<html>
  <head>
    <meta content="text/html; charset=utf-8" http-equiv="Content-Type">
  </head>
  <body bgcolor="#FFFFFF" text="#000000">
    Aaron,<br>
    <br>
    In response to your comments on the use case narrative:<br>
    <ul>
      <li>All of the data including the genomic data?  It will be made
        available to whom?</li>
      <ul>
        <li>The use case is for clinical data collected and made
          available to the clinical researchers for the study.  The
          nature of the data, e.g., genomics and other clinical results,
          is peripheral. <br>
        </li>
      </ul>
      <li>How will her genome be pseudonymized?</li>
      <ul>
        <li>The specific pseudonymization (and re-identification)
          algorithms are likely to be specific to the clinical research
          study, informed by the cited standards.      <br>
        </li>
      </ul>
      <li>If they can access her PHR why do they need to access the EMR
        as well?   Isn't the point of HEART that she have a complete
        record of all of her data in the PHR.   What is in the EHR that
        is missing from the PHR?  Why?</li>
      <ul>
        <li>I have assumed the current state of data sharing among EHRs
          and PHRs.  It is peripheral to the use case.</li>
      </ul>
      <li>This is a transitional use case that will hopefully go away
        one day.  It may be necessary for now if there is data in the
        EHR that isn't transportable to the PHR but I would hope that
        the day will come when we aren't treating the Clinical
        Operations software as the only source that inputs to the
        researchers data warehouse can be populated.  I would argue that
        PHR's will have more complete data then the two EMRs as the EMRs
        will lack the PGHD that could more readily be gathered via the
        PHR in comparison to forcing it to fit into the EMR of the
        Oncologist.</li>
      <ul>
        <li>There are multiple EHRs in this use case and, while I'd like
          all EHRs and PHRs to be interoperable, they are not
          presently.  This is peripheral to the use case.</li>
      </ul>
      <li>Am I missing something important.  Why is the patient only
        able to get a summary of the data?</li>
      <ul>
        <li>This references reports of disclosures from the EHRs to the
          CDRN.  A disclosure report for each transmission to the CDRN
          is assumed, and that may reference multiple data sets in
          summary.  The actual content and frequency of reports is not
          standardized, and is influenced by policy outside of the use
          case.  This is peripheral to the use case.</li>
      </ul>
      <li>[In reference to pharma's offer of a continuing access
        agreement and profit-sharing.]  Has this ever happened?  Is
        there anyone (from Pharma) proposing that they will do this?</li>
      <ul>
        <li>That is my hypothetical resolution to the issue of
          subsequent re-use of Alice's data.  That might have been a
          more satisfying resolution to the Henrietta Lacks case.  The
          actual resolution is peripheral to the use case.</li>
      </ul>
    </ul>
    Best,<br>
    Glen<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 1/23/16 18:39, Aaron Seib, NATE
      wrote:<br>
    </div>
    <blockquote
      cite="mid:015c01d15637$55a87b30$00f97190$@nate-trust.org"
      type="cite">
      <meta http-equiv="Content-Type" content="text/html; charset=utf-8">
      <meta name="Generator" content="Microsoft Word 14 (filtered
        medium)">
      <!--[if !mso]><style>v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style><![endif]-->
      <style><!--
/* Font Definitions */
@font-face
        {font-family:"Cambria Math";
        panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
        {font-family:Calibri;
        panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
        {font-family:Tahoma;
        panose-1:2 11 6 4 3 5 4 4 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
        {margin:0in;
        margin-bottom:.0001pt;
        font-size:12.0pt;
        font-family:"Times New Roman","serif";
        color:black;}
a:link, span.MsoHyperlink
        {mso-style-priority:99;
        color:blue;
        text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
        {mso-style-priority:99;
        color:purple;
        text-decoration:underline;}
p
        {mso-style-priority:99;
        mso-margin-top-alt:auto;
        margin-right:0in;
        mso-margin-bottom-alt:auto;
        margin-left:0in;
        font-size:12.0pt;
        font-family:"Times New Roman","serif";
        color:black;}
p.MsoAcetate, li.MsoAcetate, div.MsoAcetate
        {mso-style-priority:99;
        mso-style-link:"Balloon Text Char";
        margin:0in;
        margin-bottom:.0001pt;
        font-size:8.0pt;
        font-family:"Tahoma","sans-serif";
        color:black;}
span.EmailStyle18
        {mso-style-type:personal-reply;
        font-family:"Calibri","sans-serif";
        color:#1F497D;}
span.BalloonTextChar
        {mso-style-name:"Balloon Text Char";
        mso-style-priority:99;
        mso-style-link:"Balloon Text";
        font-family:"Tahoma","sans-serif";
        color:black;}
.MsoChpDefault
        {mso-style-type:export-only;
        font-size:10.0pt;}
@page WordSection1
        {size:8.5in 11.0in;
        margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
        {page:WordSection1;}
--></style><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
      <div class="WordSection1">
        <p class="MsoNormal"><a moz-do-not-send="true"
            name="_MailEndCompose"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Glen
              – I had a lot of questions that I captured as comments in
              the attached.<o:p></o:p></span></a></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>
        <div>
          <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:part2.03040103.08080008@securityrs.com"
                  alt="cid:image001.jpg@01D10761.5BE2FE00" 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>
