[Openid-specs-heart] FHIR Client Registration is the existential issue for HEART

Tue Dec 13 18:36:24 UTC 2016

The HEART charter is about patient-directed exchange across FHIR APIs.
There's no reason to introduce trust federations into HEART, especially
since practical trust mechanisms don't yet exist. We can imagine that
Sequoia, or DirectTrust, or the FDA will start issuing software statements
for apps someday but that's what makes trust federations a parking lot
issue today.

What we do know today is HIPAA and the API Task Force output.

If we don't provide a mechanism for resource servers to issue a warning and
receive a click-through as part of HEART, then we will force patients to
register clients manually through a patient portal the same way that you
register a client to the Google OAuth API. The usability of that process is
likely to doom HEART.

What is the alternate proposal from Glen, Aaron, or anyone else:

(1) Is HEART to assume software statements are going to be issued by
someone and federated by all RSs so that HIPAA / API Task Force warnings
are irrelevant?

(2) Is HEART to assume that dynamic client registration occurs without a
software statement?

(3) ?

Adrian

On Tue, Dec 13, 2016 at 10:34 AM, Aaron Seib <aaron.seib at nate-trust.org>
wrote:

> Regardless – I think that Glen’s assertion that HEART’s plate runneth over
> is a valid one and this specific aspect is best tabled.
>
>
>
> Are you disagreeing with him or just stating you’re policy position?
>
>
>
>
>
> Aaron Seib, CEO
>
> @CaptBlueButton
>
>  (o) 301-540-2311 <(301)%20540-2311>
>
> (m) 301-326-6843 <(301)%20326-6843>
>
> <http://nate-trust.org>
>
>
>
> *From:* Openid-specs-heart [mailto:openid-specs-heart-
> bounces at lists.openid.net] *On Behalf Of *Adrian Gropper
> *Sent:* Tuesday, December 13, 2016 10:06 AM
> *To:* Glen Marshall [SRS]
> *Cc:* Josh Mandel; Grahame Grieve; openid-specs-heart at lists.openid.net
> *Subject:* Re: [Openid-specs-heart] FHIR Client Registration is the
> existential issue for HEART
>
>
>
> The experiment to fragment the address space into trusted and untrusted
> clients has been tried many times starting with Markle Common Framework,
> NHIN, state HIEs, and DirectTrust. There's a reason the HEART charter says
> "build, run, or outsource."
>
> Patients and physicians need a system where trust is rooted in people, not
> institutions.
>
> Adrian
>
>
>
> On Tue, Dec 13, 2016 at 8:52 AM, Glen Marshall [SRS] <gfm at securityrs.com>
> wrote:
>
> I prefer this be a parking lot issue for HEART.  We have enough on our
> plate to deliver a profile for the core HEART functions.  The API Task
> Force recommendations do not have the force of current regulations.  I
> expect a marketplace solution for them, outside of HEART, should the
> recommendations find their way into regulations.
>
>
>
>
>
> Glen F. Marshall
>
> Consultant
>
> Security Risk Solutions, Inc.
>
> 698 Fishermans Bend
>
> Mount Pleasant, SC 29464
>
> Tel: (610) 644-2452
>
> Mobile: (610) 613-3084
>
> gfm at securityrs.com
>
> www.SecurityRiskSolutions.com <http://www.securityrisksolutions.com/>
>
>
>
> *From:* Openid-specs-heart [mailto:openid-specs-heart-
> bounces at lists.openid.net] *On Behalf Of *Adrian Gropper
> *Sent:* Monday, December 12, 2016 20:03
> *To:* openid-specs-heart at lists.openid.net; Josh Mandel <jmandel at gmail.com>;
> Justin P Richer <jricher at mit.edu>
> *Cc:* Grahame Grieve <grahame at healthintersections.com.au>
> *Subject:* [Openid-specs-heart] FHIR Client Registration is the
> existential issue for HEART
>
>
>
> This summer's API Task Force had, arguably, only one major conclusion:
>
> *"A Resource Server can warn a patient if the RS believes that a client
> requesting patient-directed exchange is un-trusted AND the patient can
> choose to click-through that warning and grant access to the resource
> anyway." *
>
> The API Task Force acknowledged situations where an RS could still block a
> client but these are limited to denial of service attacks and other threats
> against the integrity of _other_ patients' data on a system.
>
> There are efforts now underway to establish trust audits for FHIR clients
> which could be presented as part of a "software statement" in order to
> avoid the API Task Force warning.
>
> Regardless of whether these software statement efforts are successful and
> can be used to bypass the the API Task Force "warning", HEART has to deal
> with the API Task Force outcome and profile how a warning is issued when a
> patient-specified client does not come with a "trusted" software statement.
>
> As far as I can tell, the only way for HEART to enable the API Task Force
> conclusion is for us to specify a way for the RS to communicate the
> "warning" to the AS when a software statement is deemed inadequate by the
> RS AND to accept a "click-through" message back from the AS.
>
> As an alternative, the RS could bypass the AS and send the warning
> directly to the resource owner and expect a direct reply by secure message
> or via the patient portal that was used to register the resource with the
> AS in the first place. This alternative does not involve either HEART or
> UMA and could be considered a parking lot issue.
>
>
>
> Adrian
>
>
>
>
>
>
>
>
> --
>
>
>
> 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/
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