In addition to interoperability, what is also needed is a means to securely access and control this distributed virtual' medical record. This work would build upon Internet2 security middleware. Imagine if in that same session the patient could then authorize a specialist or clinic to access part or all of the record and authorize research access to parts of their record that dealt with a chronic disorder. The current enterprise security model that depends on perimeter security and user log-on at client windows PCs is very complex and does not work very well but grew out of necessity because there was nothing better available. Many studies have shown that the worst security threats are generally from employees who are authorized access to their network doing things they are not supposed to do rather than outsiders.
Every device is connected via personal, local or wireless networks.
Security will only work if it is built into each device from the ground up. Figure 3 brings all these building blocks together as the proposed Internet2 Health Sciences Security Roadmap. The e-Health industry will be able to supply far greater value if peole can use the Internet to access and control their real medical record. These capabilities would provide tremendous motivation for all medical records to be put on line and be part of the future virtual patient record.