[Openid-specs-heart] Openid-specs-heart Digest, Vol 147, Issue 1

Morgan,Hope (HHSC) Hope.Morgan at hhsc.state.tx.us
Wed Apr 11 18:04:18 UTC 2018


Hi Debbie

The Healthcare Directory would be for everyone, providers and patients.  Here is the url for what I believe is the most current site for this project
https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/Healthcare+Directory+TLC.   The past meeting notes may be of interest, there are several use cases mentioned.   I thought both projects could benefit from one another.


Thanks

Hope

Hope Morgan
Interim Director Office of eHealth Coordination, Medical and Social Services
Director Health Information Technology and Interoperability, Chief Technology Office – HHSC IT
Texas Health and Human Services Commission
512 438 4675

From: Debbie Bucci [mailto:debbucci at gmail.com]
Sent: Wednesday, April 11, 2018 12:30 PM
To: Morgan,Hope (HHSC) <Hope.Morgan at hhsc.state.tx.us>
Cc: openid-specs-heart at lists.openid.net
Subject: Re: [Openid-specs-heart] Openid-specs-heart Digest, Vol 147, Issue 1

Hello Hope,

HEART is not directly participating in that work but a few of us do interact with Dan and his work in that area.
Would you please clarify the use case?   I'm assuming that a healthcare directory would be an open resource for patients.

Thanks

Debbie Bucci

On Wed, Apr 11, 2018 at 10:19 AM, Morgan,Hope (HHSC) <Hope.Morgan at hhsc.state.tx.us<mailto:Hope.Morgan at hhsc.state.tx.us>> wrote:
Is the HEART group participating on the Healthcare Directory project led by Daniel Chaput at the ONC?



Thanks

Hope Morgan
Interim Director Office of eHealth Coordination, Medical and Social Services
Director Health Information Technology and Interoperability, Chief Technology Office - HHSC IT
Texas Health and Human Services Commission
512 438 4675

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Today's Topics:

   1. HEART Agenda 2018-04-09 (Debbie Bucci)
   2. HEART ad hoc meeting notes (Nancy Lush)


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Date: Sun, 8 Apr 2018 19:58:47 -0400
From: Debbie Bucci <debbucci at gmail.com<mailto:debbucci at gmail.com>>
To: openid-specs-heart at lists.openid.net<mailto:openid-specs-heart at lists.openid.net>
Subject: [Openid-specs-heart] HEART Agenda 2018-04-09
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*When:* Monday 1PM PST - 4PM EST
*Where:* GoToMeeting: https://global.gotomeeting.com/join/785234357
*US phone number:* +1 (619) 550-0003 <(619)%20550-0003>. Access Code
785-234-357
*Agenda:*


   - *Continue to work on use cases*
   - *AOB*
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Message: 2
Date: Sun, 8 Apr 2018 20:39:03 -0400
From: "Nancy Lush" <nlush at lgisoftware.com<mailto:nlush at lgisoftware.com>>
To: <openid-specs-heart at lists.openid.net<mailto:openid-specs-heart at lists.openid.net>>
Cc: <nancy.lush at lgisoftware.com<mailto:nancy.lush at lgisoftware.com>>
Subject: [Openid-specs-heart] HEART ad hoc meeting notes
Message-ID: <163601d3cf9b$29132f40$7b398dc0$@lgisoftware.com<http://lgisoftware.com>>
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Compliments of Eve and Nancy.  Sorry for the delay.



HEART ad hoc 2018-03-29



Attending:

Nancy Lush

Justin Richer

Eve Maler

Debbie Bucci

Catherine Schulten

Julie Maas



Eve shared a candidate simple HEART positioning message that she derived from a writeup of Danny van Leeuwen's. People generally liked the direction.



AI: Eve: Put this material in a GDoc and share for refinement.



Nancy presented some key assumptions:



*       Use HEART only where appropriate
*       HEART supports more robust identity assurance, but identity
assurance as such is outside the scope of HEART
*       HEART assumes oAuth2 and OpenId Connect, but as such is out of
scope.
*       Federated trusted IdP with a provider directory would enhance many
use cases and we may refer to in examples, but it's not in our scope to specify.
*       HEART contributes more to a wide-ecosystem use case.  Our
demonstration use cases should have at least one node of the interoperability exchange external to a closed healthcare network.
*       Avoid edge cases for the first pass
*       An external trusted consent server would enhance several use cases.
(Outside of scope of HEART but would be nice.)



Discussion: Is this meant to suggest an InCommon style of federation? Or not suggesting any particular topology? Maybe all the hospitals will end up trusting each other, the way InCommon's institutions trust each other. So we could discuss in a non-normative way how this could be a desirable outcome in health IT, but not commit to providing the solution ourselves.



Nancy has sketched how this might look in her "Building Block - External trusted IdP" diagram with steps, and imagined which parts of HEART they would need to especially conform to. Others have talked about building this, and a larger organization could be in a position to host one of these.
Graeme was alluding to this sort of thing in the recent private email thread. InCommon has a central metadata registry. So this is a powerful design pattern that has become quite automated (largely for SAML, but also increasingly for OIDC) and could be used in the healthcare world.



Julie notes: DirectTrust has a placeholder for a provider directory with FHIR endpoints!



*       Wide ecosystem



Discussion: What are the use cases we want to support? It's more than just partner ecosystems that are "loosely coupled". So this does seem to meet the UMA definition of a wide ecosystem. If a patient wants to share data with a specialist outside the network, the AS doesn't know who that specialist is yet.



*       (Eve suggests a new assumption that comes before wide ecosystem:)
Loosely coupled services



Discussion: AS and RS may be in different (security) domains. Nancy suggested exploring how an external trusted consent server might exchange consents with trusted parties while protecting Alice's privacy in the process.



*       Avoid edge cases for this first pass
*       Nice to have: Providing Alice with an external trusted consent
server



Discussion: This would enhance several use cases. Can we then define what "consent" (FHIR consent) means wrt authorization policy in this case? Yes, and perhaps we can simplify things by reference to HIPAA. This touches on Consent2Share.



Key HEART examples:



A. Alice selectively shares data with others

B. Alice is in her PCP office and wants to share data with a specialist

Suggestion: Break out sharing de-identified data for research.



C. Shares with a specialist (choosing wide ecosystem because without that, HEART isn't really required) This is the case of a provider sharing data with an external provider based on an electronic consent created by Alice.



D. First Appointment with a new physician.

E. Tele Health Services

F. IOT data

G. Long term care facilities



Eve pointed out that while there may be some overlap, we should write the use cases and then evaluate to determine if they are the same.  They may have subtle differences we may discover in the process.



.



Regarding sharing data for research: There's the question of long-term access. There are actually a lot of edge cases. E.g., does the RS have the ability to de-identify data that it sends out?  Do we need another scope for the ability to de-identify? What parts of this does Sync4Science do?



Five folks each agreed to write one use case, which will be used to demonstrate the power of HEART.  We will try to keep them simple and to one page.











Nancy Lush

nancy.lush at lgisoftware.com<mailto:nancy.lush at lgisoftware.com>


Lush Group, Inc

Office: (401) 423-9111


28 Narragansett Ave

PO Box 651

www.lgisoftware.com<http://www.lgisoftware.com>

Cell:(401) 965-9347


Jamestown, RI 02835
























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