such as orders, procedure, images, films and reports.

The confidentiality, integrity, and availability of this information must be assured. – authorized persons must have access to medical

data of patients, and the information must not be disclosed otherwise.


Audit Trail and Node Authentication Audit Trail and Node Authentication (ATNA) – Value Proposition(ATNA) – Value Proposition

Assures Authorized users gain access to secure nodes

Verifies that only secure nodes exchange data.

Provides audit facility to Verify compliance with procedures Permit detection of inappropriate behavior Without interfering with time critical activities


ATNA -- EnvironmentATNA -- EnvironmentRequired Physical SecurityRequired Physical Security

Doors, key access, etc. restrict accessDoors, key access, etc. restrict access

Communications and Equipment areCommunications and Equipment arekept in restricted access areaskept in restricted access areas

Access to equipment is controlledAccess to equipment is controlledCabinets, wiring, etc. are protected.Cabinets, wiring, etc. are protected.


ATNA -- EnvironmentATNA -- EnvironmentRequired Network SecurityRequired Network Security

Firewalls, VPN, and other access Firewalls, VPN, and other access controls.controls.

Unauthorized external access is denied.Unauthorized external access is denied.

Additional security facilities may be in Additional security facilities may be in place if warranted by local conditions.place if warranted by local conditions.


ATNA -- Node Authentication Configuration

System A System B

Secure networkSecured Node Secured Node

•Manually managed Node Authentication Certificates


ATNA: Typical Workflow

System A System B

Secured SystemSecure network

• Strong authentication of remote node (digital certificates)• network traffic encryption is not required

Secured System

• Local access control (authentication of user)

• Audit trail with:• Real-time access • Time synchronization

Central Audit TrailRepository


ATNA – Example “Transfer Image” ATNA – Example “Transfer Image” Audit MessageAudit Message <?xml version="1.0" encoding="UTF-8" ?>

- <AuditMessage xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:noNamespaceSchemaLocation="D:\data\DICOM\security\dicom-audit.xsd">- <EventIdentification EventActionCode="C" EventDateTime="2001-12-17T09:30:47-05:00" EventOutcomeIndicator="0"> <EventID code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> <EventTypeCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> </EventIdentification>- <ActiveParticipant UserID="String" AlternativeUserID="String" UserName="String" UserIsRequestor="true" NetworkAccessPointID="String"

NetworkAccessPointTypeCode="1"> <RoleIDCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> </ActiveParticipant>- <ActiveParticipant UserID="String" AlternativeUserID="String" UserName="String" UserIsRequestor="true" NetworkAccessPointID="String"

NetworkAccessPointTypeCode="1"> <RoleIDCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> </ActiveParticipant>- <ActiveParticipant UserID="String" AlternativeUserID="String" UserName="String" UserIsRequestor="true" NetworkAccessPointID="String"

NetworkAccessPointTypeCode="1"> <RoleIDCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> </ActiveParticipant>- <AuditSourceIdentification AuditEnterpriseSiteID="String" AuditSourceID="String"> <AuditSourceTypeCode code="1" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> </AuditSourceIdentification>- <ParticipantObjectIdentification ParticipantObjectID="String" ParticipantObjectTypeCode="1" ParticipantObjectTypeCodeRole="1" ParticipantObjectDataLifeCycle="1"

ParticipantObjectSensitivity="String"> <ParticipantObjectIDTypeCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> <ParticipantObjectName>String</ParticipantObjectName> - <ParticpantObjectDescription> <MPPS ID="String" /> <AccessionNumber ID="String" /> <SOPClass InstanceUID="String" NumberOfInstances="0" /> <SOPClass InstanceUID="String" NumberOfInstances="0" /> <SOPClass InstanceUID="String" NumberOfInstances="0" /> </ParticpantObjectDescription> </ParticipantObjectIdentification>- <ParticipantObjectIdentification ParticipantObjectID="String" ParticipantObjectTypeCode="1" ParticipantObjectTypeCodeRole="1" ParticipantObjectDataLifeCycle="1"

ParticipantObjectSensitivity="String"> <ParticipantObjectIDTypeCode code="String" codeSystem="String" codeSystemName="String" displayName="String" originalText="String" /> <ParticipantObjectName>String</ParticipantObjectName> </ParticipantObjectIdentification> </AuditMessage>


ATNA – Technical DetailsATNA – Technical Details

Locally defined User Identification, Authentication, and Authorization

Node to Node communications authenticated– HL7 – TLS – Digital Certificates– DICOM – TLS – Digital Certificates– HTTP – TLS – Digital Certificates

Audit Trails– Reliable SYSLOG (Cooked)– IETF Audit Message Schema– DICOM Audit Message details– IHE further clarifications for events not detailed in DICOM


More information….More information….

Web sites: www.himss.org/ihewww.rsna.org/ihe– IHE Rad Technical framework for year 5 – V5.5– IHE IT Technical framework for year 1 – V 1.0

Non-Technical Brochures :– IHE Fact Sheet and IHE FAQ– IHE Integration Profiles: Guidelines for Buyers– IHE Connectathon Results

integrating the healthcare enterprise audit trail and node authentication profile name of presenter...

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