Hierarchical Access Groups for Dynamic Patient Data Control
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Solution Overview
Problem
Current data access models in healthcare settings, such as IBM Watson Care Manager, are too restrictive for scenarios requiring broad access to patient health information, limiting user access based solely on care team membership or registration, which does not accommodate dynamic patient conditions or complex group hierarchies.
Innovation Solution
A novel data access system and method that utilizes dynamic data attributes, care team membership, and hierarchical group structures to grant access, allowing users to be members of multiple groups and patients to qualify for multiple groups based on customizable criteria, with intelligent caching for efficient access control.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If users are restricted to accessing only patients within their care team or registration, then data security and privacy are maintained, but access flexibility and broad cohort access are limited
Solution Approach 1:
The system segments access control into multiple hierarchical levels: organization-level groups, department-level groups, and care team-level groups. This segmentation allows users to access patients at different granularities - from broad organizational cohorts to specific care team members - resolving the contradiction between security and flexibility by providing controlled access at each level.
Solution Approach 2:
The access control system dynamically adapts group memberships and access permissions based on changing patient conditions, care team compositions, and organizational structures. Group memberships are not static but can be updated in real-time, allowing the system to maintain security while providing flexible access to broad cohorts when clinical needs change.
2Device complexity
If a simple care team membership model is used, then system complexity is reduced, but the ability to handle complex group hierarchies and dynamic patient conditions is insufficient
Solution Approach 1:
The system implements nested group structures where groups can contain sub-groups, creating a hierarchical organization model. For example, an organization-level group can contain multiple department-level groups, which in turn contain care team groups. This nesting allows complex hierarchies to be managed through a unified access control mechanism, handling complexity through structured organization rather than system complexity.
Solution Approach 2:
The group membership model serves multiple functions simultaneously: it defines organizational structure, controls data access permissions, and dynamically adapts to changing clinical conditions. This multi-functionality reduces the need for separate systems for each purpose, managing complexity through a unified universal group model.
3Measurement precision
If access control checks are performed in real-time for every data access request, then access accuracy is maintained, but system performance and response time are reduced
Solution Approach 1:
The system pre-computes and caches group membership relationships and access permissions before they are needed. When users or patients are added to groups, the access control implications are pre-determined and stored. This preliminary action allows real-time access requests to be resolved by simple cache lookups rather than complex real-time computations, maintaining accuracy while improving performance.
Solution Approach 2:
The system creates and maintains cached copies of group membership data and access permission structures. These cached copies are updated when underlying data changes, allowing the system to serve access control decisions from the cache rather than recalculating from source data on every request. This copying mechanism preserves access control accuracy while dramatically improving system performance.
Data Source
AI summary
A system and process for applying access groups for controlling data access, by a processor device. The process receives from a user a request to access data associated with a person from a file system, whereby the request invokes at least one software method. Next method interception is performed by matching the at least one software method. Group membership of the user and at least one group membership of the person is accessed. Determining if each of the following conditions of i) the user is a member of a specific group and ii) the specific group contains the person are verified. In response to the conditions being verified, the process sends the data to a user device to display to the user, otherwise denying the request to access data. Each group can have one or more criteria, which add patients to that group based on the conditions of those criteria.