Quoting "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>:
...
> >>Information archiving, retrieval and update cannot be completed
> without
> >>the Patients active participation. The Payer and Provider can each
> hold
> >>a key that individually and together cannot create access to the
> >>information and join the constituent parts.
> >>    
> >>
> >
> >Sounds very interesting.
> >
> >What do you mean by "active participation"?
> >Does the patient hold/present a key too?
> >
> The Patient or the Patient's representative holds a key. The 
> representative can be a
> legal representative, a family member or a private security agent. Both 
> the Patient
> and the representative should have a tool to audit requests for access.
> 
> The key is in turn limited/restricted, i.e., you can access records 
> related to a
> specific condition my not other non-related conditions. It would also be
> in part
> declarative, e.g., the Patient can withhold permission to use their DNA.
> 
> The Patient's key would have a structure compatible with their records
> hence
> their would be a Patient-specific format that supported general
> information,
> e.g., date-of-birth.

This sounds good and very useful. 

Typically in a key-based system, the most difficult part is key management -
from the moment of key creation. In your design, who creates these keys and
how does the system assure the security of that process?

...
> >What if the patient loses his/her key?
> >
> Patient keys can be re-generated from Records-based information (similar 
> to fault-recoverable file systems). 

What prevents non-Patients (e.g. evil government agents) from re-generating
patient keys?

> Since the key is not saddled with a fixed format, 
> additions and modifications will modify the key. 

Do you mean changing information in patient records always lead to a
modified key?

> The Patient provides information and updates rules.

That sounds good.

> The physical format of a key is simple. 256 MBytes in the volume 
> occupied by a 25 cent coin leaves some room for other things. You might 
> inject it like my dog's ID,

I agree. We can store keys on portable devices. However, there may still be
unresolved issues relating to key-regeneration and key-updating.

Best regards,

Andrew
---
Andrew P. Ho, M.D.
OIO: Open Infrastructure for Outcomes
www.TxOutcome.Org

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