<div dir="ltr">Let's generously read Adrian's claim here as "a patient who cares enough can set up her own AS, and thereby ensure that her AS's jwk is unique to her". So yes, you can (with enough effort -- which might be driven down by technology) get to the point of one jwk per AS, if you really want.<div><br></div><div>But even if you do so, the AS's jwk in HEART<b> isn't really an "encryption key" sense in the way Adrian would have it</b>. In other words, the AS's jwk is not used as an "encryption key" for the patient's healthcare data at any point. (It <i>is</i> used to sign tokens in the UMA flow, including the PAT and the AAT.)</div><div><br></div><div>By the way, <a href="http://openid.bitbucket.org/HEART/openid-heart-uma.html#rfc.section.2.1">http://openid.bitbucket.org/HEART/openid-heart-uma.html#rfc.section.2.1</a> says that an "aud" claim in the AAT specifies the "RPT authorization endpoint"; UMA refers to this as simply the "RPT endpoint", and I think the HEART profile's language should be consistent (this tripped me up for 10min just now).</div><div><br></div><div> -J</div><div><br></div><div><br></div></div><div class="gmail_extra"><br><div class="gmail_quote">On Mon, Jan 25, 2016 at 10:02 AM, Adrian Gropper <span dir="ltr"><<a href="mailto:agropper@healthurl.com" target="_blank">agropper@healthurl.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr">Why "most likely not"? Is it a security issue? a cost issue? We don't have to compromise privacy for security in our connected world.<br></div><div class="HOEnZb"><div class="h5"><div class="gmail_extra"><br><div class="gmail_quote">On Mon, Jan 25, 2016 at 9:55 AM, Justin Richer <span dir="ltr"><<a href="mailto:jricher@mit.edu" target="_blank">jricher@mit.edu</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div bgcolor="#FFFFFF" text="#000000">
But it's not like that, the arity is very different. <br>
<br>
Every record is associated with an AS, perhaps a separate AS for
each record/patient but most likely not.<br>
<br>
Every AS is associated with a jwks_uri, but only one per AS. <br><span><font color="#888888">
<br>
-- Justin</font></span><div><div><br>
<br>
<div>On 1/25/2016 9:02 AM, Adrian Gropper
wrote:<br>
</div>
<blockquote type="cite">
<div dir="ltr">It means that every patient record is associated
with a separate jwks_uri for that patient's AS.<br>
</div>
<div class="gmail_extra"><br>
<div class="gmail_quote">On Mon, Jan 25, 2016 at 8:59 AM, Justin
Richer <span dir="ltr"><<a href="mailto:jricher@mit.edu" target="_blank">jricher@mit.edu</a>></span>
wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div bgcolor="#FFFFFF" text="#000000"> Yes you did. Quote:<span><br>
<br>
"The system is also much more resistant to data breaches
as data holders (UMA Resource Servers) must implement
separate <b>encryption keys </b>for each patient."<br>
<br>
</span> So if you don't mean separately encrypting the
data for each user, what does that statement mean? The
access token isn't an encryption key. <br>
<span><font color="#888888"> <br>
-- Justin</font></span>
<div>
<div><br>
<br>
<div>On 1/25/2016 8:57 AM, Adrian Gropper wrote:<br>
</div>
<blockquote type="cite">
<div dir="ltr">
<div>I never said anything about how the data is
encrypted. I only talk about how access to the
FHIR API is controlled.<br>
<br>
</div>
Adrian<br>
</div>
<div class="gmail_extra"><br>
<div class="gmail_quote">On Mon, Jan 25, 2016 at
8:55 AM, Justin Richer <span dir="ltr"><<a href="mailto:jricher@mit.edu" target="_blank"></a><a href="mailto:jricher@mit.edu" target="_blank">jricher@mit.edu</a>></span>
wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div bgcolor="#FFFFFF" text="#000000"> Adrian,<br>
<br>
I've asked this before and thought we'd
settled it, but it keeps coming up: where
are you getting the idea of encrypting the
data to the patient using a patient's key?
That is not in scope for HEART, nor is it
part of any of the underlying protocols.<span><font color="#888888"><br>
<br>
-- Justin</font></span>
<div>
<div><br>
<br>
<div>On 1/25/2016 8:52 AM, Adrian
Gropper wrote:<br>
</div>
<blockquote type="cite">
<div dir="ltr">
<div>
<div>
<div>Establishing a separate URI
for each patient is likely to
be the only stable solution to
the patient ID problem. The
issue, however, is how many
URIs will a patient be allowed
to have? If the URIs are
coercive, in the sense of a
chip or tattoo issued by
government or an equivalent
global authority (Facebook?)
or the URI is derived from DNA
or an iris scan. (Iris scans
are a good positive IDs and
can be read from 30 feet away
with modern technology.)<br>
<br>
</div>
Let's assume, for our purposes,
that an iris scanner costs about
as much as a credit card
terminal, cheap enough for every
front office, ambulance, and
police car. Is the patient ID
problem solved? I don't think
so.<br>
<br>
</div>
Patients can have one or more
separate URIs in order to help
manage their health records.
