Tim Churches wrote: > > John Gage wrote: > > > > I would like to start a thread on the role of electronic mail in > > medical computing. > > > > I will begin with the punch-line: I believe that an entire medical > > record system that would actually be used by physicians and other > > providers can be constructed using IMAP server technology. > ----8<---snip----8<------ > > I would close with a reiteration of my comment about security. This > > system is totally secure. How? Very simple. You put a copy of Exim > > on all the clients. In this way, not only is each client a client, it > > is also a mail transfer agent. It has total control of who it talks > > to and what path it uses to transfer mail. The system would exist in > > parallel with other e-mail systems.
OK, sorry, I missed that last part: > > It has total control of who it talks > > to and what path it uses to transfer mail. The system would exist in > > parallel with other e-mail systems. So you are proposing a network of mail servers, one in each clinic or practice, which are dedicated to medical messaging, each with routing tables which ensure that messages are only routed via members of the trusted network? Problems with this: a) If Dr A sends a message to Dr C via Dr B's mail server, Dr A probably doesn't want Dr B to be able to read the message to Dr C (especially when it is complaining about Dr B's less-than-optimal management of a case...). b) How will these special purpose routing tables be maintained? Easy when there are only 10 mail servers, not so when there are 1,000 or 10,000. c) Messages can still be intercepted "on the wire" by anyone who has access to a router over which the messages travel. There are only two solutions to this: encryption or laying your own tamper-proof network cabling... The alternative wouyld be for everyone to use SSL-encrypted IMAP connections to access a single mail server, so no messages are ever transfered between mail servers. This might work, but may not be sufficiently scalable and means there is a single point of failure. Plus, that single mail server would need to be very, very secure, oth electronicall and physically. Tim C
