Download ABC`s of the Internet Cancer Registry

ABC’s of the Internet Cancer Registry
Chetan Wasekar, MD; Jeannette Jackson-Thompson, MSPH, PhD
Missouri Cancer Registry, University Missouri-Columbia,
Internet Basics
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The Internet is a global network of networks, connecting millions of
computers all over the world.
•
Every computer that logs on the Internet has a unique identifica tion
number called the Internet Protocol [IP] address which is a number is
a p.q.s.t format
•
Computers connected to the internet communicate via standardized
languages called “protocols”. For example “Hyper Text Transfer
Protocol” [http] is one such language
Central registries have an urgent need to streamline their work
processes due to the numerous challenges registries face,
including an ever-increasing volume of cancer data and the need
to implement new reporting requirements while maintaining or
improving timeliness, completeness and quality of reporting.
This is where web-based data submission promises to help. A
few registries, such as the Florida Cancer Data System and the
New York State Cancer Registry, have already implemented the
web-based process.
Internet Security Basics I:
Public Key Cryptography
•
This method involves generating a “digital signature” by first applying a
special mathematical technique to the data, known as a “Hashing algorithm”
to get a “message digest” and then encrypting that using a secret “private
key.”
Cancer Case Data
Hashing
Algorithm
Attached to
The Internet offers a number of benefits. These include:
Source
IP address =169.10.90.10
INTERNET
IP address =202.22.34.12
Destination
How data travels over the Internet - I
•
Before transmission, all data is first broken into numerous “packets”
or “cells”
•
It is these packets that traverse the Internet wires
Structure of the Internet packet
Packet Component
HEADER
Packet
BODY
FOOTER
Content of the Component
•Sender’s IP Address
•Rec eiver’s IP Address
•Pac ket N umber
•P rotocol
•T he Actual D ata
•Flag to s how end of packet
•E rror Correction
http://computer.howstuffworks.com/question525.htm
How data travels over the Internet - II
•
•
Each packet has enough information to reassemble the whole data in
the correct sequence at the destination
On the way to the destination, there are various “Routers” that read
the packet information. These components redirect the packet to
the next router or computer depending on the packet destination
address
Destination
Pac ket
Pac ket
Source
1. Pre-existing and inexpensive connectivity.
2. Abolishment or abatement of need for document imaging and
associated costs.
3. Pre-formatted and legible data.
4. Application of real-time edit checks.
5. One-time application of NAACCR layout changes at the central
registry server, rather than multiple applications at each
reporting source location.
6.Increased compliance, since the data sources don’t need to
purchase/develop reporting systems or worry about HL7
issues.
7. Automation of data receipt, diagnostic coding and database
updating.
8.Superior tracking.
9.Improvements in data timeliness and completeness.
1. Security And Privacy: As data travels from one computer to
another over the Internet, any of these routing computers can
tap into the information. This poses a security and privacy
threat to protected patient information.
2. Internet Access: Not all hospital and non-hospital data
providers have access to the Internet.
3. Technical Expertise: Some registries may not have the
required networking expertise to set up and maintain webbased reporting systems.
4 . Initial Costs: Though the Internet is inexpensive, some
central registries and reporting facilities may not be able to
afford many of the currently-available technologies for
protecting sensitive patient data.
ROUTER
The Internet revolution has transformed many businesses.
Cancer registries have yet to harness the power of the web, but
we can begin to take the first steps.
This project was supported in part by a cooperative agreement between the CDC and the Missouri
Department of Health and Senior Services (DHSS) (#U55/CCU721904-03) and a Surveillance
Contract between DHSS and the University of Missouri.
Private Key
Digital Signature
•
The web-server at the cancer registry that receives the data then
authenticates itself using a “Digital Certificate” that is purchased from
trusted third-party vendors like Verisign. This is vital to make sure that the
data does not reach the wrong hands.
•
Only after the registry web-server certificate is checked for authenticity can
the cancer data be decoded back to its original form using the sender’s
shared “Public key,” which is transmitted to the receiver along with the
data.
http://www.digsigtrust.com/support/pki_basics.html
Internet Security Basics II:
Virtual Private Networks
•
•
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These benefits imply a streamlined workflow and savings in
money and time as well as improved data quality and
completeness. However there are also some bottlenecks that
need to be tackled :
Message
digest
•
It would be great to have all cancer data providers wired to the cancer
registry via a private Wide Area Network (WAN). However, this is an
impractical solution due to its enormity and the costs involved of setting
up a private network spanning the entire state.
Virtual Private Networks (VPN) are an effective solution that provides
virtual, dedicated, private channels set up within the public Internet using
special protocols known as “Tunneling Protocols.”
“Tunneling” involves encapsulalting data packets into additional packets
which only authorized receiving parties can unfold.
VPNs also provide additional data security by various methods such as:
– Firewalls between the private session and the public Internet
– Additional protocols, such as Internet Protocol Security Protocol [IPSec]
– In combination with Digital Signatures and Digital Certificates
Source : http://www.networkcomputing.com/905/905colmoskowitz2.html