Today, we typically use email
address for this purpose, with
WebFinger <a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__webfinger.net_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=qupbYXH4yZuzhNsgW0jcwq786o--G6D1m7GlkENe1lw&e=" target="_blank"></a><a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__webfinger.net_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=qupbYXH4yZuzhNsgW0jcwq786o--G6D1m7GlkENe1lw&e=" target="_blank">https://webfinger.net/</a>
as a standardized way to discover
linked attributes such as the
patient's UMA Authorization Server
and the associated public key. <br>
<br>
UMA for patient ID brings numerous
benefits including much greater
transparency and security. The
patient now has a single portal
(their UMA AS) to view all current
relationships under that
particular patient ID persona. The
system is also much more resistant
to data breaches as data holders
(UMA Resource Servers) must
implement separate encryption keys
for each patient.<br>
<br>
</div>
<div>I think the HEART group is in a
good position to compete for the
CHIME challenge on this basis and
I'd be happy for me and PPR to
help organize a submission.<br>
<br>
</div>
<div>Adrian<br>
</div>
</div>
<div class="gmail_extra"><br>
<div class="gmail_quote">On Sun, Jan
24, 2016 at 1:20 PM, Aaron Seib <span dir="ltr"><<a href="mailto:aaron.seib@nate-trust.org" target="_blank"></a><a href="mailto:aaron.seib@nate-trust.org" target="_blank">aaron.seib@nate-trust.org</a>></span>
wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div>
<div>I appreciate your
expertise and action. </div>
<div><br>
</div>
<div>I don't necessarily agree
with some of your statements
here but that is the beauty
of open processes. </div>
<div><br>
</div>
<div>Let's strive to do all we
can - together.</div>
<div><br>
</div>
<div><br>
</div>
<div><br>
</div>
<div><span style="font-size:15.4224px">Aaron
Seib</span>
<div><span style="font-size:17.489px">@CaptBlueButton<br>
</span>
<div dir="auto"><span style="font-size:15.4224px" dir="auto">(O) <a href="tel:301-540-9549" value="+13015409549" target="_blank">301-540-9549</a></span></div>
<div dir="auto"><span style="font-size:15.4224px" dir="auto">(M) <a href="tel:301-326-6843" value="+13013266843" target="_blank">301-326-6843</a></span></div>
<div dir="auto"><span style="font-size:15.4224px" dir="auto"><br>
</span></div>
<div dir="auto"><span style="font-size:15.4224px" dir="auto">"The trick
to earning trust is to
avoid all tricks.
Including tricks on
yourself."</span></div>
<div dir="auto"><br>
</div>
</div>
</div>
<div>
<div><br>
<br>
-------- Original message
--------<br>
From: "Glen Marshall
[SRS]" <<a href="mailto:gfm@securityrs.com" target="_blank"></a><a href="mailto:gfm@securityrs.com" target="_blank">gfm@securityrs.com</a>>
<br>
Date: 2016/01/24 7:07 AM
(GMT-08:00) <br>
To: HEART List <<a href="mailto:openid-specs-heart@lists.openid.net" target="_blank"></a><a href="mailto:openid-specs-heart@lists.openid.net" target="_blank">openid-specs-heart@lists.openid.net</a>>
<br>
Subject:
[Openid-specs-heart] CHIME
Launches $1M Challenge to
Solve Patient ID Problem <br>
<br>
This is pertinent to our
data-sharing use cases.
There is no current
solution to accurately
sharing/gathering
patients' clinical data
stored among various
repositories. In turn,
that makes applying access
controls across all of a
patient's data in those
repositories difficult.
