[Openid-specs-heart] Notification in HEART and/or UMA

[Adrian Gropper]

Thanks, Aaron - I think you get it just fine - how we explain it may still
be a challenge - see inline

On Sun, Jul 31, 2016 at 9:50 AM, Aaron Seib, NATE <aaron.seib at nate-trust.org
> wrote:

> Adrian,
>
>
>
> This is a very useful description of the HEART work: “HEART is all about
> giving everyone a choice of authorization server in the FHIR context.”
>
>
>
> I think it would be a great way to start a presentation about HEART that
> would provide a better understanding of what the project is about.
>
>
>
> Before we move onto the rest of the thread here – which I think is just as
> important to understanding what is being proposed - can we deconstruct the
> meaning of two components of this sentence?
>
>
>
> ·         What does it mean to ‘give everyone a choice of authorization
> server’?
>
It means that when I begin a relationship with a service provider they
don't expect to tell me who my email provider should be. I get to choose
Google or an email from my college or run my own mail server and the
service provider just has to deal with that. By giving the person the
choice of authorization server, the service provider has to make contact in
the Inbox that's convenient to the person. Imagine if every merchant and
service provider could tell you where to sign-in to check your messages
from them. Oh, this is exactly how "secure messages" from our EHRs work
today, never mind, you don't have to imagine.

> ·         What does it mean to do so ‘in the FHIR Context’?
>
FHIR is a standard for EHR interoperability. When a standard is available a
service provider has the choice of using it or not. Email for example is an
available standard but hospitals don't choose to use it even though the
Office for Civil Rights has said unequivocally that patients have a right
to request contact by plain insecure email. (There's still some kind of
legal or regulatory challenge to be mounted on that front - but I digress.)
Direct email was another standard that hospitals have chosen not to
implement in a consumer-friendly way. Now we have the FHIR standard. We
need to learn from our experience and the JASONs and the API Task Force and
make sure that the FHIR implementations _can't_ discriminate between HIPAA
covered endpoints and patient-controlled endpoints. If we make HEART work
for patient-directed exchange and the hospitals pull another Direct
maneuver, it needs to be obvious to the regulators and politicians.


> Next, I thought that this statement was very useful:  ‘When she (*Alice*)
> engages with a FHIR service provider as a patient Alice provides three
> pieces of information:
>
> ·         an identity
>
> ·         a notification address
>
> ·         a resource registration address
>
> I want to make sure I understand what you mean when you later describe a
> potentially ideal solution as ‘Alice to provide an identity that
> automagically links to her Notification and Authorization addresses.”
>
> If I am reading it correctly – I think you are asking if an email address
> supplied by Alice would be sufficient for the identity – I just want to
> make sure I understand the question.  If I am keeping up there would be
> some way that Alice associates this email address with her choice of
> Authorization server (that a FHIR based resource server could use to
> resolve her privacy preferences) and incidentally be where the FHIR based
> Resource Server would send notifications about the disclosures it made
> based on her privacy preferences found in the Authorization Server of her
> choice in association with the email address she chooses.
>
Yes. It's a standard called WebFinger that is already in OpenID Connect.
HEART can build on WebFinger. There are other identity-related standards we
can consider if necessary.

> Thank you – this would be the kind of detail that I think we could share
> with a folks like NATE’s members et al.
>
I think HEART's patient-directed exchange is a huge opportunity for may of
NATE's members. Somebody will need to make and sell those authorization
servers :-)

Adrian

>
>
> Aaron
>
>
>
>
>
> Aaron Seib, CEO
>
> @CaptBlueButton
>
>  (o) 301-540-2311
>
> (m) 301-326-6843
>
> [image: cid:image001.jpg at 01D10761.5BE2FE00] <http://nate-trust.org>
>
>
>
> *From:* Openid-specs-heart [mailto:
> openid-specs-heart-bounces at lists.openid.net] *On Behalf Of *Adrian Gropper
> *Sent:* Saturday, July 30, 2016 1:47 PM
> *To:* openid-specs-heart at lists.openid.net
> *Cc:* Dixie Baker
> *Subject:* [Openid-specs-heart] Notification in HEART and/or UMA
>
>
>
> A new thread to consider Danny's very important reminder of how HEART will
> deal with Notification.
>
> From Alice's perspective, when she engages with a FHIR service provider as
> a patient Alice provides three pieces of information:
>
> - an identity
>
> - a notification address
>
> - a resource registration address
>
> That's a lot to ask. We're all used to providing an email address as an
> identity and a notification endpoint. We're also used to the typical OAuth
> authorization screen that sometimes appears after we use a federated
> identity such as Gmail. What we're not used-to, yet, is being given a
> choice of OAuth authorization server the same way we have a choice of
> notification address. HEART is all about giving everyone a choice of
> authorization server in the FHIR context. It's the essence of being
> patient-centered and why the HEART charter says: "build, buy, or outsource"
> the AS.
>
> The ideal situation IMHO would be for Alice to provide an identity that
> automagically links to her Notification and Authorization addresses. If
> that identity is an email address, then we have a simple, voluntary, and
> well-established way to explain HEART and to bootstrap the rest of the
> patient registration or consent to health information exchange process. Is
> there any realistic alternative to email?
>
> It's not clear at this time whether UMA will add a Notification endpoint
> to the UMA spec. If it does, then HEART can just use that. If it doesn't
> then HEART will need to deal with Notification some other way. Either way,
> HEART will need to explain to FHIR resource servers how they are expected
> to bootstrap discovery of Alice's authorization server and, incidentally,
> her Notification address.
>
> Adrian
>
>
>
>
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