[Openid-specs-heart] Proposal for reworked use case AND use case template

Tue Aug 4 17:06:49 UTC 2015

This is a superb discussion. Beyond the metaphors and similes, in terms of
standards and best practices, we need to ask where does healthcare as a
vertical end?

I suggest that healthcare ends where HL7 and FHIR deal with health-specific
data models, profiles, and a strictly policy-neutral security scheme based
on tokens.

I suggest that authentication, authorization, delegation, and credential
management... are human-specific and not specific to any particular
vertical. The OpenID Foundation and HEART are as good a place to deal with
these standards and best practices as anywhere.

Making this clear demarcation would harmonize Argonaut and HEART and make
all of our work around FHIR much more productive.

Adrian

On Tue, Aug 4, 2015 at 12:15 PM, Moehrke, John (GE Healthcare) <
John.Moehrke at med.ge.com> wrote:

> I was happy with the decision we made during the call, that patient
> identity matching is an out-of-scope thing that we presume is a
> precondition to our efforts… and that identity proofing is a local
> (healthcare providers each manage this to their own satisfaction) issue
> that is presumed as a precondition to our efforts. Our efforts are then
> more focused on the authorization workflow.   This makes it clear that they
> are ISSUES, but that they are issues that we rely  upon being solved
> elsewhere. For which, as was pointed out on the call, they are fundamental
> parts of the practice of healthcare.
>
>
>
> John
>
>
>
> *From:* Eve Maler [mailto:eve.maler at forgerock.com]
> *Sent:* Tuesday, August 04, 2015 11:10 AM
>
> *To:* Moehrke, John (GE Healthcare)
> *Cc:* Adrian Gropper; openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> I'm sorry, but that's not *entirely* true. Although in healthcare a
> physical body is what receives the service, which puts a whole new
> perspective on getting things wrong, there are regulations and standards in
> finance about proofing and authentication as well. And there are different
> parts of the financial sector in which liability is apportioned
> differentially among consumers, banks, credit card issuers, and so on.
> Looking at the US situation, the FCRA, FFIEC, and so on are obviously
> different beasts from HIPAA, but they're not nothing.
>
>
>
> Again, my point was simply that an "offline person" must often be guessed
> about heuristically when they show up for service (a la "patient matching"
> or "credit score lookups"), which can lead to mismatches, but an "online
> person" who has been proofed and authenticated to a sufficient level of
> assurance has been through a process *designed* to try and eliminate
> mismatches, and this can be leveraged throughout the rest of the online
> system.
>
>
>
> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
> Technology
> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
> Join our ForgeRock.org OpenUMA
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__forgerock.org_openuma_&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=fVjdF_sKSbXTSGPwi2xC54BK4HhqMwAONLMM2sM75WY&s=ndTibZO0poXdZF6E8_UTUAfWEC_xKdmZRLPz7THKH-I&e=>
> community!
>
>
>
> On Tue, Aug 4, 2015 at 8:59 AM, Moehrke, John (GE Healthcare) <
> John.Moehrke at med.ge.com> wrote:
>
> Eve,
>
>
>
> They do NOT have the same problem… The consumer who gave a BAD account
> number is the one that bears all the responsibility that they just sent
> their money to a blackhole.  The consumer is the one that loses everything.
> The bank just matched garbage-in to garbage-out. The bank is not held to
> Medical Records regulations. The bank is not held to HIPAA disclosure
> requirements. The bank is not held to medical ethics legal action. The bank
> is not held at fault for aiding drug-seeking behavior. The bank is not held
> at fault for medical fraud. The bank likely made money in the transaction
> through transaction fees.
>
>
>
> We can whitewash the problems away… but if we do, we will create a
> solution that is purely academic exercise and will never see the light of
> day. Unless we deal with these issues, our solution will be a waste of
> time. Again, I am not against the goal… I am just against us ignoring
> reality. I am participating because I want a solution that can be used.
