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Verifiable and Redactable Medical Documents

This paper considers how to verify provenance and integrity of data in medical documents that are exchanged in a distributed system of health IT services. Provenance refers to the sources of health information within the document and integrity means that the information was not modified after generation by the source. Our approach allows intermediate parties to redact the document by removing information that they do not wish to reveal. For example, patients can store verifiable health information and provide subsets of it to third parties, while redacting sensitive information that they do not wish employers, insurers, or others to receive. Our method uses a cryptographic primitive known as a redactable signature. We study practical issues and performance impacts of building, redacting, and verifying Continuity of Care Documents (CCDs) that are protected with redactable signatures. Results show that manipulating redactable CCDs provides superior security and privacy with little computational overhead.