<div dir="ltr">Hi Nancy-- Responding point by point below...<div class="gmail_extra"><br clear="all"><div><div data-smartmail="gmail_signature"><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr">
<p><b>Eve Maler<br></b>ForgeRock Office of the CTO | VP Innovation & Emerging Technology<br>Cell <a href="tel:%2B1%20425.345.6756" value="+14253456756" target="_blank">+1 425.345.6756</a> | Skype: xmlgrrl | Twitter: @xmlgrrl<br><b>ForgeRock Summits and UnSummits</b> <a href="http://summits.forgerock.com/" target="_blank">are coming to</a> <b>Sydney, London, and Paris!</b></p></div></div></div></div></div></div></div></div></div></div></div></div></div>
<br><div class="gmail_quote">On Tue, Jun 28, 2016 at 6:14 AM, Nancy Lush <span dir="ltr"><<a href="mailto:nlush@lgisoftware.com" target="_blank">nlush@lgisoftware.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="#0563C1" vlink="#954F72"><div><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)<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:12.0pt;color:#1f4e79"><u></u> <u></u></span></p><p><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>1.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><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.)</span></p></div></div></blockquote><div>I definitely agree that Alice should have an intuitive and simple way to share, without weird "access control list" or other "subject of the authorization policy" complications. That said, if Dr. Bob's staff, or the entire hospital, would be shared with under the actual UMA-enabled system (vs. some sort of TPO understanding), if I had my druthers, I think I'd prefer it if Alice had in option to share with something like "the Dr. Bob care team" or something.</div><div><br></div><div>We have been discussing what this could/should look like, without firm conclusions yet.</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="#0563C1" vlink="#954F72"><div><p><span style="font-size:12.0pt;color:#1f4e79"><u></u><u></u></span></p><p><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>2.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><span style="font-size:12.0pt;color:#1f4e79">Regarding what Alice shares …<u></u><u></u></span></p><p style="margin-left:1.0in"><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>a.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><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.<u></u><u></u></span></p><p style="margin-left:1.0in"><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>b.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><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.</span></p></div></div></blockquote><div>The "default permit with exclusions" pattern is really difficult technically -- the minusing out of content is a challenge. A good one to discuss.</div><div> </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="#0563C1" vlink="#954F72"><div><p style="margin-left:1.0in"><span style="font-size:12.0pt;color:#1f4e79"><u></u><u></u></span></p><p style="margin-left:1.0in"><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>c.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><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?)</span></p></div></div></blockquote><div><br></div><div>I think we've since talked about this on a call. There are additional subtleties, of course. Purpose-of-use limitations largely exist at a nontechnical level of enforcement unless you get into increasingly complicated levels of technology that wide ecosystems usually find not very workable (encryption, DRM licensing, etc.). <br></div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="#0563C1" vlink="#954F72"><div><p style="margin-left:1.0in"><span style="font-size:12.0pt;color:#1f4e79"><u></u><u></u></span></p><p style="margin-left:1.0in"><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>d.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><span style="font-size:12.0pt;color:#1f4e79">I suspect that neither tagging or types will solve this.<u></u><u></u></span></p><p style="margin-left:1.0in"><u></u><span style="font-size:12.0pt;color:#1f4e79"><span>e.<span style="font:7.0pt "Times New Roman""> </span></span></span><u></u><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.</span></p></div></div></blockquote><div><br></div><div>Boiling only a small pond, instead of an ocean, is probably a good idea! :-) </div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div lang="EN-US" link="#0563C1" vlink="#954F72"><div><p style="margin-left:1.0in"><span style="font-size:12.0pt;color:#1f4e79"><u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:12.0pt;color:#1f4e79"><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-size:12.0pt;color:#1f4e79">Thanks much,<u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:12.0pt;color:#1f4e79">Nancy</span><span style="font-size:12.0pt;color:#1f4e79"><u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:12.0pt;color:#1f4e79"><u></u> <u></u></span></p><table border="0" cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr 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