PCASSO: a design for secure communication of personal health information via the internet

The Internet holds both promise and peril for the communications of person-identifiable health information. Because of technical features designed to promote accessibility and interoperability rather than security, Internet addressing conventions and transport protocols are vulnerable to compromise by malicious persons and programs. In addition, most commonly used personal computer (PC) operating systems currently lack the hardware-based system software protection and process isolation that are essential for ensuring the integrity of trusted applications. Security approaches designed for electronic commerce, that trade known security weaknesses for limited financial liability, are not sufficient for personal health data, where the personal damage caused by unintentional disclosure may be far more serious. To overcome these obstacles, we are developing and evaluating an Internet-based communications system called PCASSO (Patient-centered access to secure systems online) that applies state of the art security to health information. PCASSO includes role-based access control, multi-level security, strong device and user authentication, session-specific encryption and audit trails. Unlike Internet-based electronic commerce 'solutions,' PCASSO secures data end-to-end: in the server; in the data repository; across the network; and on the client. PCASSO is designed to give patients as well as providers access to personal health records via the Internet.