
 
request. Once a particular interoperation need arises, 
the requesting domain may not know which domains 
contain the requested permissions, and a look-up 
mechanism is necessary to locate those domains. For 
example, the health care workers in Hospital A 
needs to know which hospital or clinic has Bob 
registered and contains Bob’s health information. 
Although in this example Bob may carry his health 
care card that contains the information of his home 
hospital, in general we cannot assume that the 
requesting domain always knows a priori the 
domains containing the requested permissions. One 
possible solution is to use a centralized database to 
maintain such global information (e.g. the hospitals 
a patient has registered in). However, such 
centralized database could become very complex 
and hard to manage. Moreover, it could also be the 
bottleneck and suffer from single point of attack. 
Therefore, decentralized look-up approaches are 
more desirable in loosely-coupled environments. We 
refer to this problem as Domain Discovery problem. 
This challenge shows that Domain Discovery is 
necessary in loosely-coupled environments. 
 
Figure 3: Access cycles in a loosely-coupled environment. 
The second challenge is how to make an access 
control decision for a particular interoperation 
request. Global policy based approach cannot be 
applied here since the interoperation needs cannot be 
predefined. For example, at the time when both 
Hospital A and Hospital B join the network, the 
administrators cannot pre-define that Hospital A can 
access Bob’s health information from Hospital B. 
This is because such interoperation need is only 
necessary when Bob needs to go to the emergency 
ward in Hospital A and this may never happen. In 
the literature, trust management systems are 
typically used to make authorizations among 
unknown domains. In a trust management system, 
each domain specifies its local trust policy (typically 
consists of credentials that is required to access 
some resources), and employs some credential 
validation and trust negotiation approaches to make 
the authorization decisions. For example, when the 
healthcare workers in Hospital A request Bob’s 
health information from Hospital B, Hospital B may 
require that only the users with valid healthcare 
licenses be allowed access to Bob’s health 
information, and ask healthcare workers in Hospital 
A to present their license in order to gain the access. 
Once the license has been verified, the access 
request is granted and the healthcare workers in 
Hospital A can now access Bob’s health information 
from Hospital B. This challenge shows that a Trust 
Management component is necessary in loosely-
coupled environments. 
The third challenge is how to prevent the access 
cycle and preserve the principle of security  during 
the interoperation. The access cycles could be 
formed when multiple authorized interoperations co-
exist within the same time period. Consider the 
example shown in Figure 3. Assume Bob is 
registered and taken cared of at his home hospital 
(Hospital B), where both the doctor and resident are 
authorized to access his healthcare information. Of 
course, doctors have more privileges, such as adding 
a new entry to his record, so Doctor role is made 
senior to Resident role in Hospital B’s local policy. 
In Hospital A located at another city, healthcare 
workers are responsible for maintaining normal 
health care information. There are specialist doctors 
that are all experts of cancer and they may need 
special privileges to maintain cancer-related 
information. Therefore, SpecialistDoctor is made 
senior to HealthCare-Worker in Hospital A. Now 
assume that Bob needs to go to the emergency ward 
in Hospital A when he travels to that city. To take 
care of Bob, the healthcare worker in Hospital A 
needs to access Bob’s health care records and also 
needs to add a new entry to Bob’s records. So 
HealthCareWorker of Hospital A is made senior to 
Doctor of Hospital B to facilitate such 
interoperation needs (Interoperation 1 in Figure 3). 
Assume at the same time, hospital B receives a 
cancer patient but is unable to make a proper 
treatment plan since they are not experts of cancer. 
The doctor in hospital B asks the resident to get 
some help from the specialist doctors in Hospital A 
(e.g. accessing some cancer-specific information in 
Hospital A to learn how to make the proper 
treatment). As a result, Resident of Hospital B is 
made senior to SpecialistDoctor of Hospital A to 
facilitate such interoperation needs (Interoperation 2 
in Figure 3). 
At this time instant when both 
interoperations 1 and 2 in Figure 3 are authorized, 
there exists an access cycle (shown by the four 
arrows) and the principle of security is violated. 
Unlike  in  a  tightly-coupled  environment,  there 
is   no   static   global   policy  in   loosely-coupled  
Specialist Doctor
HealthCare Worker
Doctor
Resident
Hospital A Hospital B
Interoperation 1
Interoperation 2
adding entries …
access health 
care records…
maintain normal health 
care information…
maintain cancer-specific 
information …
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