[Openid-specs-heart] HEART Meeting notes 2016-05-16
Adrian Gropper
agropper at healthurl.com
Wed May 18 03:40:48 UTC 2016
And could AuditEvent be triggered by an empty Subscription message?
Adrian
On Tuesday, May 17, 2016, Grahame Grieve <grahame at healthintersections.com.au>
wrote:
> Right, that would a profile on AuditEvent
>
> Grahame
>
>
> On Wed, May 18, 2016 at 1:29 PM, Adrian Gropper <agropper at healthurl.com
> <javascript:_e(%7B%7D,'cvml','agropper at healthurl.com');>> wrote:
>
>> My bad. Accounting of Disclosures it is.
>>
>> Adrian
>>
>>
>> On Tuesday, May 17, 2016, John Moehrke <johnmoehrke at gmail.com
>> <javascript:_e(%7B%7D,'cvml','johnmoehrke at gmail.com');>> wrote:
>>
>>> I have always referred to it as "Accounting of Disclosures". Meaning it
>>> is a report that indicates the disclosures that have happened (history).
>>> Which is what AuditEvent, and my blog speak to.
>>>
>>> I would expect an "Accounting FOR Disclosures" to be a record of the
>>> potential disclosures that might happen in the future (aka
>>> Consent/Authorization). So I was confused given the scope of HEART.
>>>
>>> John
>>>
>>> John Moehrke
>>> Principal Engineering Architect: Standards - Interoperability, Privacy,
>>> and Security
>>> CyberPrivacy – Enabling authorized communications while respecting
>>> Privacy
>>> M +1 920-564-2067
>>> JohnMoehrke at gmail.com
>>> https://www.linkedin.com/in/johnmoehrke
>>> https://healthcaresecprivacy.blogspot.com
>>> "Quis custodiet ipsos custodes?" ("Who watches the watchers?")
>>>
>>> On Tue, May 17, 2016 at 10:13 PM, Adrian Gropper <agropper at healthurl.com
>>> > wrote:
>>>
>>>> Accounting for Disclosures
>>>>
>>>> On Tuesday, May 17, 2016, Grahame Grieve <
>>>> grahame at healthintersections.com.au> wrote:
>>>>
>>>>> A4D?
>>>>>
>>>>> Grahame
>>>>>
>>>>>
>>>>> On Wed, May 18, 2016 at 12:55 PM, Adrian Gropper <
>>>>> agropper at healthurl.com> wrote:
>>>>>
>>>>>> I'm glad to hear they're in scope.
>>>>>>
>>>>>> Thing is, that notifications have two components: the endpoint and
>>>>>> the message format. As I recall, MVCR consent receipts are more about the
>>>>>> message format than the endpoint. I much prefer the FHIR Subscriptions
>>>>>> approach because it doesn't trigger a standards project related to the
>>>>>> format and therefore makes implementation much faster.
>>>>>>
>>>>>> All three notification types are perfectly compatible with a
>>>>>> human-readable format. In some cases, as the FHIR Subscription
>>>>>> standard points out, having a message content at all is an unacceptable and
>>>>>> unnecessary privacy liability. This applies to type (1) notifications where
>>>>>> any contact with the notification endpoint triggers a query to the FHIR
>>>>>> endpoint.
>>>>>>
>>>>>> Type (2) notifications need to be human-formatted by definition to
>>>>>> meet the intent of HIPAA and today's API Task Force recommendation. Nothing
>>>>>> would be served by trying to standardize the format as each FHIR endpoint
>>>>>> has a right to issue whatever warning it feels is appropriate to the
>>>>>> particular client and situation. Although there was interest in the
>>>>>> API discussion today in evolving a Model Privacy Notice related to this
>>>>>> Type (2) notification, that work, if and when it's available, is also meant
>>>>>> for human-readable format and it was deemed unlikely to cover all of the
>>>>>> warning situations. There are no privacy issues with Type (2) messages
>>>>>> because they need not contain any PHI. This makes them much more
>>>>>> user-friendly since they can be delivered via SMS and other insecure
>>>>>> channels.
