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    Aaron,<br>
    <br>
    Your vision is not far-fetched at all.  But I agree with John
    Moehrke regarding it probably being out-of-scope for HEART.<br>
    <br>
    I am aware of a high-security use case in which the patient is
    anonymous to the physician, and vice-versa.  The underlying EHR is
    also anonymized for the actors.  Identity proofing is out-of-band in
    the current implementation.  But that is an extreme fringe example. 
    We need to exclude such cases from HEART, at least for now.<br>
    <br>
    More mainstream is the case of an unconscious John Doe arriving for
    urgent care.  Known-name registration, identity proofing, and
    binding of PHR and EHR occur well after treatment.  Default health
    data disclosure policies need to be applied to John Doe upon an
    initial anonymous registration, subject to later revision by the
    patient or an authorized representative when the patient's identity
    is established.  Ignoring identity proofing for now, a HEART use
    case needs to accommodate this scenario.  It may be a break-glass
    example.  <br>
    <br>
    Glen <br>
    <br>
    <br>
    <div class="moz-signature">
      <p><b>Glen F. Marshall</b><br>
        Consultant<br>
        Security Risk Solutions, Inc.<br>
        698 Fishermans Bend<br>
        Mount Pleasant, SC 29464<br>
        Tel: (610) 644-2452<br>
        Mobile: (610) 613-3084<br>
        <a class="moz-txt-link-abbreviated" href="mailto:gfm@securityrs.com">gfm@securityrs.com</a><br>
        <a class="moz-txt-link-abbreviated" href="http://www.SecurityRiskSolutions.com">www.SecurityRiskSolutions.com</a></p>
    </div>
    <div class="moz-cite-prefix">On 8/12/15 09:40, Aaron Seib wrote:<br>
    </div>
    <blockquote
      cite="mid:014601d0d504$6fa20920$4ee61b60$@nate-trust.org"
      type="cite">
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        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Thank
            you Adrian.  Your perspective is informing.<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">You
            ask below this question that I pull up <o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal" style="margin-left:.5in">‘What is the law
          or regulation or moral imperative that causes this nebulous
          "other provider" to doubt Alice's unverified assertion?<o:p></o:p></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">I
            am probably the last person to argue that if the next
            “provider” is a F2F encounter that there a need for the
            provider to verify the consumers identity.<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">For
            those people that think care is always going to happen face
            to face - I am sorry to inform you that the 19<sup>th</sup>
            Century called and they want their care delivery model
            back.  <o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">As
            we see the displacement of brick and mortar care delivery we
            see the need for remotely ID proofing patients increasing. 
            I doubt think we will ever get to the point where all care
            is delivered remotely – in fact I doubt it very much.  What
            I do see if the barrier to benefiting from the reuse and
            upcycle of the F2F encounter as a means to increase the
            level of assurance on the part of the relying party that
            they are working with data related to the person that he or
            she claims to be.<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">I
            don’t think this is treating the patient as a criminal.  It
            is for their protection and a fraud prevention necessity.  I
            am not saying everyone has to subscribe to this notion for
            it to work.  You have your right to be unknown as much as I
            do.  I will argue with you about your rights effecting
            mine.  It isn’t a one size fits all universe and many of us
            would be concerned if a remote provider trusted just anyone
            claiming to be me and delivering care (not only from the
            cost but also because of the data integrity issues that
            could be introduced).<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aaron
            Seib, CEO<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">@CaptBlueButton
            <o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> (o)
            301-540-2311<o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(m)
            301-326-6843<o:p></o:p></span></p>
        <p class="MsoNormal"><a moz-do-not-send="true"
            href="nate-trust.org"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D;text-decoration:none"><img
                id="Picture_x0020_1"
                src="cid:part1.00040908.00050606@securityrs.com"
                border="0" height="48" width="205"></span></a><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></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 class="moz-txt-link-abbreviated" href="mailto:agropper@gmail.com">agropper@gmail.com</a> [<a class="moz-txt-link-freetext" href="mailto:agropper@gmail.com">mailto:agropper@gmail.com</a>] <b>On Behalf
              Of </b>Adrian Gropper<br>
            <b>Sent:</b> Tuesday, August 11, 2015 9:31 PM<br>
            <b>To:</b> Aaron Seib<br>
            <b>Cc:</b> Kinsley, William;
            <a class="moz-txt-link-abbreviated" href="mailto:openid-specs-heart@lists.openid.net">openid-specs-heart@lists.openid.net</a><br>
            <b>Subject:</b> Re: [Openid-specs-heart] Draft HEART Meeting
            Notes 2015-08-10<o:p></o:p></span></p>
        <p class="MsoNormal"><o:p> </o:p></p>
        <div>
          <p class="MsoNormal">inline...<o:p></o:p></p>
          <div>
            <p class="MsoNormal"><o:p> </o:p></p>
            <div>
              <p class="MsoNormal">On Tue, Aug 11, 2015 at 2:30 PM,
