Integrative Projects Status Report

1. Integrative ProjectsStatus Report Janos Sztipanovits

2. Content • Role of Integrative Projects in TRUST • Status Report on Project Formation: • Patient Portals • Systems/Security Co-design in Embedded Systems • Next Steps

3. Role of Integrative Projects • Link research efforts to real-life challenges • Help validating research results • Facilitate technology transitioning toward National stakeholders • Provide focus for integrating research efforts

4. Patient Portals: Societal Context • Health Insurance Portability and Accountability Act of 1996 (HIPAA) • The HIPAA Privacy Rule, which became effective in April of 2003, gives US citizens for the first time a uniform right to access to information contained in their medical records, • to request amendments or corrections to those records, • to request an accounting of disclosures of their personal health information made by their healthcare providers. • The HIPAA Security Rule, which became effective in April, 2005, requires healthcare organizations to adopt administrative, physical and technical protections for person-identifiable health data that is maintained or transmitted in electronic format. • Currently, the civil and criminal liabilities associated with the • Security Rule create additional concerns and reticence of health care • organizations to bring new classes of users into the previously private, • internal domain of electronic clinical information systems.

5. MyHealth@Vanderbilt • Experimental Patient Portal at VUMC • Patient access to lab results • Patient-entered notes e.g., dietary supplements • Automated drug-drug interaction checking for items that patients add to their medications • Opportunity • Use MyHealth as an evaluation platform for TRUST technologies

6. Criteria for Being a TRUST Integrative Project • Interest from the Medical Community • Multisciplinary: Social, Systems, Security • Scale: Societal with huge potential implications • Real: MyHealth is a live experimental system • Technical richness and fundamental challenges

7. Integrative Project Development on Patient Portals • Discussions and preparations started with Prof. Bill Stead, Director, Informatics Center and the Prof. Dan Masys, Chair, Department of Biomedical Informatics of Vanderbilt University Medical Center in September, 2005. • We jointly organized a Design Workshop for an Integrative Project related to Patient Portals on December 16, 2005 at Vanderbilt Center for Better Health. (http://dbmi.mc.vanderbilt.edu/trust/#Output) • Detailed project planning between TRUST and the MyHealth program continue.

8. Meeting at Vanderbilt

9. Presentations

10. The Nature of Biomedical Data • Complexity of privacy • Variable levels of sensitivity; “sensitive” is in the eye of multiple beholders, and highly context-dependent • No bright line between person-identifiable and “anonymous” data • So inherently rich in attributes that re-identification potential never reaches zero • Genome as Future Diary: An individual’s medical data may have implications for other family members who have much different values and preferences, and for future generations • Complexity of access rights and policies • Simple role-based access control is insufficient • Governing principles: “need-to-know” and “minimum disclosure” Source: Dan Masys’s presentation

11. Design Rounds

12. Workshop Results • Real-time Patient Data MonitoringProject (see poster) • Role-based Access Modeling for Patient Portals (see poster) • Unintended Consequences(joint study group between the MyHealth program and TRUST)

13. Patient Portals:Technical Challenges 1/2 • Access ControlUnique problems: - Policy languages - Policy validation - Distributed policy enforcement • Data PrivacyUnique problems: - Learning from data while keeping individual data private - Publishing data without possibility to link back to individuals - Information flow through data access: “leaking secret data” - Incorporating background knowledge - Interaction between privacy and policy languages

14. Patient Portals: Technical Challenges 2/2 • Distributed trust managementUnique problems: - Maintaining trust across multiple players with conflicting interests and policies • Information architecture modeling and analysisUnique problems: - Technical and organizational heterogeneity - Major role of legacy systems - Scale and complexity • Benchmarking • Creation of synthetic patient data • Real-life patient data • Societal Impact of Patient Portals- What privacy policy would make patients comfortable with contributing data to research study?

15. Approaches • What solutions are possible? • Policy languages (Stanford) • Data privacy (Cornell) • Information architecture modeling and analysis (VU, Berkeley) • Distributed trust management (Cornell) • Societal impact (Berkeley) • Use MyHealth as demo system • Put TRUST research thrusts in MyHealth contexts

16. Embedded System/Security Co-design: Societal Context • Embedded and Networked Embedded Systems have huge penetration • in all market sectors: automotive, aerospace, defense, medical, • transportation, energy, chemicals, communications and others. • Security of embedded systems is becoming a major societal concern • Resource limitations, timing, and complexity make the development of secure embedded and networked embedded systems a significant scientific and technical challenge

17. Integrative Project Development on System/Security Co-design • Discussions and preparations started with the ESCHER companies (GM, Boeing, Raytheon) in September, 2005. • We solicited input for challenge problem specificationand testbed ideas. • At the December 2005 ESCHER Advisory Group meeting we discussed specific ideas and plans • A low-cost testbed implementation is ongoing.

18. Testbed Configuration Plant Simulator DAQ Controller Controller Controller Wireless Link • Different SW platforms: • Linux • GRSecurity • Others (LynxOS, VxWorks,..) Single board computer SBC4495 from Micro/Sys Minilab 1008

19. Composition Platform Functional Models Component Models OS Security Services Access Control HW/SW Arch Componentized Model Partitioning Model Platform Model Secure Component Structure Model Deployment Model Generators Integrated Co-design Environment • Domain-specific Modeling Languages (AADL, Simulink/StateFlow, …) • Security modeling for different platforms • Model Analysis tools • Code Generators

20. Exploratory Integrative Project Ideas • Sensor Networks in Cooperation with Oak Ridge National Labs • Dirty Bomb Detection • Trusted Transportation Corridor (VU)

21. Sensor Networks: Dirty Bomb Detection Demonstration in VU Stadium Goal: Detection of Rad. Source position by tracking location of moving sensor with less than 1m error. • Demonstration in Vanderbilt Stadium, April, 2006 (IPSN’06) • ORNL: Rad. Sensor • VU-ISIS: Sensor localization and system integration • Berkeley: Platform • Cornell: Networking Oak Ridge National Labs TRUST team: Vanderbilt-Berkeley-Cornell

22. Next Steps • Additional integrative projects concepts arebeing developed (e.g. sensor networks) • Project teams are formed between TRUST groups and “stakeholders” • Detailed project plans are discussed • Integrative project teams are formed First results will be reported at the April 2006 TRUST Review Meeting