Re: [Gnumed-devel] GNUmed (debian) servers and security

[James Busser]

On 28-Jan-08, at 8:24 AM, Dave Cramer wrote:

> That being said, I'd simply use a dedicated network connection  
> between the two machines that could not be sniffed.

Connecting from a remote private machine *over which you have  
control* can be done using a ($$$) dedicated network connection, or a  
VPN like openVPN.

Connecting from a remote machine *over which you have less (or no)  
control* is the problem.

Many doctors have a need to connect to their EMR from inside the  
hospital. Even the doctors who let others look after their patients  
when in hospital, in many cases, still visit the patients at least in  
special cases or may be at the hospital for other reasons. It would  
not be unusual for at least some GPs to spend 30 or more minutes per  
day at a hospital at least a couple of times per week (in some cases  
they might spend a full morning or afternoon) and the inability to  
connect to their EMR from inside the hospital is not going to be  
acceptable.

Some hospitals might soon provide enough wireless access that a  
doctor with their own laptop might be able to set up a VPN, but the  
majority I am sure will find ports and VPNs blocked. So I think that  
doctors who could have a copy of GNUmed on a hospital machine (or USB  
stick) still have to be able to connect via ports 80 or 443 without a  
VPN.

For the purpose of a doctor accessing a single patient (or small  
number of patients' EMR) it is acceptable to let the hospital proxy  
decrypt and re-encrypt the doctor's SSL traffic to their GNUmed EMR.

I think it is important to prevent man-in-the-middle attacks on the  
connection between the hospital and the GNUmed server so unless the  
hospital offered some tunnel to this server then the SSL would be  
needed unless people figure some other way for a secure connection