<div dir="ltr"><div><div><div><div><div><div><div><div>Let's assume that central intent of Bill's use case seems is to leverage the quality of the PHR credential and the in-person identity proofing of the EHR. For example, imagine that Apple offers me a secure PHR in HealthKit linked to the fingerprint sensor and remote wipe feature. Apple may or may not do identity proofing. If I lose my iPhone, I need to restore the PHR from backup. "Apple does not see your HealthKit data."<br><br></div>Now that I have a PHR that I trust and a secure credential, I go to my Hospital and say that I want to enrollmy iPhone into their Public API. The issues are:<br><br></div>1 - Apple and the Hospital must be federated so that the EHR accepts my Apple credential on the Public API.<br><br></div>2 - If I lose my phone or Apple forsakes me, I need to be able to access the hospital's Public API through some other path. <br> <br></div><div style="margin-left:40px">2a - I have a backup credential like a password or a FIDO token that also provides access to the Hospital Public API.<br><br></div><div style="margin-left:40px">2b - I have an in-person relationship with the Hospital and they have a photo or fingerprints on file when I show up.<br><br></div><div style="margin-left:40px">2c - Both 2a and 2b<br></div><br></div>A - Are there any other choices? <br><br>B - Does it matter to the Public API if Apple is the PHR and Verizon is the IDP that accepts the Apple credential?<br><br></div>C - What changes in the Public API if Apple offers me an UMA Authorization Server as a HealthKit app?<br><br></div>D - What changes in the Public API if Verizon and the Hospital are part of a trust federation and my Apple Authorization Server is completely under my control ("Apple will not see my Authorization Server or my HealthKit data")?<br><br></div><div>Note that I've avoided use of "known to the practice" or "identity proofing" and that I've not named any particular standards other than FIDO which is here only as a placeholder for any cryptographically strong pseudonym.<br></div><div><br></div>Adrian<br><div><div><div><br><div><div><div style="margin-left:40px"><br></div><div><div><div><div><div class="gmail_extra"><br><div class="gmail_quote">On Thu, Jun 18, 2015 at 2:50 PM, Kinsley, William <span dir="ltr"><<a href="mailto:BKinsley@nextgen.com" target="_blank">BKinsley@nextgen.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
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<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">This use case specifically includes the smart phone to introduce a common two-factor authentication process. As Justin said earlier, this and all the other use cases
can be used to branch off into modified versions. <u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Specifically I wanted to address three points:<u></u><u></u></span></p>
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<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>1)<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">There are two different RP where one is designated by Alice as her single point of truth for her medical record.<u></u><u></u></span></p>
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<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>2)<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Each system has implemented different levels of:<u></u><u></u></span></p>
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<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>a.<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Identity Proofing.<u></u><u></u></span></p>
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<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>b.<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Identity Verification.<u></u><u></u></span></p>
<p style="margin-left:1.25in">
<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>c.<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Credentialing and Authentication.<u></u><u></u></span></p>
<p style="margin-left:.75in">
<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>3)<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Which lead to the discussion of how the two systems (AS and RP) manage the trust relationship to support Alice’s ability to use single sign on (SSO).<u></u><u></u></span></p>
<p style="margin-left:1.25in">
<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>a.<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Upgrading Alice’s weaker Identity Proofing and verification trust level from her PHR based on the PCP registration process (In person and government issued
photo ID vs. simple email).<u></u><u></u></span></p>
<p style="margin-left:1.25in">
<u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><span>b.<span style="font:7.0pt "Times New Roman"">
</span></span></span><u></u><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Allow the PCP’s system to authenticate Alice using her stronger two factor credential and authentication process provided by her PHR system.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Cambria",serif;color:#44546a">Bill<u></u><u></u></span></p>
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<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:windowtext"> Openid-specs-heart [mailto:<a href="mailto:openid-specs-heart-bounces@lists.openid.net" target="_blank">openid-specs-heart-bounces@lists.openid.net</a>]
<b>On Behalf Of </b>Justin Richer<br>
<b>Sent:</b> Wednesday, June 17, 2015 8:36 AM<br>
<b>To:</b> Maxwell, Jeremy (OS/OCPO); Debbie Bucci<span class=""><br>
<b>Cc:</b> <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 Use Case: Alice Enrolls with PCP<u></u><u></u></span></span></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt">I think you guys are putting too much stock in this use case. Keep in mind that the textual description in this specific use case isn't the only way any of this can transpire. If the patient doesn't have a smart
phone with them they can use the kiosk like in the original description. My workflow description was specifically to address the concern Sarah brought up of people not wanting to log in through the kiosk. Logging in to a remote IdP through a kiosk is already
worlds better than creating a local password (which would be just as susceptible to shoulder surfing security cameras and keylogging, and likely more dangerous). But if the RP is written correctly, we could support this case *also*.</p><div><div class="h5"><br>
<br>
Each use case is but a tiny branch of the tree of possibilities. We're still deciding which branches we care about and which branches we prune in this group.<br>
<br>
-- Justin<u></u><u></u></div></div><p></p><div><div class="h5">
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<p class="MsoNormal">On 6/17/2015 8:06 AM, Maxwell, Jeremy (OS/OCPO) wrote:<u></u><u></u></p>
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<p class="MsoNormal">But that means 30 million Americans don't have a cell phones. What does the workflow look like for them? <br>
<br>
Sent from my iPhone<u></u><u></u></p>
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On Jun 17, 2015, at 7:17 AM, Debbie Bucci <<a href="mailto:debbucci@gmail.com" target="_blank">debbucci@gmail.com</a>> wrote:<u></u><u></u></p>
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<p class="MsoNormal">On Tue, Jun 16, 2015 at 4:00 PM, Maxwell, Jeremy (OS/OCPO) <<a href="mailto:Jeremy.Maxwell@hhs.gov" target="_blank">Jeremy.Maxwell@hhs.gov</a>> wrote:<u></u><u></u></p>
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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1f497d">Is a smart phone necessary for the use case work flow? What about folks that don’t have smart phones?
What about folks that don’t have a cell phone?</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"><a href="http://lists.openid.net/mailman/listinfo/openid-specs-heart" target="_blank"><br>
</a><u></u><u></u></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt">According to PEW report in 2014 90% of adults have cell phones today 75% of them are smartphones. I'd say for this use case - its pretty close to the 80/20 rule<br>
<a href="http://www.pewinternet.org/data-trend/mobile/cell-phone-and-smartphone-ownership-demographics/" target="_blank">http://www.pewinternet.org/data-trend/mobile/cell-phone-and-smartphone-ownership-demographics/</a>
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<p class="MsoNormal" style="margin-bottom:12.0pt">Certainly there are issues to deal with using cell (lost, stolen, replaced) an even short term alternatives must be available. What about use of tablets and other *mobile devices?*. I'd dare to say that a
significant number of those unable to use a cell phone - will have a delegate to stand in their stead.
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<br></blockquote></div><br><br clear="all"><br>-- <br><div class="gmail_signature"><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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