Andrew Ho wrote: > With a digital notary, > > 1) I can trust your document that comes with a valid certificate. > 2) However, I won't know how many other relevant documents you are keeping > from me (e.g. progress notes and surgical reports from the same patient).
I once knew a psychiatrist who kept a two tier paper record system: the hospital notes (property of the state), and a card index to which only he and his secretary had access. I don't know if he ever shared them with anyone else. You could model such a system quite simply: maybe using a secure browser to connect to your own private server (apologies if this seems naive to folks who can packet-sniff and monitor keystrokes). BUT: in real life, most doctors (and other users) won't be able to set up their own secure server; most wouldn't be able to outsmart their own computers' internal audit trails. We already have a separation of function--system administration and clinical record entry, and in practice that seems sufficient. A few years back there was a case before the UK General Medical Council: a doctor prescribed beta-blockers to his asthmatic patient; said patient duly died; doctor tried to delete his erroneous prescription from his system, but his action was picked up on the audit trail; he was struck off. > 3) I also won't know why a document does not come with a valid > certificate. The attack could have taken place at the digital notary or at > your site. As far as I understand it, the design of GNotary addresses the defence of the integrity of clinical records in the unusual situation where you have clinicians who are also skilled system administrators, or a conspiracy between a system administrator and a clinician. Having a distributed network of well-administrated peer-to-peer servers holding GNotary data which can cross-compare data in the event of attacks on the keys themselves will surely put undetectable falsification beyond the resources of even the most highly powered conspiracy? D. -- Douglas Carnall tel:+44 (0)20 7241 1255 fax:08700 557879 mob:07900 212881 http://www.carnall.org/ [EMAIL PROTECTED]