                Aaron Seib <<a moz-do-not-send="true"
                  href="mailto:aaron.seib@nate-trust.org"
                  target="_blank">aaron.seib@nate-trust.org</a>>
                wrote:<o:p></o:p></p>
              <div>
                <div>
                  <p class="MsoNormal"
                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">IDESG
                      has been working on this since the start of the
                      Obama administration, right?  Do we know if they
                      have anything useful in this regard so far?  </span><o:p></o:p></p>
                </div>
              </div>
              <div>
                <p class="MsoNormal"><o:p> </o:p></p>
              </div>
              <div>
                <p class="MsoNormal">IDESG is doing the best job of
                  anyone I know here or in the EU in this respect.
                  Useful is a loaded term. Until the cost of
                  cybersecurity breaches becomes noticeable in the
                  competitive marketplace or very strong data protection
                  laws (like EU is trying to mandate) are passed, the
                  industry will continue to ignore this. We have a very
                  hard time getting data holders (big hospital networks,
                  insurers, and their vendors) to participate in IDESG.
                  Why would we expect "anything useful" as long as they
                  see human-centered identity federation as not worthy
                  of their attention. <o:p></o:p></p>
              </div>
              <blockquote style="border:none;border-left:solid #CCCCCC
                1.0pt;padding:0in 0in 0in
                6.0pt;margin-left:4.8pt;margin-right:0in">
                <div>
                  <div>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The
                        use case that I am hearing – whether it belongs
                        in HEART or has already been solved for by the
                        funded work of the NSTIC pilots (I think they
                        have graduated some vendors from the program who
                        address these issues already, right?) is the
                        following:</span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                    <p><span
                        style="font-size:11.0pt;font-family:Symbol;color:#1F497D">·</span><span
                        style="font-size:7.0pt;color:#1F497D">        </span><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Alice
                        is unknown to the PCP practice.  She becomes
                        known by providing the PCP with her AS URL and
                        related identifier information.  The PCP uses
                        that AS to make disclosure decisions because he
                        trust the binding of her identity to the AS.</span><o:p></o:p></p>
                  </div>
                </div>
              </blockquote>
              <div>
                <p class="MsoNormal">Alice has an in-person relationship
                  with the PCP practice. Except for the case of
                  controlled substance prescriptions, there is
                  absolutely no need for identity proofing. If
                  controlled substances are to be prescribed, identity
                  proofing needs to be an escalation over the default
                  practice. Why would we want our healthcare system to
                  treat everyone as a criminal by default?  <o:p></o:p></p>
              </div>
              <blockquote style="border:none;border-left:solid #CCCCCC
                1.0pt;padding:0in 0in 0in
                6.0pt;margin-left:4.8pt;margin-right:0in">
                <div>
                  <div>
                    <p><span
                        style="font-size:11.0pt;font-family:Symbol;color:#1F497D">·</span><span
                        style="font-size:7.0pt;color:#1F497D">        </span><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Another
                        provider wants to communicate with Alice.  She
                        remotely sends him her AS URL and related
                        identifier information.  Is there more
                        information in the universe that the new
                        provider can use to increase his level of
                        assurance that Alice is who she says she is
                        without a F2F meeting?  </span><o:p></o:p></p>
                  </div>
                </div>
              </blockquote>
              <div>
                <p class="MsoNormal">What is the law or regulation or
                  moral imperative that causes this nebulous "other
                  provider" to doubt Alice's unverified assertion? Or is
                  it just a barrier to patient and caregiver access like
                  so much of HIPAA has been interpreted to be. We are
                  all aware of the Office of Civil Rights memos and the
                  ONC data blocking reports. That is the reality. <o:p></o:p></p>
              </div>
              <blockquote style="border:none;border-left:solid #CCCCCC
                1.0pt;padding:0in 0in 0in
                6.0pt;margin-left:4.8pt;margin-right:0in">
                <div>
                  <div>
                    <p><span
                        style="font-size:11.0pt;font-family:Symbol;color:#1F497D">·</span><span
                        style="font-size:7.0pt;color:#1F497D">        </span><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">I.e.,
                        is there any way to discover that the PCP trust
                        the assertion that Alice is who she says she is
                        and uses this AS and related identifier
                        improving confidence in reliance on this
                        information shared remotely by Alice?</span><o:p></o:p></p>
