{"content":[{"text":"them, to play a more active role in their own care, and to be able to seek advice from \n information resources, human or computerised. \n Patients expect to be able to make use of their entitlements to care services purchased \n on their behalf (eg through insurance). They expect that invoices will be passed \n automatically to the respective purchaser(s) after the patient has accepted and \n authenticated them as an accurate summary of the care provided.","bbox":{"left":0.151007,"top":0.071097,"width":0.697814,"height":0.10808600000000002}},{"text":"The professional perspective \n Professionals need access to secured computer systems and services in order to \n discharge their professional duties. A professional may have one or more provider \n identities (PI) – for example one PI as a GP and another as a part-time hospital \n registrar or casualty officer. Each of these formal identities will be issued by a trusted \n authority: each will confer functional privileges (eg to issue orders for medications) \n and permit access to secured services – computing network, pathology results etc. \n The accumulation of userIDs, passwords, encryption keys and so on necessary to \n establish those secured connections in an increasingly extensive and networked \n environment is fast becoming too complex for an individual to remember and manage. \n What the health professional needs is a mechanism to authenticate their PIs and to \n establish their privileges and secured information systems access rights with the \n minimum of effort – but complete security. \n Issuing and Assuming Identities \n In both the above situations, the principle is the same. Patients and professionals must \n be able to authenticate that they are who they say, and that they own one (or more) \n ‘identity’ which is associated with various records and/or privileges. \n Issuing an identity may be simple or more complicated, depending upon what \n privileges are conferred by that identity, and therefore what levels of proof may be \n required to support that identity. For example a license to practice confers extensive \n rights and privileges: to obtain a practising identity, a doctor must be able to \n demonstrate that they meet legal and health agency requirements (usually a \n qualification and entry into a register). By contrast there is no formal requirement to \n prove status as a patient: an individual should be free simply to assume an identity of \n their choosing. However to benefit from health insurance that individual will need an \n insurance identity formally issued by their insurer: enrolment in an insurance scheme \n may entail a level of proof, including provision of data and its authentication, as \n determined by the insurer. Once an identity has been issued, the holder merely needs \n to be able to authenticate that they are the person to whom the identity in question was \n issued. \n One approach to this involves every individual being vouched for by a trusted third \n party, to whom they would prove their identity in order to acquire a single ‘cyber- \n identity’ – a national identifier. Such an approach has been widely advocated and has \n been implemented as an identity card in some jurisdictions – notably those with more \n totalitarian regimes. However this is strongly opposed by civil liberties groups, and \n not without good reason. Whilst the concept is elegant and well serves the needs of \n administration, it may be viewed as a serious threat to civil liberty and to the right of \n an individual to control who knows what about them – a cornerstone of information \n privacy and human rights provisions. It is a short step from having a national unique \n identifier to using that to carrying out cross-sectoral data trawling and matching \n expeditions, which is generally considered ethically unjustifiable unless there is prima","bbox":{"left":0.151007,"top":0.192501,"width":0.697988,"height":0.718867}}],"images_bbox":[],"images_bbox_not_text_overlap":[]}