Audit Trail and Node Authentication

Audit Trail and Node Authentication [ATNA] describes certificate-based node authentication and transmitting PHI-related audit events to a repository. This helps sites implement confidentiality policies.

Summary

The Audit Trail and Node Authentication (ATNA) Integration Profile establishes security measures which, together with the Security Policy and Procedures of the enterprise, provide patient information confidentiality, data integrity and user accountability. The Audit Trail and Node Authentication Integration Profile requires the use of bi-directional certificate-based node authentication for connections to and from each node, and requires that events concerning PHI use are recorded and transmitted to a repository where they can be monitored to detect indications of inappropriate activity.

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Details

(From an email by Rob Horn)

ATNA is already integrated into the full ITI Technical Framework. The ATNA core is section 9 of volume 1, and sections 3.16 and 3.17 of Volume II. The underlying DICOM standard can be found at: ftp://medical.nema.org/medical/dicom/supps/sup95_fz.pdf The underlying RFC can be found at a variety of RFC repositories. ATNA specializes these for some purposes, but also invokes their general support so that we don't have to redefine ATNA every time a new profile specializes an audit message for some new purpose. There are individual profile specializations scattered through all the different frameworks. This makes it hard for an implementer. It's easy to pull out the core sections as a starting point, but not the individual profile specializations.

You find sections of specializations in some of the other technical frameworks. Radiology is probably the most complete for this. This scattering of requirements reflects a fundamental conflict of documentation uses. From one perspective you would like it all in one place, and from another perspective you want it documented in the sections that will actually be read by implementers. We have done this only for profiles that were most critical (e.g. XDS, RFD, EUA, XUA). There is some interested in RID and PIX, we need help to create prioritized CP requests for clarity on profiles that the IHE community needs assistance with.

There is also some historical funny business. Originally HL7 was going to issue an HL7 side equivalent to DICOM's Supplement 95, but that lost sponsorship and got abandoned. So DICOM threw together some partial stuff to cover the immediate needs of the imaging community. It deals with only those HL7ish things that happen to DICOM equipment (like receiving orders). DICOM didn't attempt to handle the rest of the HL7 world. So the various IHE domains get creative in a variety of ways.

Systems Affected

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References

Creating an IHE ATNA-Based Audit Repository, Gregg, B. et al, Journal of Digital Imaging, Vol. 19, Number 4, 2006, pp. 307-315

See Also

Profile Status: Final Text

The IT Infrastructure Technical Framework is the official master document for this Profile.

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The ATNA Profile FAQ answers typical questions about what the Profile does.

The Profile Purchasing Template describes considerations when purchasing equipment to deploy this Profile.

Audit Trail and Node Authentication Implementation provides additional information about implementing this Profile in software. Specific questions about how to implement this profile can be found in the ATNA FAQ.

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