                  </div>
                </div>
              </blockquote>
              <div>
                <p class="MsoNormal">Yes and this is what IDESG is
                  trying to solve. As long as the large data holders
                  compete on the basis of my silo is larger than their
                  silo, progress will continue to be slow. From the
                  perspective of the individual patient and physician,
                  it could get worse than it is today.  <o:p></o:p></p>
              </div>
              <blockquote style="border:none;border-left:solid #CCCCCC
                1.0pt;padding:0in 0in 0in
                6.0pt;margin-left:4.8pt;margin-right:0in">
                <div>
                  <div>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">If
                        the NSTIC projects already considered this and
                        determined that it was a dead end that would be
                        informative.  </span><o:p></o:p></p>
                  </div>
                </div>
              </blockquote>
              <div>
                <p class="MsoNormal"><o:p> </o:p></p>
              </div>
              <div>
                <p class="MsoNormal" style="margin-bottom:12.0pt">I
                  assume that you mean the NSTIC pilots. For the most
                  part, the NSTIC pilots are based on startups and
                  companies outside of healthcare trying to get their
                  spoon into the $3 T firehose. Under these
                  circumstances, NSTIC is doing better than could be
                  expected. The EU seems to be headed toward a more
                  heavy-handed governance mechanism that goes after the
                  largest institutions first. Both approaches have their
                  merits.<o:p></o:p></p>
              </div>
              <div>
                <p class="MsoNormal">Adrian <o:p></o:p></p>
              </div>
              <blockquote style="border:none;border-left:solid #CCCCCC
                1.0pt;padding:0in 0in 0in
                6.0pt;margin-left:4.8pt;margin-right:0in">
                <div>
                  <div>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aaron
                        Seib, CEO</span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">@CaptBlueButton
                      </span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> (o)
                        <a moz-do-not-send="true"
                          href="tel:301-540-2311" target="_blank">301-540-2311</a></span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(m)
                        <a moz-do-not-send="true"
                          href="tel:301-326-6843" target="_blank">301-326-6843</a></span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a
                        moz-do-not-send="true"
                        href="http://nate-trust.org" target="_blank"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D;text-decoration:none"><img
                            id="_x0000_i1025"
                            src="cid:part6.07090005.00060402@securityrs.com"
                            border="0" height="48" width="205"></span></a><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                    <p class="MsoNormal"
                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><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 moz-do-not-send="true"
                          href="mailto:agropper@gmail.com"
                          target="_blank">agropper@gmail.com</a>
                        [mailto:<a moz-do-not-send="true"
                          href="mailto:agropper@gmail.com"
                          target="_blank">agropper@gmail.com</a>] <b>On
                          Behalf Of </b>Adrian Gropper<br>
                        <b>Sent:</b> Tuesday, August 11, 2015 1:39 PM<br>
                        <b>To:</b> Aaron Seib<br>
                        <b>Cc:</b> Kinsley, William; <a
                          moz-do-not-send="true"
                          href="mailto:openid-specs-heart@lists.openid.net"
                          target="_blank"><a class="moz-txt-link-abbreviated" href="mailto:openid-specs-heart@lists.openid.net">openid-specs-heart@lists.openid.net</a></a><br>
                        <b>Subject:</b> [Openid-specs-heart] Draft HEART
                        Meeting Notes 2015-08-10</span><o:p></o:p></p>
                    <div>
                      <div>
                        <p class="MsoNormal"
                          style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                        <div>
                          <p class="MsoNormal"
                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Aaron,<o:p></o:p></p>
                          <div>
                            <p class="MsoNormal"
                              style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                          </div>
                          <div>
                            <p class="MsoNormal"
                              style="mso-margin-top-alt:auto;margin-bottom:12.0pt">Digital
                              identity is being worked on in IDESG. The
                              verification of attributes is one aspect
                              of identity proofing. Privacy is the major
                              issue with identity proofing. In setting
                              up IDESG, NIST tried to be careful to make
                              privacy a "supercommittee" in the
                              governance process.<o:p></o:p></p>
                          </div>
                          <div>
                            <p class="MsoNormal"
                              style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">If
                              we wanted to get into this in HEART, we
