[Openid-specs-heart] "Scope" of sharing and purpose of use

Fri Dec 11 20:01:22 UTC 2015

Hi Eve,

It is clear that there is a communications problem between those that  are comfortable in the language of speaking about OAuth/UMA, and those that are comfortable in the language of speaking about Healthcare Access Control needs.  I can read every word you have said, but I have no idea what you said.

I think one of our problems is that we keep skipping from use-cases where the “user” is the “patient” trying to access their own data; and use-cases where the “user” is a clinician trying to help the “patient”. There are many MORE use-cases including parents, children, guardians. There are many MORE use-cases around researchers, public-health, billing, payers. And there are a huge variety of all of these. There are authorization mechanisms that stem from direct authorization by the patient, to indirect because of context, and the ultimate for healthcare ‘because their life is in jeopardy and I am a licensed clinician that can save their life’. Followed by many medical-ethical traps like having a personal discussion about a particularly tragic test result before the lab fact is directly exposed.

We need to solve all of these, however to solve any one would be helpful.

John

From: Eve Maler [mailto:eve.maler at forgerock.com] 
Sent: Friday, December 11, 2015 11:43 AM
To: Moehrke, John (GE Healthcare)
Cc: openid-specs-heart at lists.openid.net
Subject: "Scope" of sharing and purpose of use

Hi John-- (I changed the subject line and deleted older parts of the thread.)

When you say "scope" here, I suspect you mean "scope" of the sharing use case, rather than something like an OAuth or UMA scope, so I'm just checking. So a "single-patient scope" means that the only human we're paying attention to in the use case is the patient, and "any application with users that are authorized to multiple patients" seems to mean a use case that involves party-to-party sharing, with multiple humans involved. However, you follow the latter with "would need to get multiple scopes", so I'm not sure. Note that "getting multiple scopes" as a technical construct doesn't have anything to do with sharing with an autonomous third party.

FWIW, here is how I think, at a high level, about configuring the delegation of rights to access resources. It's all about parts of speech.

OAuth lets a user (patient) do this configuration at run time while using a client app, by opting in to the authorization server's issuance of an access token to that app. By contrast, UMA lets a user (patient) do this configuration anytime, generally by instructing the authorization server to check whether some combination of the client app and the requesting party using the app meet various requirements (policy). So OAuth is kind of an attenuated version of UMA wrt the constraints on delegation of access rights.

system          subject          verb             object                adjective

OAuth                client ID             OAuth scopes          (implicitly some endpoints)  n/a

                     (and always Alice)

UMA                  claims-based eg Bob,  UMA scopes over...    UMA resource sets            claims-based e.g. TPO,

                     client ID/type, etc.                                                     time limitations, etc.

It's possible to conflate purpose-of-use into the UMA scopes system, but it's as awkward as conflating (ordinarily implicit) resource sets into the OAuth scopes system (resource1.read, resource1.write, etc.), which is why OAuth has invented the audience parameter to try and solve the problem of a single authorization server protecting several APIs. This is why I suggest using a claims-based system above.

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=CwMFaQ&c=IV_clAzoPDE253xZdHuilRgztyh_RiV3wUrLrDQYWSI&r=B4hg7NQHul-cxfpT_e9Lh49ujUftqzJ6q17C2t3eI64&m=PHeMeoVZ7WGQVkHh4j1pjEo3WjxiOtW0zWBvptezqXM&s=BWKe_zUfK7VyJCEdTSN-5cG7TelP0b1X-x3kyeaODmk&e=>  community!

On Mon, Dec 7, 2015 at 2:00 PM, Moehrke, John (GE Healthcare) <John.Moehrke at med.ge.com> wrote:

The discussion on the call today was too hard to break into. Even for a big mouth like me.

I am okay with limiting our next couple of profiles to single patient scopes. As much of the email discussion has pointed out patient controlled access is our primary scope, and logically (if not  technically) this  is easy to understand with scopes that are single patient. 

Yes this means that any application with users that are authorized to multiple patients would need to get multiple scopes; so be it. For now…  For Enterprise use, this is troubling; but for most uses that happen from outside of an enterprise or between enterprises this limitation is not unreasonable. The most common APIs in healthcare for this are already patient centric. So it is not a big problem.

The user experience does not need to be impacted by this profiled limitation

The future does not need to be impacted by this profiled limitation.

Which means that one viewpoint for scope can be the identity of the patient that one is asking for access to. This is not the only scope we will ever support; but is one method that would satisfy some use-cases today.

Another view on scope, that I have been involved with in other groups, is to use a high-level vocabulary that is used often in the Access Control policy – PurposeOfUse. This vocabulary is items like: Treatment, Payment, Research, Emergency, etc…

To go deeper than these two vectors through scopes in a general purpose healthcare access control infrastructure is futile.

Next level deeper in scopes would come from workflow centric implementation guides. That is a specification that is defining a workflow, could define a scope(s) for that workflow.

John

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