【作者】 陈乐君；

【导师】 石锐；

【作者基本信息】 重庆大学 ， 计算机软件与理论， 2007， 硕士

【摘要】 病历是病人病情、诊断与处理方法的记录,是医护人员进行医疗活动的信息传播媒介和执行依据。随着医疗信息化的深入,病历逐渐地从纸张过渡到电子病历(EMR)。电子病历是医疗信息化的核心技术,它既是病人医疗信息的集合,又是信息共享的载体,所以研究电子病历的安全就十分重要,本课题对医疗信息事业有较大的理论和现实意义。本论文较为系统的分析了电子病历系统存在的安全隐患,并根据先行的规范和所掌握的技术提出了一种电子病历安全体系。在此基础上,对电子病历文档的规范定义、XML安全技术、XML密钥管理技术都进行了较为系统的试验研究。电子病历的安全性包括病历文档的完整性、机密性和不可否认性等方面。电子病历安全的实现需要法律、管理与技术三方面的帮助。加密、数字签名等技术为电子病历的安全提供了技术保障。本文依托“军字一号”(第三军医大学新桥医院的电子病历系统)系统,探讨了XML安全技术在电子病历系统中的应用与实现。电子病历文档在系统中采用XML文件的形式进行存储和传输。XML文件的结构化与可扩展性非常适合描述含有复杂内容的病历文档。本系统根据XML电子病历文档的特点,使用XML Schema模式库来规范病历文档的结构和内容,使病历在不同医院的无缝链接成为可能。此外,本系统使用W3C的XML加密与数字签名规范为医师提供信息加密与数字签名的组件。本论文设计了一种电子病历安全系统,给出了其中的关键模块,分析了加密和数字签名使用的时机,并重点讨论了数字签名器和加密器的设计和工作流程。同时,本文根据“军字一号”电子病历系统的应用现状,提出了一种全新的电子病历多重签名方案,具有一定的可行性。XML密钥管理规范XKMS可以提供新一代的密钥管理服务,通过结合传统PKI可以实现低成本、易部署的PKI应用。本系统使用XKMS服务来管理加密和数字签名组件所需要使用的密钥。本文为“军字一号”系统构建了一个基于Web Service的XKMS服务框架;根据应用的特点给出了XKMS的信任服务,包括密钥注册、密钥撤消、密钥定位等方法;使用XKMS来部署医院的PKI认证中心。综上所述,本论文利用基于XKMS的加密和数字签名技术为电子病历的安全给出了一种可行的解决方案。更多还原

【Abstract】 Medical record includes information that the patient provides concerning his or her symptoms and medical history, the results of examinations, reports of x rays and laboratory tests, diagnoses, and treatment plans. It is the media and executing gist of healthcare activities, it is also the information source of medical research and education. With the development of Hospital Information System, a transition from paper-based patients records to electronic medical records has taken place.EMR is the core technique of Medical Information, it is not only a collection of patient medical information,but also a vector of information sharing,therefore the security of EMR becomes very important, this issue causes a great theoretical and practical significance on the project of Medical Information.This paper analysis the potential safety problems of the electronic medical records system. According to norms and technology presents this paper design a security system for EMR, and on this basis making a more systematic study on the standard definition of EMR file, XML security technology, XML Key Management technology.Confidentiality, integrity and non-repudiation are three basic requirements for the security of EMR. The security of EMR is based on laws、management and technology. Encryption and electronic signature technology are based on asymmetric cryptography method, they provide solutions for the security of EMR. This paper relies on“Junweiyihao”system(The EMR system used in Xinqiao hospital of Third Military Medical University),and discusses XML security technology in the application and implementation of an EMR system.EMR system used for storage and transmission in the form of XML documents.The structure and expanded of XML document is very appropriate description of the contents of the medical documents containing complex. According to the characteristics of XML_based EMR, this system use XML schema models for Developing the structure and content of medical documents, and make sure the medical documents can be linked smoothly between different hospitals. Furthermore, this system provides encryption and signature components which used encryption and signature standards followed by W3C. This paper tells how to develop EMR security system, and then analysis some key modules. Focused on the design and workflow of encryption and signature, this paper analyses the timing for encryption and signature. Furthermore, relies on“Junweiyihao”system, this paper give us a new and feasible solution which use Muti-signature on EMR.XML Key Management Specification XKMS can provide new key management services, combined with traditional PKI it can implement PKI application which cost less and develop easily. This system uses XKMS services to manage the keys which are used by encryption and signature components. This system constructs a web-based service framework using XKMS services, and gives the XKMS trust services following by the applications, including key register, key revoke, key locate and some other methods. It uses XKMS PKI Authentication Center for deployment.In short, this paper develops a workable solution for the security of EMR by using encryption and signature technology based on XKMS services.更多还原