                              would probably need to start with a use
                              case.<o:p></o:p></p>
                          </div>
                          <div>
                            <div>
                              <p class="MsoNormal"
                                style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                            </div>
                            <p class="MsoNormal"
                              style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Adrian<o:p></o:p></p>
                            <div>
                              <p class="MsoNormal"
                                style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><br>
                                On Tuesday, August 11, 2015, Aaron Seib
                                <<a moz-do-not-send="true"
                                  href="mailto:aaron.seib@nate-trust.org"
                                  target="_blank">aaron.seib@nate-trust.org</a>>
                                wrote:<o:p></o:p></p>
                              <div>
                                <div>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">I
                                      am confused or might have a
                                      friendly amendment for what you
                                      are trying to communicate.</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Are
                                      you positing to the group that
                                      item (3) is out of scope because
                                      it is an Identity Federation
                                      feature and by definition not part
                                      of the charter of the HEART
                                      project?</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">If
                                      that is what you are saying could
                                      you please tell me who is working
                                      on enabling the inclusion of the
                                      PCP’s Identity Proofing of Alice
                                      in determining the level of
                                      assurance associated with her
                                      accounts (in any system – PHR, EMR
                                      or the portals thereof)?</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">This
                                      is what I am trying to discover. 
                                      When the PCP has a
                                      patient-provider relationship
                                      established with Alice and he is
                                      provide with Alice’s URL to her AS
                                      I am very interested in how we can
                                      reuse this ID proofing event to
                                      increase the level of assurance
                                      associated with Alice’s AS.  There
                                      are many ways to remote Identity
                                      proof Alice that have cost
                                      associated with them.  If we can
                                      capture the ID Proofing event (I
                                      assume that a URL and some unique
                                      Identifier related to Alice is
                                      required in the HEART transactions
                                      when Alice has her privacy
                                      preferences configured in an AS
                                      that has multiple users) from when
                                      the PCP trust the URL/GUID
                                      associated with Alice for an AS it
                                      would create value too.</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">In
                                      other words – how do we make it
                                      possible for relying parties other
                                      than Alice’s PCP to discover that
                                      her PCP has come to trust the
                                      binding of Alice’s Identity to a
                                      specific URL/ID for her AS?</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Is
                                      that being discussed anywhere
                                      other than the HEART project?  </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Aaron
                                      Seib, CEO</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">@CaptBlueButton
                                    </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> (o)
                                      <a moz-do-not-send="true"
                                        href="tel:301-540-2311"
                                        target="_blank">301-540-2311</a></span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">(m)
                                      <a moz-do-not-send="true"
                                        href="tel:301-326-6843"
                                        target="_blank">301-326-6843</a></span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><a
                                      moz-do-not-send="true"
                                      href="http://nate-trust.org"
                                      target="_blank"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D;text-decoration:none"><img
                                          moz-do-not-send="true"
                                          id="_x0000_i1026"
src="imap://gfm%40securityrs%2Ecom@outlook.office365.com:993/fetch%3EUID%3E/Drafts%3E1851?view=att&th=14f1d564d8a988e7&attid=0.1&disp=emb&realattid=cea212b74cdc1b4b_0.1&zw&atsh=1"
