Secret sharing homomorphisms: keeping shares of a secret secret
Proceedings on Advances in cryptology---CRYPTO '86
Optimistic security: a new access control paradigm
Proceedings of the 1999 workshop on New security paradigms
Communications of the ACM
Secure and selective dissemination of XML documents
ACM Transactions on Information and System Security (TISSEC)
Proactive Secret Sharing Or: How to Cope With Perpetual Leakage
CRYPTO '95 Proceedings of the 15th Annual International Cryptology Conference on Advances in Cryptology
How to Break Access Control in a Controlled Manner
CBMS '06 Proceedings of the 19th IEEE Symposium on Computer-Based Medical Systems
A practical scheme for non-interactive verifiable secret sharing
SFCS '87 Proceedings of the 28th Annual Symposium on Foundations of Computer Science
Restoring the Patient Control over Her Medical History
CBMS '08 Proceedings of the 2008 21st IEEE International Symposium on Computer-Based Medical Systems
A hybrid public key infrastructure solution (HPKI) for HIPAA privacy/security regulations
Computer Standards & Interfaces
Towards a mechanism for discretionary overriding of access control
SP'04 Proceedings of the 12th international conference on Security Protocols
eHealth system interoperability
Information Systems Frontiers
XML privacy protection model based on cloud storage
Computer Standards & Interfaces
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Privacy is an important aspect of interoperable medical information systems. Governments and health care organizations have established privacy policies to prevent abuse of personal health data. These policies often require organizations to obtain patient consent prior to exchanging personal information with other interoperable systems. The consents are defined in form of so-called disclosure directives. However, policies are often not precise enough to address all possible eventualities and exceptions. Unanticipated priorities and other care contexts may cause conflicts between a patient's disclosure directives and the need to receive treatments from informed caregivers. It is commonly agreed that in these situations patient safety takes precedence over information privacy. Therefore, caregivers are typically given the ability to override the patient's disclosure directives to protect patient safety. These overrides must be logged and are subject to privacy audits to prevent abuse. Centralized "shared health record" (SHR) infrastructures include consent management systems that enact the above functionality. However, consent management mechanisms do not extend to information systems that exchange clinical information on a peer-to-peer basis, e.g., by secure messaging. Our article addresses this gap by presenting a consent management mechanism for peer-to-peer interoperable systems. The mechanism restricts access to sensitive, medical data based on defined consent directives, but also allows overriding the policies when needed. The overriding process is monitored and audited in order to prevent misuse. The mechanism has been implemented in an open source project called CDAShip and has been made available on SourceForge.