title: Comprehensive management of the access to a component-based healthcare information system.
abstract: OBJECTIVE
  to describe the key concepts and elements used to implement a comprehensive access management system to a distributed, component-based healthcare information system.
  
  
  METHODS
  the a priori access is based on an institution-wide policy for access rights coupled to proximity process for the granting of such rights. Access rights are explicit and externalized from the information systems components. A posteriori control is based on a centralized, exhaustive journal of accesses to all components coupled to a decentralized verification process for suspicious accesses.
  
  
  RESULTS
  the system has been operational for three years, initially used for the access to the computerized patient record components, and now extending to all the components of the hospital information system. The same architecture will be used for the development of the trans-institutional community health information network.
authors.affiliation: Service of Medical Informatics, Geneva University Hospitals, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Lovis
authors.forename: Stéphane
authors.initials: S
authors.lastname: Spahni
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cassoni-Schoellhammer
authors.forename: Antoine
authors.initials: A
authors.lastname: Geissbuhler
mesh_terms: D022126:Access to Information; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D013557:Switzerland