title: Applying a presentation content manifest for signing clinical documents.
abstract: In this paper, we demonstrate how to digitally sign a content manifest of a presentable clinical document that contains multiple clinical data with presentations. Only one signature is needed for an entire clinical document with multiple data resources, which can reduce the computation time during signing and verifying processes. In the radiology field, a report may contain text descriptions, images, and annotations that are stored separately in different data resources. The manifest signature would be a proper means for integrity checking for all the clinical data within the manifest. The manifest signature can be extended with a trusted third party to add a digital time signature for long-term verifiability. The performance of the manifest signing compared with that of a traditional digital signing was evaluated. The new manifest signature can be used for signing different types of presentable clinical documents, such HL7 CDA documents and DICOM image reports.
authors.affiliation: Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chung-Yueh
authors.initials: CY
authors.lastname: Lien
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Hsiao
authors.forename: Lu-Chou
authors.initials: LC
authors.lastname: Huang
authors.forename: Tsair
authors.initials: T
authors.lastname: Kao
mesh_terms: D016494:Computer Security; D003219:Confidentiality; D001330:Electronic Data Processing / Q000592:standards / Q000639:trends*; D005568:Forms and Records Control; D055991:Health Records, Personal; D006801:Humans; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized; D010818:Practice Patterns, Physicians'; D011786:Quality Control; D011873:Radiology Information Systems / Q000592:standards / Q000639:trends