An access control framework for secure and interoperable cloud computing applied to the healthcare domain

Abstract

The healthcare domain is an emergent application for cloud computing, in which the Meaningful Use Stage 3 guidelines recommend health information technology (HIT) systems to provide cloud services that enable health-related data owners to access, modify, and exchange data. This requiresmobile and desktop applications for patients and medical providers to obtain healthcare data from multiple HITs, which may be operating with different paradigms (e.g., cloud services, programming services, web services), use different cloud service providers, and employ different security/access control techniques. To address these issues, this chapter introduces and discusses an Access Control Framework for Secure and Interoperable Cloud Computing (FSICC) that provides a mechanism for multiple HITs to register cloud, programming, and web services and security requirements for use by applications. FSICC supports a global security policy and enforcement mechanism for cloud services with role-based (RBAC), discretionary (DAC), and mandatory (MAC) access controls. The Fast Healthcare Interoperability Resources (FHIR) standard models healthcare data using a set of 93 resources to track a patient's clinical findings, problems, etc. For each resource, an FHIR Application Program Interface (API) is defined to share data in a common format for each HIT that can be accessed by mobile applications. Thus, there is a need to support with a heterogeneous set of information sources and differing security protocols (i.e., RBAC, DAC, and MAC). To demonstrate the realization of FSICC, we apply the framework to the integration of the Connecticut Concussion Tracker (CT2) mHealth application with the OpenEMR electronic medical record utilizing FHIR.