Combating Abuse of Health Data in the Age of eHealth Exchange

The eHealth Exchange is a widely distributed system that allows various healthcare enterprises to share electronic health data across the United States. Unfortunately, the healthcare system in the United States is plagued with abuse and fraud which costs the country an estimated 80 billion every year. The eHealth Exchange will likely become a target of new online attacks and such abuse will possibly increase in scale. In this paper, we discuss some of the emerging online threats that would likely target systems that facilitate sharing of electronic medical records. We design an enhanced version of the eHealth Exchange with mechanisms to prevent, detect and facilitate investigation of fraudulent medical claims resulting from successful breach of sensitive health data. We also support patient-awareness over how their data is consumed within the distributed network, and augment the accountability present within it. We implement our enhancements within CONNECT, which is an open-source implementation of the eHealth Exchange, and OpenMRS, which is a popular open source electronic medical record system platform. We provide a security analysis and preliminary performance results of our implementation.