A national database of medical data requires policy decisions and then technology the enable that policy. It will be difficult to determine who has access to different portions of health care data. Once the health care data access policies are complete, access rules will be created to enforce who has access to the data and encryption will be used to protect the data. But, because encryption with certificates requires a root key, the institution owning the key will have great power.

Gregory Machler is an information security architect and cloud security expert and a frequent contributor to CSOonline.