>
>
>
> John
>
>
>
> *From:* Eve Maler [mailto:eve.maler at forgerock.com]
> *Sent:* Tuesday, August 04, 2015 10:41 AM
> *To:* Moehrke, John (GE Healthcare)
> *Cc:* Adrian Gropper; openid-specs-heart at lists.openid.net
>
>
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> Well, that didn't at all have the intended efffect. I'm sorry. Let me try
> again.
>
>
>
> I'm *not at all* saying we should follow the financial industry's model!
> I'm saying that when they transfer data "behind people's backs", they have
> exactly the same trouble the healthcare industry has in identifying people.
> When an industry actually invites people in to the process, and gathers
> their consent, and learns more about them, then the "online person" is a
> participant in the process and is the "head" of their own account. That
> gives them the beginnings of control.
>
>
>
> (From this point, you have a technological fulcrum on which to place
> individual control in future.)
>
>
>
> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
> Technology
> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
> Join our ForgeRock.org OpenUMA
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__forgerock.org_openuma_&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=eoGc0essWt93lgEVpvhM01qXsZEaxz50ypubaTF8gqc&s=6v5Vm0pyt2VRpFuTuPeLiTF8Blz2AX9ZJ0QY3uANNnk&e=>
> community!
>
>
>
> On Tue, Aug 4, 2015 at 8:17 AM, Moehrke, John (GE Healthcare) <
> John.Moehrke at med.ge.com> wrote:
>
> I find it very troubling when the financial industry is brought up as an
> example that healthcare should follow. From a user experience, I agree with
> Adrian that it seems to be a well ‘consumer centric’ model. The reality is
> that they are not consumer centric, they act only by force of consumer and
> often with payment for transaction fee.
>
>
>
> But the financial industry are dealing with fungible assets that can
> easily be insured and they have regulated maximum damages. Healthcare has
> NOTHING close to this. Further the only reason that the financial industry
> communicates is because they are moving your  money, an asset they get to
> leverage far beyond the kind of analytics that the healthcare community is
> often accused  of doing (some rightly so). The financial world does not
> communicate in any way to your benefit, they are perfectly happy having
> fragmented and non-aligned assets. Where as in healthcare there is an
> expectation that your current treatment plan is chosen based on your full
> medical history, without any piece of information misunderstood
> (malpractice).
>
>
>
> This said, I am not against the goal that Adrian is promulgating. I am
> just frustrated at the overbroad statements about how wonderful the
> financial industry is.
>
>
>
> John
>
>
>
> *From:* Openid-specs-heart [mailto:
> openid-specs-heart-bounces at lists.openid.net] *On Behalf Of *Eve Maler
> *Sent:* Tuesday, August 04, 2015 10:03 AM
> *To:* Adrian Gropper
>
>
> *Cc:* openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> Adrian, your patient vs. banking identity explanation was really good --
> I'm going to steal that one. :-) Warning, musings on identity and proofing
> below. Hope they're marginally interesting/helpful.
>
>
>
> In the world of marketing data brokerage, they deal in heuristic data
> about people all the time but don't have to (or, maybe, even want to)
> precisely identify a unique human being. (If you ever want to be weirded
> out, read about Acxiom Personicx
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.oceanoutdoor.com_site_wp-2Dcontent_uploads_ORCGuideToPersonicx.pdf&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=QtcwptaLBxuQh2WeoBs1IhxRnZzLuQe2ljx-h2VKN4A&e=> psychographics
> codes. I had someone in the field tell me she looked "herself" up in the
> data warehouse. She said, "They knew my bra size.")
>
>
>
> In the world of credit data brokerage, they have much the same problem as
> the "offline patient identity" world does, though with a somewhat different
> regulatory environment. If you're in the US and you want to try and look up
> the annual free credit scores that you're entitled to by law, think about
> the trouble you have to go through to identify yourself with
> multiple-choice questions about your past financial life. Outside the US,
> it's even harder because privacy laws limit the sources of data. As
> demographics shift and more and more people get comfortably online/mobile,
> identification gets easier because an organization funneled someone through
> the process once and now owns the "hygiene" of that credential over time --
> *everyone* can amortize the investment. However, of course, data privacy
> gets more challenging.
