<div dir="ltr">Also a bit hesitant, but in order to encourage others to jump in the pool... :)<br><div class="gmail_extra"><br clear="all"><div><div><div dir="ltr"><div><div dir="ltr">
<p><b>Eve Maler<br></b>ForgeRock Office of the CTO | VP Innovation & Emerging Technology<br>Cell <a href="tel:%2B1%20425.345.6756" value="+14253456756" target="_blank">+1 425.345.6756</a> | Skype: xmlgrrl | Twitter: @xmlgrrl<br>Join our <a href="http://forgerock.org/openuma/" target="_blank">ForgeRock.org OpenUMA</a> community!</p></div></div></div></div></div>
<br><div class="gmail_quote">On Mon, Apr 20, 2015 at 7:40 AM, Debbie Bucci <span dir="ltr"><<a href="mailto:debbucci@gmail.com" target="_blank">debbucci@gmail.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div style="font-size:13px">Hesitant to speak up but since John asked ...</div><span><div style="font-size:13px"><br></div><div style="font-size:13px">With regard to UMA Authorization Servers, are you suggesting that we consider a mix of personally-controlled and institutionally-controlled Authorization Servers or just one or the other?</div><div style="font-size:13px"><br></div></span><div><b>Mixed. I could see places where an Authorization service would/could be logically stood up outside an institutions borders (in case of Health IT - ACO, HIE etc). Additionally if these entities focus on patient/consumer value add service, those authorization services could/should allow the patient to add additional end points ...perhaps even federate with other known/trusted authorization services. Including Adrian's 5.00 a month service - providing the binding is strong enough to be trusted.</b></div></div></blockquote><div><br></div><div>When I think about "considering" authorization servers/services, it makes me think we (HEART?) have the power to determine the answer. I'm not sure we do. Someone I knew in the standards game used to talk about "sanction vs. traction", sanction being formal blessing, and traction being ecosystem adoption. With individual preferences and proclivities in the mix, weird/cool things could happen. If constrained by regulation, certain market distortions are certain to take place.</div><div><br></div><div>I would really hope that we don't sequester <i>sources</i> of data in our use cases. Our charter certainly doesn't, and life doesn't work that way. This is why I was trying to point out in my first response to John that we have new examples of data coming from patients as the most-upstream resource owners now. It would seem important for clinical purposes, not just for generic consumer purposes, to accommodate this in the access control picture.</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><span><div style="font-size:13px"><br></div><div style="font-size:13px">With regard to interface scopes, are there particular scopes that should be considered before others?</div><div style="font-size:13px"><br></div></span><div style="font-size:13px"><b>Don't understand this question. I think its use case driven</b></div></div></blockquote><div><br></div><div>I took this to mean that there are various standardized permission scopes that are worth driving towards in our work here -- but I'm not sure.</div><div><br></div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><span><div style="font-size:13px"><br></div><div style="font-size:13px">With regard to identity management and identity federation, would we consider patient ID before or after provider ID?</div><div style="font-size:13px"><br></div></span><div style="font-size:13px"><b>In order to access the API the identity negotiation would need to be completed upfront. In the in PoF demonstration - we repeated said it was out of scope but if you looked closely ... Alice did use a federated credential. John did bring up identity proofing/LOA/trust in one of the early calls. Even though we do not deal with it directly it does need to be represented/addressed and is a necessary part of the authorization/access "calculus". I know there are a number of folks on this list already tackling this problem space and are looking for way to integrate into these profiles/workflow. We should let them help us. </b></div></div></blockquote><div><br></div><div>What Deb said.</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><span><div style="font-size:13px"><br></div><div style="font-size:13px">With regard to patient matching and discovery, would we try to keep these in or out of scope for the early parts of the roadmap?</div><div style="font-size:13px"><br></div></span><div><b>If we presume the patient is mediating in the center and has a a explicit binding to their resources - there are no matching issues. </b></div></div></blockquote><div><br></div><div>What Deb said. :-)</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div><b style="font-size:13px"><br></b></div><div><b style="font-size:13px">Client dynamic registration and AS discovery would be in scope from my POV.</b></div><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><b>There has been a very promising discussion on the UMA list about a webfinger-ish personal discovery service. Not real yet though- a gap that I hope get closed in the near future.</b></div></div></blockquote><div><br></div><div>I'm hoping to actually read that thread soon! Whre.