>>>>>>
>>>>>> Type (3) notifications - A4D - are the only ones that might benefit
>>>>>> from a standard format. Even so, standard formatting is not expected - we
>>>>>> are perfectly happy to receive activity messages from banks and merchants
>>>>>> even though their format is all over the place. In addition, type (3)
>>>>>> messages do have privacy implications if they contain any PHI or even
>>>>>> indication of the metadata. Therefore, it would be preferable to make these
>>>>>> opaque or content-free and allow the recipient to query the FHIR server for
>>>>>> A4D if they choose.
>>>>>>
>>>>>> @Grahame: Does FHIR already specify an A4D resource?
>>>>>>
>>>>>> Is the discussion above an appropriate addition to the current
>>>>>> use-case?
>>>>>>
>>>>>> Adrian
>>>>>>
>>>>>> On Tuesday, May 17, 2016, Debbie Bucci <debbucci at gmail.com> wrote:
>>>>>>
>>>>>>> Notifications were always in scope. One type of notification was in
>>>>>>> the form of a consent receipt. You may recall Sarah doing some research
>>>>>>> and comparing to ...was it HL7? The receipt could be use to acknowledge a
>>>>>>> number of state changes.
>>>>>>>
>>>>>>> I am very familiar with topics/queues and pub/sub from my SOA
>>>>>>> infrastructure days. A brief glance at subscriptions seem to be a similar
>>>>>>> pattern.
>>>>>>>
>>>>>>> Dont think its a scope issue. It could be a implementation choice
>>>>>>> in use cases to use a subscription to deliver a message that either
>>>>>>> acknowledges a receipt or triggers another process in the work flow
>>>>>>>
>>>>>>> I think that would cover your 3 examples listed below.
>>>>>>>
>>>>>>> On May 17, 2016 8:45 PM, "Adrian Gropper" <agropper at healthurl.com>
>>>>>>> wrote:
>>>>>>>
>>>>>>>> As mentioned in the other thread, there are three different kinds
>>>>>>>> of notification under HIPAA (and probably in the general case):
>>>>>>>> (1) a resource has changed - this is p53 of the NZ doc
>>>>>>>> (2) a client is being registered that requires specific affirmation
>>>>>>>> by the Grantor
>>>>>>>> (3) accounting for disclosures - the resource server has been
>>>>>>>> accessed by a client
>>>>>>>>
>>>>>>>> The FHIR spec lists 4 different standards for push notifications
>>>>>>>> http://hl7.org/fhir/subscription.html .
>>>>>>>>
>>>>>>>> I believe all three of these kinds of notification are in-scope for
>>>>>>>> HEART. The three endpoints do not all have to be the same, do not all have
>>>>>>>> to be UMA, and we may want to restrict some of the 4 options offered in the
>>>>>>>> FHIR spec.
>>>>>>>>
>>>>>>>> Can we add these three kinds of notification to the current use
>>>>>>>> case as proposed by Eve?
>>>>>>>>
>>>>>>>> Adrian
>>>>>>>>
>>>>>>>>
>>>>>>>> On Tuesday, May 17, 2016, Eve Maler <eve.maler at forgerock.com>
>>>>>>>> wrote:
>>>>>>>>
>>>>>>>>> Supplementing with the link I referred to during the call:
>>>>>>>>>
>>>>>>>>> The UMA case study "Users Managing Delegated Access to Online
>>>>>>>>> Government Services" conducted by the New Zealand government available on
>>>>>>>>> the UMA wiki:
>>>>>>>>>
>>>>>>>>>
>>>>>>>>> http://kantarainitiative.org/confluence/display/uma/Case+Study%3A+Users+Managing+Delegated+Access+to+Online+Government+Services
>>>>>>>>> (PDF report downloadable here
>>>>>>>>> <http://kantarainitiative.org/confluence/download/attachments/76907066/NZ%20ProjectClosureReport_PoC%20Delegations-Final%20Version%20SIG%20redacted%20Rev1.pdf?api=v2>
>>>>>>>>> )
>>>>>>>>>
>>>>>>>>> ...documents in Sec 8.4.3.3.3 (p. 46) a desire for "notifications"
>>>>>>>>> that can be achieved by sending email or by other means, with a discussion
>>>>>>>>> in Sec 8.4.9 (p. 53) about sending push notifications to an UMA requesting
>>>>>>>>> party through a mobile app from a resource owner's smart device. The case
>>>>>>>>> study didn't, I believe, use FHIR.
