Patient Summaries in Context of Large Scale EHR Networks with Fine Granular Access Control Restrictions

Large Scale Electronic Health Record (EHR) systems tend to contain a significant higher amount of patient data compared to traditional local Electronic Medical Record (EMR) silos. This demands the requirement of providing a user context and role specific summary of the patient record. Security and Access Control systems are a crucial part of modern EHR systems controlling legal policies and patient consents. Goal of this paper is to elaborate a concept enhancing an already existing, commonly based on IHE XDS and XACML based, EHR systems with summarization functionalities.

Using literature review and analysis of technical background of standards and currently running eHealth projects the state of the art is compiled. Based on this knowledge a workflow concept is derived and verified using a prototype based on an EHR product.

Using the IHE Profiles XDR and On-Demand a standard based connection to the EHR product is established. The data is extracted and stored with a link to the document reference it was contained in. With a standard based IHE ITI-18 transaction the query is filtered by the ACS of the domain. Using the resulting information a patient summary document can be compiled including only data which was gathered from documents the user has access to.