>
>
>
> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
> Technology
> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
> Join our ForgeRock.org OpenUMA
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__forgerock.org_openuma_&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=4_28RyfGvM2JnAA2r2PC92ouszRmNenZ1TmMlmOhcg8&e=>
> community!
>
>
>
> On Mon, Aug 3, 2015 at 7:52 PM, Adrian Gropper <agropper at healthurl.com>
> wrote:
>
> I'm paying $15K / year for health insurance with a $4K deductible through
> my insurance exchange. I just saved $200 out-of pocket on ONE prescription
> by looking it up in GoodRX. If I was living in any other rich country, my
> insurance would be less than half that and the prescription hassles would
> be much less.
>
> The information system is rigged against the consumer in every way they
> can think of. Most of it involves sharing our information selectively
> beyond our control. We are being farmed.
>
> Adrian
>
>
>
> On Mon, Aug 3, 2015 at 10:01 PM, Aaron Seib <aaron.seib at nate-trust.org>
> wrote:
>
> I am serious – what is the performance requirements to operate an UMA
> server for one patient?  I wasn’t giving you a hard time.
>
>
>
> If we assume that we want to make this work for 10 million people in the
> population tomorrow what do we have to pay to make it work?  I am assuming
> that there are hosting requirements for an UMA server and every consumer
> needs to be trained on how to use it.
>
>
>
> What is trivial?  Is it $10 per person per year?  $0.10 per person per
> year?  What is required to make it operational?  How much will they need to
> get paid to establish it?
>
>
>
> Are there comparable deployments that are operating at that scale that we
> can refer to from other consumer domains?
>
>
>
> I am making this point as I don’t want to inadvertently exclude options
> that should be considered for some transactions if they are sufficient if
> they have the same outcome at a lower cost per transaction for some
> transactions.
>
>
>
> You ask who wouldn’t want to have every transaction verified against their
> own UMA server?  The person who is paying a per transaction fee to get it
> done for them.
>
>
>
>
>
> Aaron Seib, CEO
>
> @CaptBlueButton
>
>  (o) 301-540-2311
>
> (m) 301-326-6843
>
>
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__nate-2Dtrust.org&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=sCSOzpc0Dh4XfwS-oVrarXol9DJR1znq3FaRb45-Plg&e=>
>
>
>
> *From:* agropper at gmail.com [mailto:agropper at gmail.com] *On Behalf Of *Adrian
> Gropper
> *Sent:* Monday, August 03, 2015 9:07 PM
>
>
> *To:* Aaron Seib
> *Cc:* Id Coach; openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> On Mon, Aug 3, 2015 at 6:31 PM, Aaron Seib <aaron.seib at nate-trust.org>
> wrote:
>
> I don’t get the assertion that  FHIR avoids the patient identity problem.
> I don’t get this assertion.  Can you get the crayons out and explain that
> to me?
>
>
>
> Why don't we have a banking identity problem? It's because people
> self-identify to their bank and their merchant. When somebody moves our
> money without that, we call it theft.
>
> Self-identification is core to OAuth. You don't even need UMA and the
> patient ID problem disappears.
>
> What confuses the issue is discovery. In banking, we don't try to make our
> banking or shopping activity open to discovery. In the case of some
> purchases, we actually try to hide it. In general, to the extent our
> purchasing habits are subject to surveillance, we consider it creepy and
> opt for systems like cash or ApplePay where the merchants, at least, can't
> sell our purchase data to the data brokers.
>
> For some reason, healthcare starts from the assumption that people's
> private activity needs to be tracked whether they like it or not by dozens
> of "exchanges" and data brokers that we don't even know about. We are
> treating people the way we do cows in the feedlot. In banking we have three
> credit bureaus that track some of your activity but they're regulated and
> we have access to "free credit reports". Good luck trying to get the
> equivalent for your health care. For example, in many states, we have the
> equivalent of state credit bureaus in the form of All Payer Claims
> Database. Not one of them lets the patient access, check for errors, or
> benefit from this credit bureau behavior. Who wouldn't want a report from
> their All Payer Claims Database at the end of the yer when it's time to
> choose a Bronze, Silver, Gold or Platinum deductible form the health
> insurance exchange?
