The main problem with Digital Signatures is NOT the standards, it is the Policies and overhead in issuing proper Digital Identity (PKI). Once there are Digital Certificates issued for the purpose of Digital Signatures, then there are many use-cases that can be enabled. However that first justification of the costs is very hard to do, and somehow combining justifications just never seems to happen.
The Document Digital Signature (DSG) profile is a Document Content profile that provides general purpose methods of digitally signing of documents for communication and persistence. This method can be used within a Document Sharing infrastructure (e.g., XDS, XCA, XDM, XDR, and MHD).
Electronic documents are being increasingly relied upon in healthcare. Signatures have been a part of the electronic documentation process in health care and have traditionally been indicators of accountability. Reliable exchange of data between disparate systems requires a standard that implements non-repudiation to prevent document creators from denying authorship and rejecting responsibility.
- An Enveloping Signature is a Digital Signature Document that contains both the signature block and the content that is signed. Access to the contained content is through removing the Enveloping - Digital Signature. Among other uses, this method should not be used with Document Sharing infrastructure.
- A Detached Signature is a Digital Signature Document that contains a manifest that points at independently managed content. Detached signatures leave the signed document or documents in the original form. Among other uses, this method is recommended for use with a Document Sharing infrastructure to support Digital Signatures, as this method does not modify the original Document Content. This method uses the Document Sharing “SIGNS” relationship provide linkage.
- A SubmissionSet Signature is a Detached Signature Document that attests to the content in a SubmissionSet by: containing a manifest of all the other Documents included in the SubmissionSet, and a reference to the SubmissionSet. The Document Sharing “SIGNS” relationship may be used but is not required.
- IHE - Privacy and Security Profiles - Document Digital Signature
- Signing CDA Documents
- Using both Document Encryption and Document Signature
- Non-Repudiation is a very old art --- the story behind the picture which is of a signature on a receipt for goods.