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

Fri Dec 11 22:28:59 UTC 2015

Hi Aaron, Thanks for highlighting the important issue of discovery.

Discovery means: the user doesn't know who will be on the list. That puts a
lot of responsibility on the RS to do the right thing. In HIEs for example,
they insist the user is a practicing physician because they want to reduce
their liability if someone's name pops up on a list that the user should
not have seen.

I meant RO (resource owner), It makes no sense for the RS to send a notice
to themselves.

Yes, RqP is the Requesting Party which is the party that controls the
Client that is accessing the AS and the RS. The RqP might be the patient
subject (the RO) themselves using an app or PHR but that case would be
handled by OAuth. (We call that the Alice-to-Alice case). UMA is
interesting because it allows the RqP user to be someone other than Alice
therefore enabling true health information exchange. This is what makes
HEART so useful and our HEART Profiles so important.

Adrian

On Fri, Dec 11, 2015 at 4:53 PM, Aaron Seib <aaron.seib at nate-trust.org>
wrote:

> Hi – I meant to ask you last week.  When you say Discovery in the first
> bullet I am not sure I know what you mean.  Can you expand on that for me?
> I think I get everything except that below.
>
>
>
> I don’t know why we are trying to be so cryptic on the work group.  This
> is unfortunate.
>
>
>
> You use RO below and I think it might be a typo but have to confirm.  Is
> it meant to have been something else?
>
>
>
> What is RqP an abbreviation of? Requesting Party?
>
>
>
> *From:* Openid-specs-heart [
> mailto:openid-specs-heart-bounces at lists.openid.net
> <openid-specs-heart-bounces at lists.openid.net>] *On Behalf Of *Adrian
> Gropper
> *Sent:* Friday, December 11, 2015 3:37 PM
> *To:* Moehrke, John (GE Healthcare)
> *Cc:* openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] "Scope" of sharing and purpose of use
>
>
>
> Let me attempt at mediation :-)
>
> - We're talking about resources that have a single subject (the patient)
> Resources with more than one subject, such as a patient list are a
> completely different matter because they involve discovery (I don’t get
> this?  Discovery of what?  The identity of each person in the list?). The
> special case of a mom with 2 kids can simply, if inelegantly, be handled by
> polling for each of the subjects. There's no discovery involved.
>
> - The major difference between OAuth and UMA is that in UMA the resource
> is under the control of a separate legal entity. Therefore, when a client
> (and the client's user) shows up to request the resource, the client may
> present claims or attributes to either or both the resource server (RS)
> and/or the authorization server (AS). To say this another way: In UMA
> there's some kind of legal agreement between the resource server and the
> authorization server. In OAuth there is none because they are the same.
>
> - The sharing of control between the RS and the AS is subject to
> institutional, local, and federal controls. All of the situations that John
> listed boil down to "good faith" and "notice" to the RO when the resource
> server acts on the instructions of the AS based on the actual attributes of
> the client (C)* by client attributes do you mean attributes of MSHV or of
> the User of MSHV, Aaron Seib?* and the client's user (RqP – this is Aaron
> Seib, right?  What does RqP stand for?).
>
> Adrian
>
>
>
> On Fri, Dec 11, 2015 at 3:01 PM, Moehrke, John (GE Healthcare) <
> John.Moehrke at med.ge.com> wrote:
>
> 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
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>
>
> 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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> --
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>
>
> Adrian Gropper MD
>
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