>
>
>
> It sounds Miraculous and as far as assertions about software capabilities
> are concerned I am an agnostic.
>
>
>
> What are the pre-conditions that allow for the patient identity problem is
> addressed.  What problem is created by eliminating that one?
>
>
>
> Just so I am clear – the patient-centric approach essentially says that
> each individual has an UMA server set up that captures their privacy
> preference and subsequent changes through time.  Whenever data about the
> consumer is to be exchanged the service is checked to determine if the
> disclosure is permitted.
>
>
>
> Yes.
>
>
>
> I would like to have an understanding of the performance considerations of
> such a system so we can start the procurement process now.
>
>
>
> We already have this understanding. Bulk transfer of patient data dates
> back to the paper and mainframe days. It works just as well for hackers as
> it does for the primary business. It seems to take 4-8 months to discover a
> breach of millions of records. The system is certainly very efficient. It's
> time to introduce technology on the part of the user. The friction you're
> worried about is a good thing. It means the subject is aware of their data
> being moved from one custodian to another and breaches would be reported in
> minutes. The computing cost of this notice is now trivial. Think of the UMA
> server as simply a convenient way for your "providers" to notify you of
> data transfers out of your account. What patient or family caregiver would
> say no to that?
>
> Adrian
>
>
>
> Aaron Seib, CEO
>
> @CaptBlueButton
>
>  (o) 301-540-2311
>
> (m) 301-326-6843
>
>
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__nate-2Dtrust.org&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=sCSOzpc0Dh4XfwS-oVrarXol9DJR1znq3FaRb45-Plg&e=>
>
>
>
> *From:* agropper at gmail.com [mailto:agropper at gmail.com] *On Behalf Of *Adrian
> Gropper
> *Sent:* Monday, August 03, 2015 11:22 AM
> *To:* Aaron Seib
> *Cc:* Id Coach; openid-specs-heart at lists.openid.net
>
>
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> Aaron,
>
> My definition of "patient-centric" is what we use in The Society for
> Participatory Medicine: "Nothing about me without me."
>
> This is not as hypothetical as it sounds. A number of us in HEART worked
> on the "Privacy on FHIR" pilot for last HIMSS. We demoed a patient-centered
> system that included private EHR, gov EHR, 42CFR Part 2 sensitive data,
> PHR, phone apps, and wearable IoT devices all sharing data using FHIR.
> http://wiki.siframework.org/file/view/HIMSS15_Privacy%20on%20FHIR%20FINAL.PDF/555755441/HIMSS15_Privacy%20on%20FHIR%20FINAL.PDF
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__wiki.siframework.org_file_view_HIMSS15-5FPrivacy-2520on-2520FHIR-2520FINAL.PDF_555755441_HIMSS15-5FPrivacy-2520on-2520FHIR-2520FINAL.PDF&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=raPiIPoJutNckiSpXupDug4l3yKctfT8REEI8MxBKbs&e=>
> The use of a single UMA Authorization Server for Alice across all of these
> FHIR resources is the embodiment of "Nothing about me without me."
>
> The patient-centered or patient-directed approach to FHIR solves, or at
> least avoids, the very difficult patient ID problem. It buys us time while
> cybersecurity initiatives like NSTIC/IDESG figure out how to implement
> practical trust frameworks for identity and related verified attributes.
> Human ID is not a healthcare-specific issue, because we don't license human
> patients. While others work on Human ID, we can use the patient-directed
> approach to match patients across institutions.
>
> The patient-directed approach also avoids the difficult problem of
> delegation to a family caregiver or custodian. Instead of every FHIR
> resource having to implement a delegation method and policy, that
> responsibility shifts to the patient's AS and becomes mostly transparent to
> the resource server.
>
> The patient-directed approach provides increased cybesecurity because the
> AS is consulted for every new interface access. This means that breaches
> can be discovered in minutes instead of months. This also fulfills the
> much-delayed Accounting for Disclosures requirement in HIPAA.
