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OASIS is a non–for-profit consortium that drives the development convergence and adoption of open standards for the global information society. It involves more than 600 organizations and individuals as well as IT leaders Sun, Microsoft, IBM and Oracle. One of it’s standard is XACML which appears a few years ago and now there are about 150 000 hits on Google. XACML (eXtensible Access Control Markup Language) is not technology related. Sun published in 2004 open source Sun XACML which is in compliance with XACML 1.0. specification and now worked to be in compliance with XACML 2.0. The heart of XACML are attributes values of defined type and name that is to be attached to a subject, a resource, an action and an environment in which subject request action on resource. On that way XACML is to replace Role Based Access Control which dominated for years. The paper examines performances in CEN 13 606 and ISO 22 600 based healthcare system which use XACML for access control. 1 Related Work on using XACML At the RSA 2008 Conference, members of the OASIS open standards consortium, in cooperation with the Health Information Technologies Standards Panel (HITSP), demonstrated interoperability of the Extensible Access Control Markup Language (XACML) version 2.0. Simulating a real world scenario provided by the U.S. Department of Veterans Affairs, the demo showed how XACML ensures successful authorization decision requests and the exchange of authorization policies. The XACML Interop at the RSA 2008 conference utilizes requirements from Health Level Seven (HL7), ASTM International, and the American National Standards Institute (ANSI). The demo features role-based access control (RBAC), privacy protections, structured and functional roles, consent codes, emergency overrides and filtering of sensitive data. Vendors show how XACML obligations can provide capabilities in the policy decision making process. The use of XACML obligations and identity providers using the Security Assertion Markup Language (SAML) are also highlighted. According to the ANSI/HITSP announcement, the multi-vendor demonstrations "highlight the use of OASIS standards in HITSP-approved guidelines, known as Sucurovic S. and Simic D. (2009). Writing Open Source SunXACML Access Control in Electronic Health Record with Acceptable Performances . In Proceedings of the 1st International Workshop on Open Source in European Health Care: The Time is Ripe, pages 59-68 DOI: 10.5220/0001813400590068 Copyright c © SciTePress 'constructs,' to meet healthcare security and privacy needs. The Panel's security and privacy specifications address common data protection issues in a broad range of subject areas, including electronic delivery of lab results to a clinician, medication workflow for providers and patients, quality, and consumer empowerment. HITSP is a multi-stakeholder coordinating body designed to provide the process within which affected parties can identify, select, and harmonize standards for communicating health care information throughout the health care spectrum. As mandated by the U.S. Department of Health and Human Services (HHS), the Panel's work supports Use Cases defined by the American Heath Information Community (AHIC)[1]. 2 Related Work on Access Control Standards 2.1 Commite European de Normalisation (CEN) Standard ENV 13606 [2] In 2008 ISO has given ISO 13 606 on Electronic Healthcare Record Architecture. This standard is revised Comitte European de Normalisation standard CEN ENV 13 606. This standard is base for access control in European standards and developed systems. The main item in the CEN healthcare information system architecture (CEN, 2002) standard is an Architectural Component. The Architectural Components are organized in a hierarchical structure. Each Architectural Component has a reference to access control list for that component defined as Distribution Rules. A Distribution Rule comprises classes Who, Where, When, Why and How which define who, where, when, why and how is allowed to access the component (Table 1). To access the system a user presents his attributes that correspond to attributes of class Who, When, Where, Why and How. Classes Who, When, Where, Why and How are processed with operator AND. There can be one or more DR attached to AC and they are processed with operator OR. 2.2 ISO 22 600 Standard [3] ISO/TS 22600-1:2006 is intended to support the needs of healthcare information sharing across unaffiliated providers of healthcare, healthcare organizations, health insurance companies, their patients, staff members and trading partners. It is also intended to support inquiries from both individuals and application systems. ISO/TS 22600-1:2006 supports collaboration between several authorization managers that may operate over organizational and policy borders. 60