[Openid-specs-heart] HEART Meeting notes 2016-05-16
Adrian Gropper
agropper at healthurl.com
Wed May 18 03:29:26 UTC 2016
My bad. Accounting of Disclosures it is.
Adrian
On Tuesday, May 17, 2016, John Moehrke <johnmoehrke at gmail.com> wrote:
> I have always referred to it as "Accounting of Disclosures". Meaning it is
> a report that indicates the disclosures that have happened (history). Which
> is what AuditEvent, and my blog speak to.
>
> I would expect an "Accounting FOR Disclosures" to be a record of the
> potential disclosures that might happen in the future (aka
> Consent/Authorization). So I was confused given the scope of HEART.
>
> John
>
> John Moehrke
> Principal Engineering Architect: Standards - Interoperability, Privacy,
> and Security
> CyberPrivacy – Enabling authorized communications while respecting Privacy
> M +1 920-564-2067
> JohnMoehrke at gmail.com
> <javascript:_e(%7B%7D,'cvml','JohnMoehrke at gmail.com');>
> https://www.linkedin.com/in/johnmoehrke
> https://healthcaresecprivacy.blogspot.com
> "Quis custodiet ipsos custodes?" ("Who watches the watchers?")
>
> On Tue, May 17, 2016 at 10:13 PM, Adrian Gropper <agropper at healthurl.com
> <javascript:_e(%7B%7D,'cvml','agropper at healthurl.com');>> wrote:
>
>> Accounting for Disclosures
>>
>> On Tuesday, May 17, 2016, Grahame Grieve <
>> grahame at healthintersections.com.au
>> <javascript:_e(%7B%7D,'cvml','grahame at healthintersections.com.au');>>
>> wrote:
>>
>>> A4D?
>>>
>>> Grahame
>>>
>>>
>>> On Wed, May 18, 2016 at 12:55 PM, Adrian Gropper <agropper at healthurl.com
>>> > wrote:
>>>
>>>> I'm glad to hear they're in scope.
>>>>
>>>> Thing is, that notifications have two components: the endpoint and the
>>>> message format. As I recall, MVCR consent receipts are more about the
>>>> message format than the endpoint. I much prefer the FHIR Subscriptions
>>>> approach because it doesn't trigger a standards project related to the
>>>> format and therefore makes implementation much faster.
>>>>
>>>> All three notification types are perfectly compatible with a
>>>> human-readable format. In some cases, as the FHIR Subscription
>>>> standard points out, having a message content at all is an unacceptable and
>>>> unnecessary privacy liability. This applies to type (1) notifications where
>>>> any contact with the notification endpoint triggers a query to the FHIR
>>>> endpoint.
>>>>
>>>> Type (2) notifications need to be human-formatted by definition to meet
>>>> the intent of HIPAA and today's API Task Force recommendation. Nothing
>>>> would be served by trying to standardize the format as each FHIR endpoint
>>>> has a right to issue whatever warning it feels is appropriate to the
>>>> particular client and situation. Although there was interest in the
>>>> API discussion today in evolving a Model Privacy Notice related to this
>>>> Type (2) notification, that work, if and when it's available, is also meant
>>>> for human-readable format and it was deemed unlikely to cover all of the
>>>> warning situations. There are no privacy issues with Type (2) messages
>>>> because they need not contain any PHI. This makes them much more
>>>> user-friendly since they can be delivered via SMS and other insecure
>>>> channels.
>>>>
>>>> Type (3) notifications - A4D - are the only ones that might benefit
>>>> from a standard format. Even so, standard formatting is not expected - we
>>>> are perfectly happy to receive activity messages from banks and merchants
>>>> even though their format is all over the place. In addition, type (3)
>>>> messages do have privacy implications if they contain any PHI or even
>>>> indication of the metadata. Therefore, it would be preferable to make these
>>>> opaque or content-free and allow the recipient to query the FHIR server for
>>>> A4D if they choose.
>>>>
>>>> @Grahame: Does FHIR already specify an A4D resource?
>>>>
>>>> Is the discussion above an appropriate addition to the current use-case?
>>>>
>>>> Adrian
>>>>
>>>> On Tuesday, May 17, 2016, Debbie Bucci <debbucci at gmail.com> wrote:
>>>>
>>>>> Notifications were always in scope. One type of notification was in
>>>>> the form of a consent receipt. You may recall Sarah doing some research
>>>>> and comparing to ...was it HL7? The receipt could be use to acknowledge a
>>>>> number of state changes.
>>>>>
>>>>> I am very familiar with topics/queues and pub/sub from my SOA
>>>>> infrastructure days. A brief glance at subscriptions seem to be a similar
>>>>> pattern.