>
> The patient-directed approach avoids most of the provenance issues because
> information flows directly from one institution to another without the
> opportunity for delay or corruption by intermediary PHRs or HIEs.
>
> The patient-directed approach solves the "multiple portals" problem. Once
> registration is complete, the patient or custodian need not interact with
> the patient portal at the Resource Server again. In some cases, it's
> possible that the resource server can avoid running a patient portal
> altogether by allowing a staff member to complete enrollment of the
> patient's AS as part of registration.
>
>
> The Russian Dolls metaphor doesn't work for me. What I see is a simple
> bifurcation at the root of FHIR design: either you enable a
> patient-specified Authorization Server as a third-party in server-client
> FHIR exchange or you don't. If you start down the UMA branch, then all of
> the benefits above accrue downstream. If you don't start down the UMA
> branch, then complexity explodes as we try to invent accessory actors,
> federations and governance mechanisms.
>
> Adrian
>
>
>
>
>
> On Mon, Aug 3, 2015 at 10:00 AM, Aaron Seib <aaron.seib at nate-trust.org>
> wrote:
>
> Adrian,
>
>
>
> Hi – I agree with your assessment regarding the sufficiency of oAuth for
> the use case as documented.  It is a good way and block and tackle the
> problem space to get to consensus of what separate components are capable
> of doing and resolving them from the basic to the complex.
>
>
>
> Does everyone agree with that starting point?
>
>
>
>
>
> For discussion purposes lets assume we have consensus on that.  For the
> use case where the consumer has PGHD that the Provider wants oAuth is
> sufficient.
>
>
>
> This sentence from your email:
>
>
>
> If the problem is to begin HEART with a patient-centricity as the problem,
> then this particular use-case distorts the discussion by presuming Alice
> wants a PHR and diminishes the patient-centered benefits of UMA as a health
> information exchange technology.
>
>
>
> I want to parse that better so I understand – can you help edify me about
> what is meant by “patient-centricity as the problem”?
>
>
>
> I don’t have the same feelings about the fact that part of the work HEART
> is doing is inventorying what the different use cases are and their
> sufficiency.  In fact I think this step may prove informative to the end
> point that we are all pursuing.
>
>
>
> One use case that is important that doesn’t follow the “Consumer has PGHD
> that the Provider Wants” that readily comes to mind is the pattern of
> Provider A having PHI about Patient X that Provider B (whom has a
> patient-provider relationship with Patient X) should have if and only iff
> (IFF) it is aligned with the privacy preferences of Patient X for Provider
> B to have said data.
>
>
>
> To close the loop – is that a statement of a patient-centricity use case?
> Does what we are learning with the first use case inform what needs to be
> done to satisfy the second use case?
>
>
>
> From a laypersons perspective I see a Russian Dolls exposition of the use
> cases one building on another until we solve the problems established by
> this work groups charter.
>
>
>
> Thank you for letting me share.
>
>
> Aaron
>
>
>
> Aaron Seib, CEO
>
> @CaptBlueButton
>
>  (o) 301-540-2311
>
> (m) 301-326-6843
>
>
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__nate-2Dtrust.org&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=sCSOzpc0Dh4XfwS-oVrarXol9DJR1znq3FaRb45-Plg&e=>
>
>
>
> *From:* Openid-specs-heart [mailto:
> openid-specs-heart-bounces at lists.openid.net] *On Behalf Of *Adrian Gropper
> *Sent:* Sunday, August 02, 2015 2:30 PM
> *To:* Id Coach
> *Cc:* openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] Proposal for reworked use case AND
> use case template
>
>
>
> Thank you Eve!! I hope we can reach consensus on something like the format
> you present.
>
>
>
> Narratives are much easier to understand when they begin with a clear
> statement of the problem. Shouldn't use cases be asked to clearly state the
> problem they are trying to solve right up front?
>
> This particular use-case seems to be trying to solve some or all of three
> problems: federated sign-in, eliminating the registration clipboard hassle,
> and updating a PHR with encounter results. All of these can be solved by
> OAuth alone.
