HISEHR

HISEHR is an acronym for High-Integrity Secure Electronic Health Records. It refers to a conceptual framework and set of practices intended to enable secure, private, and interoperable management of electronic health records across healthcare providers and settings.

The framework emphasizes data integrity, confidentiality, availability, provenance, and patient consent. It seeks to provide auditability and tamper resistance while supporting patient control over who can access their information.

Key components include strong cryptographic protections (encryption at rest and in transit, digital signatures), robust access control (role-based and attribute-based access), consent management, and data provenance with tamper-evident logs. The architecture envisions modular services that exchange data via interoperable formats such as FHIR and HL7, and may employ distributed ledger techniques or cryptographic hash chains to detect unauthorized changes.

HISEHR is designed to be compatible with existing EHR standards and privacy regulations, and is often described as a target for cross-institution sharing and patient-centered data governance. As of now, HISEHR is not a formal international standard; it appears primarily in academic papers, industry white papers, and pilot projects led by consortia seeking to pilot secure data sharing.

Adoption faces challenges including implementation costs, vendor fragmentation, and the need for comprehensive key management and privacy safeguards. Proponents argue that it could reduce data breaches, improve trust, and enable safer research use of health data, while critics warn that without broad stakeholder alignment, it risks creating new interoperability gaps.