>>>>>>>>>
>>>>>>>>>
>>>>>>>>> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
>>>>>>>>> Technology
>>>>>>>>> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
>>>>>>>>> Check out the 2016 schedule <https://summits.forgerock.com> for *ForgeRock
>>>>>>>>> Summits and UnSummits*!
>>>>>>>>>
>>>>>>>>> On Tue, May 17, 2016 at 7:04 AM, Debbie Bucci <debbucci at gmail.com>
>>>>>>>>> wrote:
>>>>>>>>>
>>>>>>>>>> Adrian was given the floor to discuss his concerns that he has
>>>>>>>>>> labeled for point of reference as “Independent Decision Support at the
>>>>>>>>>> Point of Care for Physicians and Patients"
>>>>>>>>>>
>>>>>>>>>> Adrian indicated there were 4 primary functions needed. Many in
>>>>>>>>>> the group translated it in different ways but Debbie’s version was:
>>>>>>>>>>
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> Release of Information
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> Notification of Disclosures
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> Subscribe to changes
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> Automated patient right of access.
>>>>>>>>>>
>>>>>>>>>> Eve translated the bullets to both technical and policy work out
>>>>>>>>>> of the UMA workgroup and pointed to relevant/related publication developed
>>>>>>>>>> in close coordination with NZ.
>>>>>>>>>>
>>>>>>>>>> Josh was concerned that Adrian perhaps was proposing an entirely
>>>>>>>>>> new standard. John and others were trying to get clarification
>>>>>>>>>> around what Adrian was referring to as Data Blocking.
>>>>>>>>>>
>>>>>>>>>> After an hour long of healthy discussion – Josh asked if there
>>>>>>>>>> were any procedure on how to document to handle such a discussion within
>>>>>>>>>> the group Adrian was concerned about HEART’s
>>>>>>>>>> functionality/relevance in relation to his concerns. Hope the
>>>>>>>>>> following points brought up in the meeting addresses these concerns:
>>>>>>>>>>
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> HEART’s function is not to create standards but to create
>>>>>>>>>> profiles of existing recognized standards to encourage interoperable
>>>>>>>>>> implementations of these standards. Please see :
>>>>>>>>>> http://openid.net/wg/heart/charter/
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> All members are encouraged to bring use cases to the group to
>>>>>>>>>> consider. The functional use case is broken down into
>>>>>>>>>> technical functionalities that are flagged as core or peripheral to the
>>>>>>>>>> standards being considered under HEART.
>>>>>>>>>> -
>>>>>>>>>>
>>>>>>>>>> We acknowledge that with both the Standards and profiles,
>>>>>>>>>> there may be implementation decisions made to bridge gaps where existing
>>>>>>>>>> functionality does not exist. We strongly encourage those
>>>>>>>>>> implementers to officially log the gaps and solutions they made back with
>>>>>>>>>> the relevant Standards Bodies in order to give feedback to future
>>>>>>>>>> iterations of the Standards.