>>>>>
>>>>> Dont think its a scope issue. It could be a implementation choice in
>>>>> use cases to use a subscription to deliver a message that either
>>>>> acknowledges a receipt or triggers another process in the work flow
>>>>>
>>>>> I think that would cover your 3 examples listed below.
>>>>>
>>>>> On May 17, 2016 8:45 PM, "Adrian Gropper" <agropper at healthurl.com>
>>>>> wrote:
>>>>>
>>>>>> As mentioned in the other thread, there are three different kinds of
>>>>>> notification under HIPAA (and probably in the general case):
>>>>>> (1) a resource has changed - this is p53 of the NZ doc
>>>>>> (2) a client is being registered that requires specific affirmation
>>>>>> by the Grantor
>>>>>> (3) accounting for disclosures - the resource server has been
>>>>>> accessed by a client
>>>>>>
>>>>>> The FHIR spec lists 4 different standards for push notifications
>>>>>> http://hl7.org/fhir/subscription.html .
>>>>>>
>>>>>> I believe all three of these kinds of notification are in-scope for
>>>>>> HEART. The three endpoints do not all have to be the same, do not all have
>>>>>> to be UMA, and we may want to restrict some of the 4 options offered in the
>>>>>> FHIR spec.
>>>>>>
>>>>>> Can we add these three kinds of notification to the current use case
>>>>>> as proposed by Eve?
>>>>>>
>>>>>> Adrian
>>>>>>
>>>>>>
>>>>>> On Tuesday, May 17, 2016, Eve Maler <eve.maler at forgerock.com> wrote:
>>>>>>
>>>>>>> Supplementing with the link I referred to during the call:
>>>>>>>
>>>>>>> The UMA case study "Users Managing Delegated Access to Online
>>>>>>> Government Services" conducted by the New Zealand government available on
>>>>>>> the UMA wiki:
>>>>>>>
>>>>>>>
>>>>>>> http://kantarainitiative.org/confluence/display/uma/Case+Study%3A+Users+Managing+Delegated+Access+to+Online+Government+Services
>>>>>>> (PDF report downloadable here
>>>>>>> <http://kantarainitiative.org/confluence/download/attachments/76907066/NZ%20ProjectClosureReport_PoC%20Delegations-Final%20Version%20SIG%20redacted%20Rev1.pdf?api=v2>
>>>>>>> )
>>>>>>>
>>>>>>> ...documents in Sec 8.4.3.3.3 (p. 46) a desire for "notifications"
>>>>>>> that can be achieved by sending email or by other means, with a discussion
>>>>>>> in Sec 8.4.9 (p. 53) about sending push notifications to an UMA requesting
>>>>>>> party through a mobile app from a resource owner's smart device. The case
>>>>>>> study didn't, I believe, use FHIR.
>>>>>>>
>>>>>>>
>>>>>>> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
>>>>>>> Technology
>>>>>>> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
>>>>>>> Check out the 2016 schedule <https://summits.forgerock.com> for *ForgeRock
>>>>>>> Summits and UnSummits*!
>>>>>>>
>>>>>>> On Tue, May 17, 2016 at 7:04 AM, Debbie Bucci <debbucci at gmail.com>
>>>>>>> wrote:
>>>>>>>
>>>>>>>> Adrian was given the floor to discuss his concerns that he has
>>>>>>>> labeled for point of reference as “Independent Decision Support at the
>>>>>>>> Point of Care for Physicians and Patients"
>>>>>>>>
>>>>>>>> Adrian indicated there were 4 primary functions needed. Many in
>>>>>>>> the group translated it in different ways but Debbie’s version was:
>>>>>>>>
>>>>>>>> -
>>>>>>>>
>>>>>>>> Release of Information
>>>>>>>> -
>>>>>>>>
>>>>>>>> Notification of Disclosures
>>>>>>>> -
>>>>>>>>
>>>>>>>> Subscribe to changes
>>>>>>>> -
>>>>>>>>
>>>>>>>> Automated patient right of access.
>>>>>>>>
>>>>>>>> Eve translated the bullets to both technical and policy work out of
>>>>>>>> the UMA workgroup and pointed to relevant/related publication developed in
>>>>>>>> close coordination with NZ.
>>>>>>>>
>>>>>>>> Josh was concerned that Adrian perhaps was proposing an entirely
>>>>>>>> new standard. John and others were trying to get clarification
>>>>>>>> around what Adrian was referring to as Data Blocking.