                                          border="0" height="48"
                                          width="205"></span></a><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><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"">
                                      Openid-specs-heart [<a
                                        moz-do-not-send="true"
                                        href="mailto:openid-specs-heart-bounces@lists.openid.net"
                                        target="_blank"><a class="moz-txt-link-freetext" href="mailto:openid-specs-heart-bounces@lists.openid.net">mailto:openid-specs-heart-bounces@lists.openid.net</a></a>]
                                      <b>On Behalf Of </b>Adrian
                                      Gropper<br>
                                      <b>Sent:</b> Monday, August 10,
                                      2015 7:33 PM<br>
                                      <b>To:</b> Kinsley, William<br>
                                      <b>Cc:</b> <a
                                        moz-do-not-send="true"
                                        href="mailto:openid-specs-heart@lists.openid.net"
                                        target="_blank"><a class="moz-txt-link-abbreviated" href="mailto:openid-specs-heart@lists.openid.net">openid-specs-heart@lists.openid.net</a></a><br>
                                      <b>Subject:</b> Re:
                                      [Openid-specs-heart] Draft HEART
                                      Meeting Notes 2015-08-10</span><o:p></o:p></p>
                                  <p class="MsoNormal"
                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                  <div>
                                    <div>
                                      <div>
                                        <div>
                                          <div>
                                            <div>
                                              <p class="MsoNormal"
                                                style="mso-margin-top-alt:auto;margin-bottom:12.0pt">(Proposed)
                                                <b>Problem Statement</b>
                                                (for HEART EHR-PHR Use
                                                Case:<o:p></o:p></p>
                                            </div>
                                            <p class="MsoNormal"
                                              style="mso-margin-top-alt:auto;margin-bottom:12.0pt">This
                                              use-case is designed to
                                              (1) enable automated
                                              update of Alice's PHR when
                                              new findings or orders are
                                              entered by the physician
                                              or practice staff into the
                                              practice's EHR; (2) to
                                              enable messaging with
                                              attached documents from
                                              the practice's EHR via
                                              Alice's PHR; and (3) to
                                              enable _________ by
                                              allowing the practice to
                                              identity proof Alice's
                                              persona as authenticated
                                              by Alice's PHR.<o:p></o:p></p>
                                          </div>
                                          <div>
                                            <p class="MsoNormal"
                                              style="mso-margin-top-alt:auto;margin-bottom:12.0pt">Discussion
                                              of proposed problem
                                              statement:<o:p></o:p></p>
                                          </div>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;margin-bottom:12.0pt">I
                                            think I understand the
                                            intent, but I'm having a
                                            difficult time coming up
                                            with a transaction that
                                            would be enabled or even
                                            enhanced by (3). The intent
                                            could be to enhance an
                                            un-tethered PHR like
                                            Microsoft HealthVault or a
                                            health information exchange
                                            that don't have an in-person
                                            relationship with Alice in
                                            case Alice loses her
                                            password and forgets her
                                            secret questions. In that
                                            case, Alice could presumably
                                            go to her PCP's office or
                                            any other practice that is
                                            federated with the PHR or
                                            HIE and present a verified
                                            ID to reclaim control of her
                                            PHR account. As Sarah points
                                            out in her comment, this is
                                            a federation use-case
                                            outside the scope of HEART.