</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div style="font-size:13px"><br></div><span><div style="font-size:13px"><br></div><div style="font-size:13px">Is there a class of providers or data holders (hospitals, payers, labs, public facilities, etc...) that we could prioritize? </div><div style="font-size:13px"><br></div></span><div style="font-size:13px"><b>Do we need to prioritize? Who's willing to share? Please let us know!</b></div></div></blockquote><div><br></div><div>Ditto! :-)</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><b>Separate concerns - </b></div><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><b>If we believe the JOSE/JWT is essential for secure data exchange - we should stand behind it not compromise.</b></div><div style="font-size:13px"><b>If we unearth some real policy concerns (US and International) or gaps in the standards - how do we place in parking lot/acknowledge for others to tackle. Ae there folk on this list willing to take on some of those challenges?</b></div></div></blockquote><div><br></div><div>I firmly believe that there is no inherent difference between the security characteristics of JSON/JOSE/JWT and XML/XML Encryption/SAML -- it's all just punctuation for data. The "security and privacy knobs can always be cranked up to 11" if that's what we want to do.</div><div><br></div><div>Eve</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr"><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><b>Deb</b></div><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><b>P.S. Disclaimer - Deb's personal views mindfully sent using Deb's personal email.</b></div><div style="font-size:13px"><br></div><div style="font-size:13px"><b><br></b></div><div style="font-size:13px"><br></div></div><div class="gmail_extra"><br><div class="gmail_quote"><div><div>On Sun, Apr 19, 2015 at 9:47 PM, Adrian Gropper <span dir="ltr"><<a href="mailto:agropper@healthurl.com" target="_blank">agropper@healthurl.com</a>></span> wrote:<br></div></div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div><div><div dir="ltr">Then this is an excellent discussion. It suggests that there's a roadmap and some metric for achievability.<div><br></div><div>For example:</div><div><br></div><div>With regard to UMA Authorization Servers, are you suggesting that we consider a mix of personally-controlled and institutionally-controlled Authorization Servers or just one or the other?</div><div><br></div><div>With regard to interface scopes, are there particular scopes that should be considered before others?</div><div><br></div><div>With regard to identity management and identity federation, would we consider patient ID before or after provider ID?</div><div><br></div><div>With regard to patient matching and discovery, would we try to keep these in or out of scope for the early parts of the roadmap?</div><div><br></div><div>Is there a class of providers or data holders (hospitals, payers, labs, public facilities, etc...) that we could prioritize? </div><span><font color="#888888"><div><br></div><div>Adrian</div><div><br></div><div><br></div></font></span></div><div><div><div class="gmail_extra"><br><div class="gmail_quote">On Sun, Apr 19, 2015 at 9:33 PM, Moehrke, John (GE Healthcare) <span dir="ltr"><<a href="mailto:John.Moehrke@med.ge.com" target="_blank">John.Moehrke@med.ge.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="blue" vlink="purple"><div><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">I am not trying to limit the destination. I am trying to define the next achievable step. <u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">John<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"><u></u> <u></u></span></p><p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:agropper@gmail.com" target="_blank">agropper@gmail.com</a> [mailto:<a href="mailto:agropper@gmail.com" target="_blank">agropper@gmail.com</a>] <b>On Behalf Of </b>Adrian Gropper<br><b>Sent:</b> Sunday, April 19, 2015 5:13 PM</span></p><div><div><br><b>To:</b> Moehrke, John (GE Healthcare)<br><b>Cc:</b> Eve Maler; <a href="mailto:openid-specs-heart@lists.openid.net" target="_blank">openid-specs-heart@lists.openid.net</a><br><b>Subject:</b> Re: [Openid-specs-heart] HEART stepping stones<u></u><u></u></div></div><p></p><div><div><p class="MsoNormal"><u></u> <u></u></p><div><p class="MsoNormal">Hello John,<u></u><u></u></p><div><p class="MsoNormal"><u></u> <u></u></p></div><div><p class="MsoNormal">There's no need for you to take my perspective personally. <u></u><u></u></p><div><p class="MsoNormal"><u></u> <u></u></p></div><div><p class="MsoNormal">"Data created fully by the patient" seems to be urging us to down-scope HEART to the non-HIPAA domain.