I'm happy to see Chime's
challenge.<br>
<br>
However, the related
problem of discovering
where all of one's data
might be is
computationally
intractable. It is
equally intractable to
gather and combine all
access permissions and
regulatory restrictions on
patients' data, even if
there were a useful means
to do so. (Both are
equivalent to the <a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__en.wikipedia.org_wiki_Halting-5Fproblem&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=eVT2hXrUini0He7H6c-zHwPxd4ROV6nwfZ53AECX76o&e=" target="_blank">halting
problem</a>.)<br>
<br>
Having a single "source of
truth" repository is one
direction for a solution,
as is having a single
access permissions
source. Keeping them
updated with new data and
permissions is possible,
even if difficult in the
short run.<br>
<br>
However, establishing
unique URIs for each
patient's data and
permissions is the same as
having a universal patient
identifier. That might be
subject to current
Congressional funding
restrictions. <br>
<br>
<br>
<i>The College of
Healthcare Information
Management Executives on
Tuesday launched a $1
million National Patient
ID Challenge to develop
solutions to ensure 100
percent accuracy of
every patient’s identity
to reduce preventable
medical errors.</i><i><br>
</i><i><br>
</i><i><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__www.healthdatamanagement.com_news_chime-2Dlaunches-2D1m-2Dchallenge-2Dto-2Dsolve-2Dpatient-2Did-2Dproblem&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=_qW1n-yVrg_DP1kqs-CW-XiipWZapB1GXpTiUdB-pMo&e=" target="_blank"></a><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__www.healthdatamanagement.com_news_chime-2Dlaunches-2D1m-2Dchallenge-2Dto-2Dsolve-2Dpatient-2Did-2Dproblem&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=_qW1n-yVrg_DP1kqs-CW-XiipWZapB1GXpTiUdB-pMo&e=" target="_blank">http://www.healthdatamanagement.com/news/chime-launches-1m-challenge-to-solve-patient-id-problem</a></i><br>
<div>-- <br>
<p><b>Glen F. Marshall</b><br>
Consultant<br>
Security Risk
Solutions, Inc.<br>
698 Fishermans Bend<br>
Mount Pleasant, SC
29464<br>
Tel: <a href="tel:%28610%29%20644-2452" value="+16106442452" target="_blank">(610)
644-2452</a><br>
Mobile: <a href="tel:%28610%29%20613-3084" value="+16106133084" target="_blank">(610)
613-3084</a><br>
<a href="mailto:gfm@securityrs.com" target="_blank"></a><a href="mailto:gfm@securityrs.com" target="_blank">gfm@securityrs.com</a><br>
<a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__www.SecurityRiskSolutions.com&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=sO0EFn2RDc6nTcNVSjD-lEfCdZqy-TatdAT6ccpnTZI&e=" target="_blank"></a><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__www.SecurityRiskSolutions.com&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=sO0EFn2RDc6nTcNVSjD-lEfCdZqy-TatdAT6ccpnTZI&e=" target="_blank">www.SecurityRiskSolutions.com</a></p>
</div>
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</div>
</div>
<br>
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</blockquote>
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<br>
<br clear="all">
<br>
-- <br>
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div><br>
<div dir="ltr">Adrian
Gropper MD<span style="font-size:11pt"></span><br>
<br>
<span style="font-family:"Arial",sans-serif;color:#1f497d">PROTECT
YOUR FUTURE -
RESTORE Health
Privacy!</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
HELP us fight for
the right to
control personal
health data.</span><span style="font-family:"Arial",sans-serif;color:#1f497d"></span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
DONATE: <a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank"><span style="color:#0563c1"></span></a><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank"></a><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank">http://patientprivacyrights.org/donate-2/</a></span><span style="color:#1f497d"></span> </div>
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<br>
<fieldset></fieldset>
<br>
<pre>_______________________________________________
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</pre>
</blockquote>
<br>
</div>
</div>
</div>
</blockquote>
</div>
<br>
<br clear="all">
<br>
-- <br>
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div><br>
<div dir="ltr">Adrian Gropper MD<span style="font-size:11pt"></span><br>
<br>
<span style="font-family:"Arial",sans-serif;color:#1f497d">PROTECT
YOUR FUTURE - RESTORE Health
Privacy!</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
HELP us fight for the right to
control personal health data.</span><span style="font-family:"Arial",sans-serif;color:#1f497d"></span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
DONATE: <a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank"><span style="color:#0563c1"></span></a><a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank">http://patientprivacyrights.org/donate-2/</a></span><span style="color:#1f497d"></span> </div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</blockquote>
<br>
</div>
</div>
</div>
</blockquote>
</div>
<br>
<br clear="all">
<br>
-- <br>
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div>
<div dir="ltr">
<div><br>
<div dir="ltr">Adrian Gropper MD<span style="font-size:11pt"></span><br>
<br>
<span style="font-family:"Arial",sans-serif;color:#1f497d">PROTECT
YOUR FUTURE - RESTORE Health Privacy!</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
HELP us fight for the right to control
personal health data.</span><span style="font-family:"Arial",sans-serif;color:#1f497d"></span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>
DONATE:
<a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank"><span style="color:#0563c1">http://patientprivacyrights.org/donate-2/</span></a></span><span style="color:#1f497d"></span>
</div>
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</div>
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</div>
</div>
</blockquote>
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</blockquote></div><br><br clear="all"><br>-- <br><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><br><div dir="ltr">Adrian Gropper MD<span style="font-size:11pt"></span><br><br><span style="font-family:"Arial",sans-serif;color:#1f497d">PROTECT YOUR FUTURE - RESTORE Health Privacy!</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>HELP us fight for the right to control personal health data.</span><span style="font-family:"Arial",sans-serif;color:#1f497d"></span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>DONATE:
<a href="https://urldefense.proofpoint.com/v2/url?u=http-3A__patientprivacyrights.org_donate-2D2_&d=BQMFaQ&c=qS4goWBT7poplM69zy_3xhKwEW14JZMSdioCoppxeFU&r=c7b1QeR755-dBx2b0xnlepDTylromoEzcLl-6ixmBL3TpXSxSvtAvT553fzSgLpm&m=2VMieJq3EmwTLglsueFRPjnL6SoON964_PI0l93fF_Q&s=z-4rXqaGl6wWaDWmWBhUiw11pQ596WWRLsAHF3kxUgM&e=" target="_blank"><span style="color:#0563c1">http://patientprivacyrights.org/donate-2/</span></a></span><span style="color:#1f497d"></span>
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