>>>>>>>>>>
>>>>>>>>>> Standards development is an iterative process and versioning
>>>>>>>>>> control of standards and specs are an implementation reality we have to
>>>>>>>>>> deal with. Changes are made incrementally
>>>>>>>>>>
>>>>>>>>>> We concluded the discussion by asking Adrian to develop a
>>>>>>>>>> functional use case to bring to the group for consideration. Subsequently
>>>>>>>>>> there has been a recap discussion posted prior to the notes that we will
>>>>>>>>>> append to these meeting notes to round out context to the discussion
>>>>>>>>>>
>>>>>>>>>> Next week’s meeting (May 23rd) will focus on the comment
>>>>>>>>>> submitted by Mike Jones re: suggested changes to the HEART
>>>>>>>>>> profile. Additionally, if permissible, we will revisit and
>>>>>>>>>> consider the Argonaut report and their recommendations as part of this
>>>>>>>>>> review. All members interested that may have input to the
>>>>>>>>>> impending updates, please make it a point to attend.
>>>>>>>>>>
>>>>>>>>>> * AI:* Justin is developing a step by step analysis for us to
>>>>>>>>>> consider.
>>>>>>>>>>
>>>>>>>>>> Will cancel the next two meetings due to conflicts: May 30th
>>>>>>>>>> (US holiday) and June 5th (Cloud Identity Summit )
>>>>>>>>>> On June 12th We should be prepared to go back to the current use
>>>>>>>>>> case
>>>>>>>>>> https://bitbucket.org/openid/heart/wiki/Alice_Shares_with_Physicians_and_Others_UMA_FHIR
>>>>>>>>>> and stay with that use case until we complete our final draft
>>>>>>>>>> semantic profile.
>>>>>>>>>> Adrian's new use case is the next in the queue and welcome any
>>>>>>>>>> others that folk may want to submit.
>>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>> _______________________________________________
>>>>>>>>>> Openid-specs-heart mailing list
>>>>>>>>>> Openid-specs-heart at lists.openid.net
>>>>>>>>>> http://lists.openid.net/mailman/listinfo/openid-specs-heart
>>>>>>>>>>
>>>>>>>>>>
>>>>>>>>>
>>>>>>>>
>>>>>>>> --
>>>>>>>>
>>>>>>>> Adrian Gropper MD
>>>>>>>>
>>>>>>>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>>>>>>>> HELP us fight for the right to control personal health data.
>>>>>>>> DONATE: http://patientprivacyrights.org/donate-2/
>>>>>>>>
>>>>>>>>
>>>>>>
>>>>>> --
>>>>>>
>>>>>> Adrian Gropper MD
>>>>>>
>>>>>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>>>>>> HELP us fight for the right to control personal health data.
>>>>>> DONATE: http://patientprivacyrights.org/donate-2/
>>>>>>
>>>>>>
>>>>>
>>>>>
>>>>> --
>>>>> -----
>>>>> http://www.healthintersections.com.au /
>>>>> grahame at healthintersections.com.au / +61 411 867 065
>>>>>
>>>>
>>>>
>>>> --
>>>>
>>>> Adrian Gropper MD
>>>>
>>>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>>>> HELP us fight for the right to control personal health data.
>>>> DONATE: http://patientprivacyrights.org/donate-2/
>>>>
>>>>
>>>> _______________________________________________
>>>> Openid-specs-heart mailing list
>>>> Openid-specs-heart at lists.openid.net
>>>> http://lists.openid.net/mailman/listinfo/openid-specs-heart
>>>>
>>>>
>>>
>>
>> --
>>
>> Adrian Gropper MD
>>
>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>> HELP us fight for the right to control personal health data.
>> DONATE: http://patientprivacyrights.org/donate-2/
>>
>>
>
>
> --
> -----
> http://www.healthintersections.com.au / grahame at healthintersections.com.au
> <javascript:_e(%7B%7D,'cvml','grahame at healthintersections.com.au');> /
> +61 411 867 065
>
--
Adrian Gropper MD
PROTECT YOUR FUTURE - RESTORE Health Privacy!
HELP us fight for the right to control personal health data.
DONATE: http://patientprivacyrights.org/donate-2/
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