Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation




Computer Science

First Advisor

Dr. Mukesh Singhal

Second Advisor

Dr. Dakshnamoorthy Manivannan


In the current digital age, almost every healthcare organization (HCO) has moved from storing patient health records on paper to storing them electronically. Health Information Exchange (HIE) is the ability to share (or transfer) patients’ health information between different HCOs while maintaining national security standards like the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Over the past few years, research has been conducted to develop privacy and access control frameworks for HIE systems. The goal of this dissertation is to address the privacy and access control concerns by building practical and efficient HIE frameworks to secure the sharing of patients’ health information.

The first solution allows secure HIE among different healthcare providers while focusing primarily on the privacy of patients’ information. It allows patients to authorize a certain type of health information to be retrieved, which helps prevent any unintentional leakage of information. The privacy solution also provides healthcare providers with the capability of mutual authentication and patient authentication. It also ensures the integrity and auditability of health information being exchanged. The security and performance study for the first protocol shows that it is efficient for the purpose of HIE and offers a high level of security for such exchanges.

The second framework presents a new cloud-based protocol for access control to facilitate HIE across different HCOs, employing a trapdoor hash-based proxy signature in a novel manner to enable secure (authenticated and authorized) on-demand access to patient records. The proposed proxy signature-based scheme provides an explicit mechanism for patients to authorize the sharing of specific medical information with specific HCOs, which helps prevent any undesired or unintentional leakage of health information. The scheme also ensures that such authorizations are authentic with respect to both the HCOs and the patient. Moreover, the use of proxy signatures simplifies security auditing and the ability to obtain support for investigations by providing non-repudiation. Formal definitions, security specifications, and a detailed theoretical analysis, including correctness, security, and performance of both frameworks are provided which demonstrate the improvements upon other existing HIE systems.

Digital Object Identifier (DOI)