Columbia University College of Physicians and Surgeons (PandS) at Columbia Presbyterian Medical Center (CPMC) of New York Presbyterian Hospital and the SUNY Upstate Medical University received a $28 million grant from the Health Care Financing Administration (HCFA) to bring health care into the homes of underserved rural and inner-city residents suffering from diabetes. The initiative is the largest telemedicine effort ever funded by the federal government's Department of Health and Human Services.
Columbia and SUNY Upstate join five other sites in the initiative, called the Informatics for Diabetes Education and Telemedicine (IDEATel) project, that will serve as a test bed for the national use of Internet technology to increase access to health care for all Americans. The demonstration project will be a model to develop more effective treatments for other diseases such as heart failure, asthma, depression, and obesity.
The new platform integrates public key infrastructures (PKI), Web security and database services to enable strong mutual authentication, encryption and authorisation capabilities in a single service utilising client and server digital certificates. The patients need only a simple browser, an Internet connection, and a digital certificate signed by the dedicated and trusted IDEATel certificate authority to access clinical and educational applications designed specifically for this project.
"Security was a critical requirement handling patient information and the new Health Insurance Portability and Accountability Act legislation of 1996 (HIPAA) which will impact every health care provider and institution. Simplicity was equally important because the study group includes elderly patients using the system from their home. The digital certificate mechanism offered the best of both worlds: security and convenience", explained Justin Starren, MD, PhD, Assistant Professor of Medical Informatics and Radiology at Columbia PandS and co-principal investigator on the project.
"Crosshair carefully listened to our requirements, integrated the right technologies and had our beta system operational within weeks", Dr. Starren added. The complete PKI and Web security production system was installed on time and within budget. The other key features of the security platform include single sign-on and multiple authentication management. Physicians currently use a token-based authentication scheme to access other clinical applications within the Columbia environment. To maintain the same user experience and reduce operational overhead, the novel platform can manage both digital certificate and token authentications.
In addition, patients authenticating to the disease management application by means of their digital certificate will be able to access another application operating in an entirely different data centre by utilising the single sign-on capabilities which are to be designed into the service later this year. The application can also serve Web content matching the user's native language and literacy rate, based on attribute data provided by a centrally managed authorisation engine.
"Using public key infrastructures in health care is proving a promising solution for extending clinical information to patients who can now be more involved with their care. The Internet continues to expand with PKI providing the necessary security mechanism to enable innovative services and ways for people to communicate", commented Gary Ring, Partner Crosshair Technologies.
Crosshair Technologies specialises in the creation of trusted environments for Web users. The company embraces the power of the Internet, believing that even greater social and economic advances will be achieved when the proper security and management services are integrated with the public Internet to form trusted communities of interest. For more details, you can check in at the IDEATel project Web site. You can also read the VMW November 2000 article IDEATel study to monitor diabetes patients at home with advanced telemedicine equipment and services.