>
> If the problem is to begin HEART with a patient-centricity as the problem,
> then this particular use-case distorts the discussion by presuming Alice
> wants a PHR and diminishes the patient-centered benefits of UMA as a health
> information exchange technology.
>
> I've tried to clarify these fundamental issues in my comments on the
> document and hope we can resolve this before we move on to semantic
> profiling and scopes.
>
>
>
> Adrian
>
>
>
> On Sat, Aug 1, 2015 at 3:32 PM, Id Coach <coach at digitalidcoach.com> wrote:
>
> Thanks Eve,
>
> This is wonderful. I questioned/commented on things only a newbie is
> likely to ask/care about.
>
> It's also a useful template for other use cases. To your point about
> explaining oAuth and other template terms, you're using a new language and
> a new ecosystem to many, so I encourage those template terms to be
> explained over and over again as needed and as appropriate.
>
> It will be helpful to me to illustrate or diagram this process. I'll take
> a crack at that in the next few days (I hope).
>
>   judi
>
>
>
> On 8/1/15 11:20 AM, Eve Maler wrote:
>
> Completing my action item, you'll find our (well-worn :-) use case
> document here
> <https://urldefense.proofpoint.com/v2/url?u=https-3A__docs.google.com_document_d_1IvbdWerdvMuA1dQ-2DKQvVKqIBrAas7FoenNVUtgpqYrw_edit-3Fusp-3Dsharing&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=mFAukEQMozyggbR5vc6wYMWgsvuGIr11-W6P-mLm6Qo&e=>.
> Following is my proposal. If we like what I've done here, I recommend that
> we:
>
>    - Edit the doc title to match the use case title I've supplied (just
>    below the horizontal line).
>
>
>    - Resolve all the comments above my title (fear not, they're all
>    accounted for in the comments I've inserted) and delete all the text above
>    that point (I've retained all our existing text above the line, just in
>    case).
>
>
>    - Resolve all the comments I've inserted -- as quickly as possible! We
>    don't have to take up call time to do the minor ones, if people take the
>    initiative to review them offline and supply their feedback as responses to
>    this note. Note that, in this new template, I have avoided the use of the
>    comment mechanism for anything that should be a permanent part of the
>    document.
>
>
>    - Ask people to write their other use cases in GDoc using this style.
>
>
>    - Obviously, if you have suggestions on how to improve the template,
>    weigh in! If you want to make invasive suggestions, contact me and we can
>    do a collaborative editing session together.
>
> I'm extremely glad I finally did this exercise, because it caused me to
> understand more of what we need to consider profiling and more of the
> "health SME" point of view. And, to be honest (perhaps forestalling a
> comment from Justin ;-), I don't feel that it was wasteful to go to this
> degree of mapping to the technologies because it flushed out some
> mismatches that really didn't make sense to me all this time. I now feel we
> can go straight to the heart (ahem) of the profiling matter with as many
> future use cases as we want, and in fact, we can begin profiling and write
> more use cases in parallel.
>
>
>
> Thanks to you all for letting me "get my OCD on".
>
>
> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
> Technology
> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
> Join our ForgeRock.org OpenUMA
> <https://urldefense.proofpoint.com/v2/url?u=http-3A__forgerock.org_openuma_&d=AwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=BjxAvFx8QWs4XC6iU1PL1lgMCP4YVzdBhh4vu2fWdeU&s=4_28RyfGvM2JnAA2r2PC92ouszRmNenZ1TmMlmOhcg8&e=>
> community!
>
>
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>
>
> Adrian Gropper MD
>
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>
>
> Adrian Gropper MD
>
> RESTORE Health Privacy!
> HELP us fight for the right to control personal health data.
> DONATE: http://patientprivacyrights.org/donate-2/
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> Adrian Gropper MD
>
> RESTORE Health Privacy!
> HELP us fight for the right to control personal health data.
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> --
>
>
>
> Adrian Gropper MD
>
> RESTORE Health Privacy!
> HELP us fight for the right to control personal health data.
> DONATE: http://patientprivacyrights.org/donate-2/
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-- 

Adrian Gropper MD

RESTORE Health Privacy!
HELP us fight for the right to control personal health data.
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