                                            <o:p></o:p></p>
                                        </div>
                                        <p class="MsoNormal"
                                          style="mso-margin-top-alt:auto;margin-bottom:12.0pt">Another
                                          possible intent could be to
                                          enhance the ability for
                                          another practice, for example
                                          the Quest Lab used by the PCP,
                                          to share results with Alice or
                                          Alice's PHR through the lab's
                                          portal or FHIR interface. This
                                          is another situation where the
                                          other practice, the Lab, has
                                          no in-person relationship with
                                          Alice. It's another example of
                                          federation because the Lab
                                          would have to be federated
                                          with the PHR host in order to
                                          trust that indeed, the
                                          identity proofing was done.
                                          I'm not sure how this would
                                          work. There's obviously trust
                                          between the PCP and the Lab
                                          because the PCP sent the order
                                          to the Lab directly under the
                                          HIPAA TPO exemption but the
                                          PHR is another matter.<br>
                                          <br>
                                          It would be nice if the PCP
                                          could send the order to the
                                          Lab via the PHR. This would be
                                          even more valuable in the case
                                          of e-prescribing because Alice
                                          would then have the
                                          opportunity to shop various
                                          pharmacies using, for example
                                          GoodRX. With today's EHRs,
                                          Alice has lost this ability to
                                          shop around except if the EHR
                                          prints a paper prescription or
                                          lab order. The value of
                                          shopping around, in the case
                                          of orders for an expensive
                                          test such as an MRI can be
                                          over $1,000. To enable this
                                          benefit, the EHR would have to
                                          (a) digitally sign the order
                                          and optionally (b) in the case
                                          of a controlled substance
                                          prescription, identity proof
                                          Alice so that the pharmacy can
                                          check her ID when she comes to
                                          pick up her prescription.
                                          Digitally signing the order or
                                          prescription (a) before
                                          sending it to the PHR under
                                          case (1) or (2) above has
                                          nothing to do with HEART and
                                          may be considered a federation
                                          or trust framework issue
                                          anyway.<o:p></o:p></p>
                                      </div>
                                      <p class="MsoNormal"
                                        style="mso-margin-top-alt:auto;margin-bottom:12.0pt">Although
                                        identity proofing could be
                                        valuable for giving Alice access
                                        to the portals of labs,
                                        pharmacies, and health
                                        information exchanges this is
                                        purely a matter of federation
                                        and doesn't have directly to do
                                        with FHIR, OAuth, or UMA. <b>I
                                          suggest there is no Problem
                                          (3).</b><o:p></o:p></p>
                                    </div>
                                    <div>
                                      <p class="MsoNormal"
                                        style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">The
                                        relationship between FHIR and
                                        Problem (1) and Problem (2) is
                                        yet another matter. I suggest we
                                        take that up as part of the
                                        scopes discussion once we have
                                        finalized the Problem Statement.<o:p></o:p></p>
                                    </div>
                                    <div>
                                      <p class="MsoNormal"
                                        style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                    </div>
                                    <p class="MsoNormal"
                                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Adrian<o:p></o:p></p>
                                    <div>
                                      <div>
                                        <div>
                                          <div>
                                            <p class="MsoNormal"
                                              style="mso-margin-top-alt:auto;margin-bottom:12.0pt"> <o:p></o:p></p>
                                          </div>
                                        </div>
                                      </div>
                                    </div>
                                  </div>
                                  <div>
                                    <p class="MsoNormal"
                                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                    <div>
                                      <p class="MsoNormal"
                                        style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">On
                                        Mon, Aug 10, 2015 at 5:21 PM,
                                        Sarah Squire <<a
                                          moz-do-not-send="true"
                                          href="mailto:sarah@engageidentity.com"
                                          target="_blank"><a class="moz-txt-link-abbreviated" href="mailto:sarah@engageidentity.com">sarah@engageidentity.com</a></a>>
                                        wrote:<o:p></o:p></p>
                                      <div>
                                        <p class="MsoNormal"
                                          style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Most
                                          of the discussion was captured
                                          in the use case document
                                          itself, but I noted the
                                          discussion topics here as well