<u></u><u></u></p></div><div><p class="MsoNormal"><u></u> <u></u></p></div><div><p class="MsoNormal">Adrian <u></u><u></u></p></div></div></div><div><p class="MsoNormal"><u></u> <u></u></p><div><p class="MsoNormal">On Sun, Apr 19, 2015 at 5:21 PM, Moehrke, John (GE Healthcare) <<a href="mailto:John.Moehrke@med.ge.com" target="_blank">John.Moehrke@med.ge.com</a>> wrote:<u></u><u></u></p><div><div><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Hi Adrian,</span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Interesting misrepresentation of what I said. I am disappointed that you feel it necessary to misrepresent what I said. I am also disappointed that you feel it necessary to bring in other negative topics that I said nothing about. I am trying to find ground that we can progress forward on; while you seem to be just wanting to make personal assaults. </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">Looking for the constructive message in your comment, I think you are suggesting that we scope our efforts to the flow of information from the patient possession to points-elsewhere. I am fine with that kind of a scope. It also avoids the issues I was bringing up. I very much agree that data created fully by the patient is, and should be, totally controlled by the patient. This scope also avoids the concerns that encumber healthcare provider environments: Medical Ethics concerns, Safety concerns, and concerns of wrongful disclosure. </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d">John</span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1f497d"> </span><u></u><u></u></p><p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> <a href="mailto:agropper@gmail.com" target="_blank">agropper@gmail.com</a> [mailto:<a href="mailto:agropper@gmail.com" target="_blank">agropper@gmail.com</a>] <b>On Behalf Of </b>Adrian Gropper<br><b>Sent:</b> Sunday, April 19, 2015 12:42 PM<br><b>To:</b> Moehrke, John (GE Healthcare)<br><b>Cc:</b> Eve Maler; <a href="mailto:openid-specs-heart@lists.openid.net" target="_blank">openid-specs-heart@lists.openid.net</a><br><b>Subject:</b> Re: [Openid-specs-heart] HEART stepping stones</span><u></u><u></u></p><p class="MsoNormal"> <u></u><u></u></p><div><p class="MsoNormal">John, I find your perspective both paternalistic and unscalable. <u></u><u></u></p><div><div><div><p class="MsoNormal"> <u></u><u></u></p></div><div><p class="MsoNormal">US healthcare is awash in lack of transparency and the result is $1Trillion of unwarranted care. It's paternalistic and incredibly self-serving to presume that just because the institution has been given a right to use patient data without any accountability as long as the data is for Treatment, Payment, or Operations or De-Identified, or "Break the Glass", or prescription drug monitoring, or just plain lack of segmentation for access, that it's good policy. The current regulations are the result of heavy and effective lobbying by a very well organized industry trying to protect its secrets by avoiding the HIPAA accounting for disclosures and and patient right of access because they're "too hard". Think of HEART as trying to fix the "too hard" problem.<u></u><u></u></p></div><div><p class="MsoNormal"> <u></u><u></u></p></div><div><p class="MsoNormal">Your perspective is also unscalable as more and more health-related data originates in wearables as well home and environmental monitors, and then ends-up in trans-national analytics completely outside of the HIPAA regs. It's also unscalable as patient data such as genomes can no longer be collected under informed consent because nobody has any idea of how your genomic information will be interpreted three years from now and how that interpretation might affect you or your children. It's also unscalable as the ability to promise de-identification for research becomes less and less realistic.<u></u><u></u></p></div><div><p class="MsoNormal"> <u></u><u></u></p></div><div><p class="MsoNormal">The simple fact is that surveillance, data processing, and data storage is now effectively free compared to the economic value of the patient data. Rent-seeking-behavior by politically astute institutions has been effective for the past few years but the natives are getting restless. If you want to read more: <a href="http://thehealthcareblog.com/blog/2015/04/16/last-chance-for-meaningful-use/" target="_blank">http://thehealthcareblog.com/blog/2015/04/16/last-chance-for-meaningful-use/</a> and I hope you make the comments above on the blog.<u></u><u></u></p></div><div><p class="MsoNormal"> <u></u><u></u></p></div><div><p class="MsoNormal">Adrian<u></u><u></u></p></div></div></div></div></div></div></div><p class="MsoNormal"><br><br clear="all"><u></u><u></u></p><div><p class="MsoNormal"><u></u> <u></u></p></div><p class="MsoNormal">-- <u></u><u></u></p><div><div><p class="MsoNormal">Adrian Gropper MD<span style="font-size:7.5pt"><br></span><span style="font-size:10.0pt">Ensure Health Information Privacy. Support Patient Privacy Rights.<br><a href="http://patientprivacyrights.org/donate-2/" target="_blank">http://patientprivacyrights.org/donate-2/</a><u><span style="color:blue"> </span></u></span><span style="font-size:11.0pt"><u></u><u></u></span></p><p class="MsoNormal"><u></u> <u></u></p></div></div></div></div></div></div></div></blockquote></div><br><br clear="all"><div><br></div>-- <br><div><div dir="ltr">Adrian Gropper MD<span style="font-size:11pt"></span><font size="1"><br><font size="2">Ensure Health Information Privacy. Support Patient Privacy Rights.<br></font></font><span style="font-size:11pt"><font size="1"></font></span><font size="2"><a href="http://patientprivacyrights.org/donate-2/" target="_blank"><font color="blue"><u>http://patientprivacyrights.org/donate-2/</u></font></a><font color="blue"><u> </u></font></font><span style="font-size:11pt"></span><span style="font-size:11pt"></span><span style="font-size:11pt"><font size="1"> <br></font><div></div></span><br></div></div>
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