[Openid-specs-heart] Considering profiling resource sets/scopes for the "before first visit" sharing scenario

Mon Jun 27 04:03:34 UTC 2016

Thank you John for making things clear. Changing the subject line of my "Is
HEART Profiling Privacy?" thread does not solve the problem but I do
appreciate and respect Eve's intent.

I'm not sure the OpenID Connect analogy is useful for HEART or for UMA in
general.

I claim that building on FHIR Confidentiality Classification is beyond
HEART's charter. Patient Privacy Rights would love to participate in that
discussion with whomever in HL7 wants to join in but it's not easy to see
who else would be at that table and I don't see anyone clamoring to charter
that group. For reference, I've attache a nice study of what might be
involved in such an exercise.

I hope UMA does not force HEART to profile privacy. As John makes clear,
FHIR resource types are not being designed to make privacy classifications
or patient understanding of privacy issues particularly easy or hard. I
suspect the same thing is true outside of healthcare.

My suggestion does not require that HEART profiles privacy or make use of
confidentiality classification. A HEART resource server (a) can publish the
list of resource types it supports, and
(b) can post to a specific HEART AS which resource types are or are not
available for a particular resource registration, and maybe
(c) can optionally post explanations, hints, resource type groupings, or
examples to the specific HEART AS. This would enable a RS to send the
equivalent of their current Release of Information form to the AS.

Note that (c) is optional. Whether (c) is there or not, FHIR supports
whatever granularity it supports and there's no reason an AS should not
choose to take advantage of that.

Therefore (a) and (b) together allow any RS to register with any AS and
it's up to the AS to map the resource types into policy choices for the
resource owner. Rather than HEART profiling privacy, i suggest we allow ASs
to compete on how to present the privacy issues to the resource owner.

Adrian

On Sun, Jun 26, 2016 at 9:21 PM, John Moehrke <johnmoehrke at gmail.com> wrote:

> Hi Eve,
>
> It would seem that we would indeed have this figured out. But reality is
> that we never quite talk about it so bluntly, mostly because classifying
> healthcare data is so very hard. Further the various ways that would be
> logical don't fall nicely upon the logical ways that data can be segmented.
> That is the way that people would like to segment their data is according
> to how sensitive it is; yet this doesn't align with FHIR resources, or
> departments, or function, etc...  Plus data changes sensitivity based on
> current medical knowledge (HIV was very sensitive a few years ago, today it
> tends to trend closer to normal data).
>
> So the best I have to offer is the _confidentiality classifications we
> have in the security-tags: It is a scale that centers around Normal - that
> group of data that everyone agrees is the typical healthcare data
> (mathematically normal). Think of it as a risk scale of 6 different risk
> quantum. All data MUST have one of these values assigned to it.
>    http://hl7-fhir.github.io/v3/ConfidentialityClassification/vs.html
>
> so U, L, M, N, R, V --- definitions are on the page above.
>
> Is this a good solution? NO! but it does exist today.
>
> More on my blog article
>
> https://healthcaresecprivacy.blogspot.com/2015/07/how-to-set-confidentialitycode.html
> or
>   https://healthcaresecprivacy.blogspot.com/2016/01/fhir-oauth-scope.html
>
> 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
> https://www.linkedin.com/in/johnmoehrke
> https://healthcaresecprivacy.blogspot.com
> "Quis custodiet ipsos custodes?" ("Who watches the watchers?")
>
> On Sun, Jun 26, 2016 at 11:18 AM, Eve Maler <eve.maler at forgerock.com>
> wrote:
>
>> This message is intended to give shape to our profiling efforts. I
>> apologize in advance if I "step in it" due to my lack of HL7 or FHIR
>> knowledge. :-)
>>
>> Given our first sharing scenario
>> <https://bitbucket.org/openid/heart/wiki/Alice_Shares_with_Physicians_and_Others_UMA_FHIR> (in
>> the latest use case) of providing basic data before a first visit, are
>> there various subsets or supersets of such data, e.g., in different
>> jurisdictions, that Alice would be expected to provide, or one obvious and
>> universally understood data set? I'm guessing that payment data is one
>> subset of data that doesn't apply in some jurisdictions, whereas quite a
>> lot of "medically related data" would generally be considered desirable to
>> share if available.
>>
>> What I'm going for here is: If you could have a system of "keywords"
>> representing virtual clipboard-type data sets and how you want them shared,
>> what's the smallest arrangement of keywords that would do the trick?
>>
>> By (very rough) analogy, look at how OpenID Connect standardizes client
>> requests for claims using scope values
>> <http://openid.net/specs/openid-connect-core-1_0.html#ScopeClaims>. It
>> rolls up multiple identity claims under single scope names, so that
>> "openid" gives the client full access at the UserInfo endpoint, "profile"
>> gets access to 14 specific claims, "email" gets access to two claims, etc.
>>
>> UMA gives us two dimensions to play with, so it could be like this:
>>
>> Potential resource sets to access (I'm totally making this up! for all I
>> know, HL7 figured this out 10 years ago and it doesn't look anything like
>> this...):
>>
>>    - BasicVirtualClipboardData
>>    - FinancialVirtualClipboardData (or a unique version per
>>    jurisdiction?)
>>    - AllVirtualClipboardData (an aggregation of the two of them)
>>
>> Potential scopes of action across them (same for each one? it doesn't
>> have to be that way, and other resource sets might have deidentified-read
>> options or something...):
>>
>>    - read
>>    - write
>>
>> Note that the scope work already begun in our OAuth FHIR profile, coming
>> from the SMART on FHIR work, gives us ideas for things like a "read" verb
>> and a "write" verb, but for right now, we can think outside the box if
>> that's the right thing to do.
>>
>>
>> *Eve Maler*ForgeRock Office of the CTO | VP Innovation & Emerging
>> Technology
>> Cell +1 425.345.6756 | Skype: xmlgrrl | Twitter: @xmlgrrl
>> *ForgeRock Summits and UnSummits* are coming to
>> <http://summits.forgerock.com/> *Sydney, London, and Paris!*
>>
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>>
>>
>
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-- 

Adrian Gropper MD

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