                                          just for future reference.<o:p></o:p></p>
                                        <div>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                        </div>
                                        <div>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><b><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Attending:</span></b><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Debbie
                                              Bucci</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Sarah
                                              Squire</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Danny
                                              van Leeuwen</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Andy
                                              Oram</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Robert
                                              Horn</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Mark
                                              Russell</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">William
                                              Kinsley</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Eve
                                              Maler</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Adrian
                                              Gropper</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Glen
                                              Marshall</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Andrew
                                              Hughes</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Corey
                                              Spears</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Tom
                                              Sullivan</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Abbie
                                              Barbir</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Thomas
                                              Hardjono</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Justin
                                              Richer</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Edmund
                                              Jay</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Catherine
                                              Schulten</span><o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Chad
                                              Evans</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><b><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Next
                                                steps:</span></b><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">We
                                              will continue to address
                                              this use case next week.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><b><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Notes:</span></b><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">We
                                              worked on closing out
                                              issues on the enrollment
                                              use case document:</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><a
                                              moz-do-not-send="true"
href="https://docs.google.com/document/d/1IvbdWerdvMuA1dQ-KQvVKqIBrAas7FoenNVUtgpqYrw/edit"
                                              target="_blank"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif""><a class="moz-txt-link-freetext" href="https://docs.google.com/document/d/1IvbdWerdvMuA1dQ-KQvVKqIBrAas7FoenNVUtgpqYrw/edit">https://docs.google.com/document/d/1IvbdWerdvMuA1dQ-KQvVKqIBrAas7FoenNVUtgpqYrw/edit</a></span></a><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Are
                                              registration and
                                              enrollment
                                              interchangeable?</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Registration
                                              is being used for Alice to
                                              enroll with both her
                                              doctor’s practice and the
                                              practice’s patient portal.
                                              We could use registration
                                              to mean practice
                                              registration and
                                              enrollment to mean EHR
                                              enrollment. When we use
                                              the term “known to the
                                              practice” it means that
                                              the practice has seen or
                                              heard from the patient and
                                              the practice has checked
                                              for insurance eligibility.
                                              A patient can be enrolled
                                              into an EHR by a staff
                                              member or they can enroll
                                              themselves. We decided to
                                              use the term “register” in
                                              the title rather than
                                              enroll since we are
                                              referring to the practice.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">The
                                              PHR and EHR already have
                                              an established
                                              relationship in this use
                                              case so that we do not
                                              have to address dynamic
                                              registration or service
                                              discovery. We have made
                                              the decision not to
                                              address this problem so
                                              that we can focus on other
                                              technical questions.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">Acknowledgement
                                              of receipt of privacy
                                              practices is peripheral.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">We
                                              have removed the waiting
                                              room step since it has
                                              been captured in previous
                                              steps.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">We
                                              confirmed that the doctor
                                              does record the results of
                                              the physical examination
                                              directly into the EHR
                                              without any sort of later
                                              transcription.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">We
                                              should not use the word
                                              “results” with regard to a
                                              physical exam. We should
                                              use the phrase “clinical
                                              findings.”</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">The
                                              lab results are peripheral
                                              but have been included so
                                              that we can come back to
