[Openid-specs-heart] Patient Consent

[Salyards, Kenneth (SAMHSA/OPPI)]

Hello Debbie, here is a high-level view of the Consent 2 Share (C2S) architecture. For the RS to be able to do what you are proposing, it would need to have a segmentation engine to enforce fined grain consent directives. Enforcing these consent directives is based on (for C2S at least) value sets based on diagnosis, medications, tests/labs and procedures associated with the sensitive conditions. We have defined these types of value sets which are used in C2S for data segmentation. I can send them to you if you would like to see the content. Also, segmentation can only be accomplished currently on structured clinical content. We are exploring ways in which to use the value set content to redact textual information related to sensitive conditions, however currently we redact all text in a segmented document.

With the current state-of-art in EHR technology, the content of exchanged records is highly variable from simple text documents (all CDA really requires) to documents with text and actual clinical entries. In the future FHIR may improve this pitiful condition.

As John has said before, there is no inherent capability within FHIR that can define a resource set that provides data segmentation at any level.

Hope this helps, Ken.

From: Openid-specs-heart [mailto:openid-specs-heart-bounces at lists.openid.net] On Behalf Of Debbie Bucci
Sent: Monday, July 11, 2016 3:31 PM
To: John Moehrke
Cc: openid-specs-heart at lists.openid.net
Subject: Re: [Openid-specs-heart] Patient Consent

So ... the RS  *should* have an idea of what medications aligns with  each diagnosis.   Wouldn't a patient request to not reveal /release HIV for some purpose of use info be enough info to provide to the RS to use (but note the RS may not comply due to various reasons  - but should record for audit purposes)
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