Persistent Security, Privacy, and Governance for Healthcare Information

A fundamental tension between accessibility and governance exists in the design of healthcare information systems. In order to be useful in practice health information must be distributed, but as the information moves between systems — and different information governance policies — the risk of privacy and security violations increases. The lack of a persistent policy enforcement mechanism thus inhibits the dissemination of health information, making it less useful for research and treatment. In this paper, we argue that trusted computing and policy management technologies are required to allow for broad distribution of health information while preserving security and privacy. We also introduce the concept of derived resources, which helps to address many of the unique challenges in the governance of health information.