ARBoR: an identity and security solution for clinical reporting.

TitleARBoR: an identity and security solution for clinical reporting.
Publication TypeJournal Article
Year of Publication2019
AuthorsVenner, E, Murugan, M, Hale, W, Jones, JM, Lu, S, Yi, V, Gibbs, RA
JournalJ Am Med Inform Assoc
Volume26
Issue11
Pagination1370-1374
Date Published2019 11 01
ISSN1527-974X
KeywordsClinical Laboratory Techniques, Computer Security, Genetic Testing, Genome, Human, Genomics, Humans, Laboratories, Medical Records, Organizational Case Studies
Abstract

MOTIVATION: Clinical genome sequencing laboratories return reports containing clinical testing results, signed by a board-certified clinical geneticist, to the ordering physician. This report is often a PDF, but can also be a paper copy or a structured data file. The reports are frequently modified and reissued due to changes in variant interpretation or clinical attributes.

MATERIALS AND METHODS: To precisely track report authenticity, we developed ARBoR (Authenticated Resources in a Hashed Block Registry), an application for tracking the authenticity and lineage of versioned clinical reports even when they are distributed as PDF or paper copies. ARBoR tracks clinical reports as cryptographically signed hash blocks in an electronic ledger file, which is then exactly replicated to many clients.

RESULTS: ARBoR was implemented for clinical reporting in the Human Genome Sequencing Center Clinical Laboratory, initially as part of the National Institute of Health's Electronic Medical Record and Genomics (eMERGE) project.

CONCLUSIONS: To date, we have issued 15 205 versioned clinical reports tracked by ARBoR. This system has provided us with a simple and tamper-proof mechanism for tracking clinical reports with a complicated update history.

DOI10.1093/jamia/ocz107
Alternate JournalJ Am Med Inform Assoc
PubMed ID31241152
PubMed Central IDPMC6798556
Grant ListU01 HG008664 / HG / NHGRI NIH HHS / United States
UM1 HG008898 / HG / NHGRI NIH HHS / United States