                                              them later.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">The
                                              lab results should also
                                              include patient
                                              instructions such as
                                              fasting - this is also
                                              peripheral.</span><o:p></o:p></p>
                                          <p class="MsoNormal"
                                            style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                          <p
                                            style="margin:0in;margin-bottom:.0001pt"><span
style="font-size:11.0pt;font-family:"Arial","sans-serif";color:black">The
                                              problem statement is to
                                              autoupdate through the PHR
                                              and message through the
                                              PHR.</span><o:p></o:p></p>
                                          <div>
                                            <p class="MsoNormal"
                                              style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
                                                style="color:#888888"> </span><o:p></o:p></p>
                                          </div>
                                          <div>
                                            <div>
                                              <div>
                                                <div>
                                                  <p class="MsoNormal"
                                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="color:#888888">Sarah Squire</span><o:p></o:p></p>
                                                </div>
                                                <div>
                                                  <p class="MsoNormal"
                                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="color:#888888">Engage Identity</span><o:p></o:p></p>
                                                </div>
                                                <div>
                                                  <p class="MsoNormal"
                                                    style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span
style="color:#888888"><a moz-do-not-send="true"
                                                        href="http://engageidentity.com/"
                                                        target="_blank"><span
style="color:#1155CC">http://engageidentity.com</span></a></span><o:p></o:p></p>
                                                </div>
                                              </div>
                                            </div>
                                          </div>
                                        </div>
                                      </div>
                                      <p class="MsoNormal"
                                        style="mso-margin-top-alt:auto;margin-bottom:12.0pt"><br>
_______________________________________________<br>
                                        Openid-specs-heart mailing list<br>
                                        <a moz-do-not-send="true"
                                          href="mailto:Openid-specs-heart@lists.openid.net"
                                          target="_blank">Openid-specs-heart@lists.openid.net</a><br>
                                        <a moz-do-not-send="true"
                                          href="http://lists.openid.net/mailman/listinfo/openid-specs-heart"
                                          target="_blank">http://lists.openid.net/mailman/listinfo/openid-specs-heart</a><o:p></o:p></p>
                                    </div>
                                    <p class="MsoNormal"
                                      style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><br>
                                      <br clear="all">
                                      <br>
                                      -- <o:p></o:p></p>
                                    <div>
                                      <div>
                                        <div>
                                          <div>
                                            <div>
                                              <p class="MsoNormal"
                                                style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"> <o:p></o:p></p>
                                              <div>
                                                <p class="MsoNormal"
                                                  style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto">Adrian
                                                  Gropper MD<br>
                                                  <br>
                                                  <span
style="font-family:"Arial","sans-serif";color:#1F497D">RESTORE
                                                    Health Privacy!<br>
                                                    HELP us fight for
                                                    the right to control
                                                    personal health
                                                    data.<br>
                                                    DONATE: <a
                                                      moz-do-not-send="true"
href="http://patientprivacyrights.org/donate-2/" target="_blank"><span
                                                        style="color:#0563C1"><a class="moz-txt-link-freetext" href="http://patientprivacyrights.org/donate-2/">http://patientprivacyrights.org/donate-2/</a></span></a></span>
                                                  <o:p></o:p></p>
                                              </div>
                                            </div>
                                          </div>
                                        </div>
                                      </div>
                                    </div>
                                  </div>
                                </div>
                              </div>
                            </div>
                          </div>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </blockquote>
            </div>
            <p class="MsoNormal"><br>
              <br clear="all">
              <br>
              -- <o:p></o:p></p>
            <div>
              <div>
                <div>
                  <div>
                    <div>
                      <p class="MsoNormal"><o:p> </o:p></p>
                      <div>
                        <p class="MsoNormal">Adrian Gropper MD<br>
                          <br>
                          <span
style="font-family:"Arial","sans-serif";color:#1F497D">RESTORE
                            Health Privacy!<br>
                            HELP us fight for the right to control
                            personal health data.<br>
                            DONATE: <a moz-do-not-send="true"
                              href="http://patientprivacyrights.org/donate-2/"
                              target="_blank"><span
                                style="color:#0563C1">http://patientprivacyrights.org/donate-2/</span></a></span>
                          <o:p></o:p></p>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
      <br>
      <fieldset class="mimeAttachmentHeader"></fieldset>
      <br>
      <pre wrap="">_______________________________________________
Openid-specs-heart mailing list
<a class="moz-txt-link-abbreviated" href="mailto:Openid-specs-heart@lists.openid.net">Openid-specs-heart@lists.openid.net</a>
<a class="moz-txt-link-freetext" href="http://lists.openid.net/mailman/listinfo/openid-specs-heart">http://lists.openid.net/mailman/listinfo/openid-specs-heart</a>
</pre>
    </blockquote>
    <br>
  </body>
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