Towards Self-Protecting Security for e-Health CDA Documents

To protect the security and privacy of electronic medical records, it is often necessary to employ a variety of security mechanisms such as encryption, integrity control, authentication, and access control. This paper proposes a framework that extends HL7 Clinical Document Architecture (CDA) documents with markups from XML based security standards, including eXtensible Access Control Markup Language, XML Encryption, and XML Signature. This integrated structure uses a CDA document as the container while access control policies, digital signatures and encrypted data are all embedded within the same CDA document in a fine-grained manner. This approach can be used to provide self-protecting security for CDA documents no matter where they reside: in transit within HL7 messages or in existence as independent persistent information objects outside messages.