Context: Data sharing is necessary in medical contexts where the main objective is to increase the professional potential of each specialist for better management of clinical cases. In recent years, a cooperative consulting technique (Multi-Disciplinary Team or MDT) has been spreading more and more. This technique consists of a series of specialists from different medical disciplines sitting at the same table. This type of collaboration allows several specialists to address the problems of a patient from various points of view, that include diagnostic definition and therapeutic proposal. Cooperative consulting requires that large sets of medical data are both pre-processed and post-processed before and after the actual exchange across the hospitals in order to apply the proper data transformations and make it compliant with a common language and format. The case study that will be addressed concerns patients management in an oncology context, namely a radiation oncology department. In this particular context it is routinary to have all patients information available on different electronic archives and it is very often necessary to share patient information in real time, with the surgeon, oncologist, internist, radiotherapist and radiologist or nuclear doctor not on site. It is therefore necessary to use technologies capable of correctly, and above all safely, perform pre-processing and post-processing procedures when the exchange of information between medical specialists takes place.

Missed Opportunities and potential negative impacts due to cybersecurity risks: The typical solution in the health domain is the use of anonymized/pseudonymized data: data security is guaranteed via anonymization and pseudonymization techniques. Anonymization and pseudonymization have enabled throughout the years the creation of very large and heterogeneous databases, which are a valuable asset for medical research. In many cases these techniques are effective, since they allow the specialist to obtain a series of medical information without going against the current privacy regulations. Conversely, anonymization and pseudonymization fail to meet the requirements of our pilot. Flexible and high performing hardening mechanisms are needed, to enable secure and timely data sharing. Protection of data-in-use must be provided for pre-processing and post-processing of health records, to make sure any violation is prevented, and confidentiality is guaranteed. Ease-of-use must be ensured to avoid the burden of doctors’ training activities.

Infrastructure: In a typical setup, the specialists involved are not at the same hospital but are located on national or international territory and it is necessary that all information and clinical data are immediately shared. Use of the cloud is possible, nonetheless it remains challenging.

Expected ENCRYPT impact: The availability of effective and flexible security features, protecting data from safety and privacy violations, will enable full automation of the process, and will result in better treatment at a fraction of the cost.