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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'>I wanted to make a couple of points that I was not able to squeeze in on this last call. (I tried to send this out yesterday, but it did not go through)<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'><o:p> </o:p></span></p><p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>1.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>The notion that Alice shares with Dr. Bob – I think we need to leave that phrase just as it is. It should be understood that Dr. Bob’s administrative staff would prepare that information for Dr. Bob prior to the visit. But Alice should not have to specify all that detail – all she should have to know is that she is sharing with Dr. Bob. (My opinion and suggestion.)<o:p></o:p></span></p><p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>2.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>Regarding what Alice shares …<o:p></o:p></span></p><p class=MsoListParagraph style='margin-left:1.0in;text-indent:-.25in;mso-list:l0 level2 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>a.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>A couple of practical examples that were raised repeatedly during patient engagement work groups include Alice not wanting to share behavioral health information or not wanting to share her HIV diagnosis. Let’s use these two practical examples to be explicit about how the consent is defined.<o:p></o:p></span></p><p class=MsoListParagraph style='margin-left:1.0in;text-indent:-.25in;mso-list:l0 level2 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>b.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>If we are referring to the granting access at FHIR resource level: If Alice consents to share her problem list with Dr. Bob – what would be the method for her to exclude her HIV diagnosis from the problem list? Ditto for her behavioral health diagnosis.<o:p></o:p></span></p><p class=MsoListParagraph style='margin-left:1.0in;text-indent:-.25in;mso-list:l0 level2 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>c.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>If Alice consents to share her Medication list with Dr. Bob, could she exclude her med that clearly is used only to treat her HIV? (And on the other side of the argument, if she were allowed to do that how might that impact drug interaction considerations?)<o:p></o:p></span></p><p class=MsoListParagraph style='margin-left:1.0in;text-indent:-.25in;mso-list:l0 level2 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>d.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>I suspect that neither tagging or types will solve this.<o:p></o:p></span></p><p class=MsoListParagraph style='margin-left:1.0in;text-indent:-.25in;mso-list:l0 level2 lfo1'><![if !supportLists]><span style='font-size:12.0pt;color:#1F4E79'><span style='mso-list:Ignore'>e.<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-size:12.0pt;color:#1F4E79'>I wanted to raise these cases for consideration and to point out that we will have granularities that will be difficult to define. That said, I am totally in agreement to ‘not go so deep’ in this first iteration. Just so long as we are aware of this common set of examples.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'>Thanks much,<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'>Nancy</span><span style='font-size:12.0pt;color:#1F4E79'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:12.0pt;color:#1F4E79'><o:p> </o:p></span></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'><tr style='height:1.0pt'><td width=342 colspan=2 valign=top style='width:256.7pt;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><div style='mso-element:para-border-div;border:none;border-bottom:solid windowtext 1.5pt;padding:0in 0in 1.0pt 0in'><p class=MsoNormal style='line-height:115%;border:none;padding:0in'><span style='font-size:8.0pt;line-height:115%;color:#1F4E79'><o:p> </o:p></span></p></div><p class=MsoNormal style='line-height:115%'><span style='font-size:8.0pt;line-height:115%;color:#1F4E79'><o:p> </o:p></span></p></td></tr><tr style='height:1.0pt'><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><b><span style='font-size:10.0pt;line-height:115%;color:#222A35'>Nancy Lush </span></b><b><span style='font-size:10.0pt;line-height:115%;color:#222A35'><o:p></o:p></span></b></p></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>nancy.lush@lgisoftware.com</span><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><o:p></o:p></span></p></td></tr><tr style='height:1.0pt'><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><b><span style='font-size:10.0pt;line-height:115%;color:#222A35'>Lush Group, Inc<o:p></o:p></span></b></p></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>Office: (401) 423-9111</span><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><o:p></o:p></span></p></td></tr><tr style='height:1.0pt'><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>28 Narragansett Ave<o:p></o:p></span></p><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>PO Box 651</span><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><o:p></o:p></span></p></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>www.lgisoftware.com</span><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'> <o:p></o:p></span></p><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>Cell:(401) 965-9347<o:p></o:p></span></p></td></tr><tr style='height:1.0pt'><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'>Jamestown, RI 02835<o:p></o:p></span></p></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt;height:1.0pt'></td></tr><tr><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt'></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><o:p> </o:p></span></p></td></tr><tr><td width=342 colspan=2 valign=top style='width:256.7pt;padding:0in 5.75pt 0in 5.75pt'><p class=MsoNormal style='line-height:115%'><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><img width=153 height=50 style='width:1.5937in;height:.5208in' id="Picture_x0020_1" src="cid:image001.gif@01D1D11D.82B51FA0" alt="LGI_logo_small"></span><span style='font-size:10.0pt;line-height:115%;color:#1F4E79'><o:p></o:p></span></p></td></tr><tr><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt'></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt'></td></tr><tr><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt'></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt'></td></tr><tr><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt'></td><td width=203 valign=top 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5.75pt'></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt'></td></tr><tr><td width=139 valign=top style='width:1.45in;padding:0in 5.75pt 0in 5.75pt'></td><td width=203 valign=top style='width:152.3pt;padding:0in 5.75pt 0in 5.75pt'></td></tr><tr><td width=342 colspan=2 valign=bottom style='width:256.7pt;padding:0in 5.75pt 0in 5.75pt'></td></tr></table><p class=MsoNormal><span style='color:#1F4E79'><o:p> </o:p></span></p><p class=MsoNormal><o:p> </o:p></p></div></body></html>