As far as PHR data security and privacy are concerned, Web-based PHR systems usually allow patients to collect and
store digitized health information, but they usually implement only very simple selective access delegation policies [32].
About commercial systems, PeopleChart 2, for instance, allows separating private and public health information and defining specific roles (e.g. provider or caregiver) to access the information classified as public. MyPHRMachines allows a finer grained sharing approach, where patients can delegate access to subsets of their PHR data to individual caregivers. Such functionality may of course be extended with a role-based access control similar to PeopleChart’s, e.g. to share PHR data to all GPs known by a patient, but this extension will still build on the fine grained sharing already implemented in the current version of our prototype.
Unlike MyPHRMachines, the existing PHR platforms provide no technical measures for preventing data abuse by the
plug-ins that are contributed by third party software vendors. Instead, they confront patients with take-it-or-leave-it terms
of use agreements for each individual third party plug-in. Typically, in such agreements the third party vendors promise
not to abuse the data. Consequently, upon ad-hoc end-user permission, their software service gets download access to the patient data and it is up to external audits to verify that the terms of use are adhered to. While this architecture may be adequate for sharing information to providers whose reputation is at stake (e.g. an established hospital), it seems much less adequate for a genomic analysis service provided by a niche player from the rapidly evolving bio-informatics industry.