        </div>
        <p class="MsoNormal"><span
style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
        <div>
          <div style="border:none;border-top:solid #B5C4DF
            1.0pt;padding:3.0pt 0in 0in 0in">
            <p class="MsoNormal"><b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">From:</span></b><span
style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:windowtext">
                Openid-specs-heart
                [<a class="moz-txt-link-freetext" href="mailto:openid-specs-heart-bounces@lists.openid.net">mailto:openid-specs-heart-bounces@lists.openid.net</a>] <b>On
                  Behalf Of </b>Glen Marshall [SRS]<br>
                <b>Sent:</b> Saturday, January 23, 2016 12:58 PM<br>
                <b>To:</b> Sarah Squire<br>
                <b>Cc:</b> HEART List<br>
                <b>Subject:</b> Re: [Openid-specs-heart] HEART Clinical
                Research UMA<o:p></o:p></span></p>
          </div>
        </div>
        <p class="MsoNormal"><o:p> </o:p></p>
        <p class="MsoNormal">Gladly!  See attached PDF.<o:p></o:p></p>
        <div>
          <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 moz-do-not-send="true" href="mailto:gfm@securityrs.com">gfm@securityrs.com</a><br>
            <a moz-do-not-send="true"
              href="http://www.SecurityRiskSolutions.com">www.SecurityRiskSolutions.com</a><o:p></o:p></p>
        </div>
        <p class="MsoNormal" style="margin-bottom:12.0pt"><o:p> </o:p></p>
        <div>
          <p class="MsoNormal">On 1/23/16 12:53, Sarah Squire wrote:<o:p></o:p></p>
        </div>
        <blockquote style="margin-top:5.0pt;margin-bottom:5.0pt">
          <div>
            <p class="MsoNormal">Hi Glen, <o:p></o:p></p>
            <div>
              <p class="MsoNormal"><o:p> </o:p></p>
            </div>
            <div>
              <p class="MsoNormal">Your sharepoint link isn't working.
                Could you send a pdf to the list please?<o:p></o:p></p>
            </div>
            <div>
              <p class="MsoNormal"><o:p> </o:p></p>
            </div>
            <div>
              <p class="MsoNormal">Thanks,<o:p></o:p></p>
            </div>
            <div>
              <p class="MsoNormal"><o:p> </o:p></p>
            </div>
            <div>
              <p class="MsoNormal">Sarah<o:p></o:p></p>
            </div>
          </div>
          <div>
            <p class="MsoNormal"><br clear="all">
              <o:p></o:p></p>
            <div>
              <div>
                <div>
                  <div>
                    <p class="MsoNormal"><span style="color:#888888">Sarah
                        Squire<o:p></o:p></span></p>
                  </div>
                  <div>
                    <p class="MsoNormal"><span style="color:#888888">Engage
                        Identity<o:p></o:p></span></p>
                  </div>
                  <div>
                    <p class="MsoNormal"><span style="color:#888888"><a
                          moz-do-not-send="true"
                          href="http://engageidentity.com"><a class="moz-txt-link-freetext" href="http://engageidentity.com">http://engageidentity.com</a></a><o:p></o:p></span></p>
                  </div>
                </div>
              </div>
            </div>
            <p class="MsoNormal"><o:p> </o:p></p>
            <div>
              <p class="MsoNormal">On Fri, Jan 22, 2016 at 2:55 PM, Glen
                F. Marshall <<a moz-do-not-send="true"
                  href="mailto:glen.f.marshall@gmail.com"
                  target="_blank">glen.f.marshall@gmail.com</a>>
                wrote:<o:p></o:p></p>
              <div>
                <p class="MsoNormal" style="margin-bottom:12.0pt">Team,<br>
                  <br>
                  Here is a <b><a moz-do-not-send="true"
href="https://srsmail-my.sharepoint.com/personal/gfm_securityrs_com/_layouts/15/guestaccess.aspx?guestaccesstoken=2QxXSnxuijrIbiElNuU%2bCJIV0G6FBK5uWbdt0FvvVFg%3d&docid=2_1c5c33062f8ee4dbe9dbf61ba9524ca39"
                      target="_blank">link</a></b> to a read-only shared
                  copy of the updated Clinical Research (UMA) use case. 
                  It now contains fleshed-out business prerequisites,
                  sequence diagrams, and some minor corrections.<br>
                  <br>
                  Please respond with your suggestions, corrections,
                  etc.  But please do not alter the document itself, as
                  the master Word copy and Visio graphics are all in my
                  personal cloud storage.<br>
                  <br>
                  Note I have not included the final sequence diagram --
                  review of disclosures and modification of UMA
                  permissions -- as I'd like to discuss the proper UMA
                  mechanisms and flow to accomplish the modifications.<br>
                  <br>
                  Also note I have specifically made the AS a singular
                  IRB-selected element within the use case.  All access
                  control policies are determined by the IRB for ongoing
                  access, with the patient consenting to them.  This
                  also keeps HEART away from ongoing political,
                  regulatory, and policy matters that are properly out
                  of scope for our technical work.<br>
                  <br>
                  Since I will be at the IHE Connectathon next week, I
                  won't be on our schedule 1/25 call.  Looking forward
                  to discussions on-list and in February meetings.<br>
                  <br>
                  Best,<br>
                  Glen<br>
                  <br>
                  <o:p></o:p></p>
              </div>
              <p class="MsoNormal" style="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">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"><o:p> </o:p></p>
          </div>
        </blockquote>
        <p class="MsoNormal"><o:p> </o:p></p>
      </div>
    </blockquote>
    <br>
  </body>
</html>