Evaluation of an Enhanced Role-Based Access Control model to manage information access in collaborative processes for a statewide clinical education program

Background: Managing information access in collaborative processes is a critical requirement to team-based biomedical research, clinical education, and patient care. We have previously developed a computation model, Enhanced Role-Based Access Control (EnhancedRBAC), and applied it to coordinate information access in the combined context of team collaboration and workflow for the New York State HIV Clinical Education Initiative (CEI) program. We report in this paper an evaluation study to assess the effectiveness of the EnhancedRBAC model for information access management in collaborative processes when applied to CEI. Methods: We designed a cross-sectional study and performed two sets of measurement: (1) degree of agreement between EnhancedRBAC and a control system CEIAdmin based on 9152 study cases, and (2) effectiveness of EnhancedRBAC in terms of sensitivity, specificity, and accuracy based on a gold-standard with 512 sample cases developed by a human expert panel. We applied stratified random sampling, partial factorial design, and blocked randomization to ensure a representative case sample and a high-quality gold-standard. Results: With the kappa statistics of four comparisons in the range of 0.80-0.89, EnhancedRBAC has demonstrated a high level of agreement with CEIAdmin. When evaluated against the gold-standard, EnhancedRBAC has achieved sensitivities in the range of 97-100%, specificities at the level of 100%, and accuracies in the range of 98-100%. Conclusions: The initial results have shown that the EnhancedRBAC model can be effectively used to manage information access in the combined context of team collaboration and workflow for coordination of clinical education programs. Future research is required to perform longitudinal evaluation studies and to assess the effectiveness of EnhancedRBAC in other applications.