>>>>>>>>
>>>>>>>> After an hour long of healthy discussion – Josh asked if there were
>>>>>>>> any procedure on how to document to handle such a discussion within the
>>>>>>>> group Adrian was concerned about HEART’s
>>>>>>>> functionality/relevance in relation to his concerns. Hope the
>>>>>>>> following points brought up in the meeting addresses these concerns:
>>>>>>>>
>>>>>>>> -
>>>>>>>>
>>>>>>>> HEART’s function is not to create standards but to create
>>>>>>>> profiles of existing recognized standards to encourage interoperable
>>>>>>>> implementations of these standards. Please see :
>>>>>>>> http://openid.net/wg/heart/charter/
>>>>>>>> -
>>>>>>>>
>>>>>>>> All members are encouraged to bring use cases to the group to
>>>>>>>> consider. The functional use case is broken down into
>>>>>>>> technical functionalities that are flagged as core or peripheral to the
>>>>>>>> standards being considered under HEART.
>>>>>>>> -
>>>>>>>>
>>>>>>>> We acknowledge that with both the Standards and profiles, there
>>>>>>>> may be implementation decisions made to bridge gaps where existing
>>>>>>>> functionality does not exist. We strongly encourage those
>>>>>>>> implementers to officially log the gaps and solutions they made back with
>>>>>>>> the relevant Standards Bodies in order to give feedback to future
>>>>>>>> iterations of the Standards.
>>>>>>>>
>>>>>>>> Standards development is an iterative process and versioning
>>>>>>>> control of standards and specs are an implementation reality we have to
>>>>>>>> deal with. Changes are made incrementally
>>>>>>>>
>>>>>>>> We concluded the discussion by asking Adrian to develop a
>>>>>>>> functional use case to bring to the group for consideration. Subsequently
>>>>>>>> there has been a recap discussion posted prior to the notes that we will
>>>>>>>> append to these meeting notes to round out context to the discussion
>>>>>>>>
>>>>>>>> Next week’s meeting (May 23rd) will focus on the comment submitted
>>>>>>>> by Mike Jones re: suggested changes to the HEART profile. Additionally,
>>>>>>>> if permissible, we will revisit and consider the Argonaut report and their
>>>>>>>> recommendations as part of this review. All members interested
>>>>>>>> that may have input to the impending updates, please make it a point to
>>>>>>>> attend.
>>>>>>>>
>>>>>>>> * AI:* Justin is developing a step by step analysis for us to
>>>>>>>> consider.
>>>>>>>>
>>>>>>>> Will cancel the next two meetings due to conflicts: May 30th (US
>>>>>>>> holiday) and June 5th (Cloud Identity Summit )
>>>>>>>> On June 12th We should be prepared to go back to the current use
>>>>>>>> case
>>>>>>>> https://bitbucket.org/openid/heart/wiki/Alice_Shares_with_Physicians_and_Others_UMA_FHIR
>>>>>>>> and stay with that use case until we complete our final draft
>>>>>>>> semantic profile.
>>>>>>>> Adrian's new use case is the next in the queue and welcome any
>>>>>>>> others that folk may want to submit.
>>>>>>>>
>>>>>>>>
>>>>>>>> _______________________________________________
>>>>>>>> Openid-specs-heart mailing list
>>>>>>>> Openid-specs-heart at lists.openid.net
>>>>>>>> http://lists.openid.net/mailman/listinfo/openid-specs-heart
>>>>>>>>
>>>>>>>>
>>>>>>>
>>>>>>
>>>>>> --
>>>>>>
>>>>>> Adrian Gropper MD
>>>>>>
>>>>>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>>>>>> HELP us fight for the right to control personal health data.
>>>>>> DONATE: http://patientprivacyrights.org/donate-2/
>>>>>>
>>>>>>
>>>>
>>>> --
>>>>
>>>> Adrian Gropper MD
>>>>
>>>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>>>> HELP us fight for the right to control personal health data.
>>>> DONATE: http://patientprivacyrights.org/donate-2/
>>>>
>>>>
>>>
>>>
>>> --
>>> -----
>>> http://www.healthintersections.com.au /
>>> grahame at healthintersections.com.au / +61 411 867 065
>>>
>>
>>
>> --
>>
>> Adrian Gropper MD
>>
>> PROTECT YOUR FUTURE - RESTORE Health Privacy!
>> HELP us fight for the right to control personal health data.
>> DONATE: http://patientprivacyrights.org/donate-2/
>>
>>
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>>
>
--
Adrian Gropper MD
PROTECT YOUR FUTURE - RESTORE Health Privacy!
HELP us fight for the right to control personal health data.
DONATE: http://patientprivacyrights.org/donate-2/
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