<div dir="ltr"><span id="docs-internal-guid-eb6b3a18-dbe7-0d94-d567-eb39fc48b0cf"><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Attendees:</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie Bucci</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Glen Marshall</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Scott Shorter</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah Squire</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">David Batchelor</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Nancy Lush</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Tom Sullivan</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John Moehrke</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Dale Moberg</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Thompson Boyd</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Jim Kragh</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Edmund Jay</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen Connor</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Jin Wen</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Julie Maas</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin Richer</span></p><br><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Let’s say there are FHIR resource sets that talk about meds and things that you define. How do you define them if they’re not resource sets?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Nancy:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Everything should be in a FHIR resource. All the clinical data should be covered. The difficulty is in defining the cases that come out of that.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The way that FHIR is choosing to divy up - this kind of stuff goes into this kind of resource. They do it based on the data model. That structure works great for organizing the data into a resource that holds that kind of data, but when it comes to privacy topics, they are cross-cutting and don’t align well. For instance, information about abortion or HIV status might cut across multiple resources.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I’m trying to think simpler. Dr. Bob wants access to some data. Alice generates an RPT ticket saying that’s the data they can see. However, an RPT only implies consent, there’s nothing that explicitly expresses consent.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We’re looking at using the id-event standard being developed in the IETF. That would be a SCIM-based standard. However, it’s not defined yet.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We’re working on getting FHIR consent onto the HL7 ballot this fall.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Glen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We also have to keep in mind that the consent resource in FHIR needs to be computable. It needs to be acted on by the security subsystem during operation. There could be other types of access control involved.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">There’s a lot of history also around CDA consent. There’s another approach. What Graham did with the information that’s governed by the consent. It’s good for making resource sets computable. Alice’s consent is what allows the resource server to describe her permissions to the AS. If there was a FHIR consent that, for instance, limited disclosure to certain dates. The resource server could use the description to indicate that to the AS.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The location of the resources and the location of the consent object don’t have to be in the same place. It’s just an object. It could be in a resource server dedicated to consent objects.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So you’re saying you would use an authorization server to identify the type of attributes?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We’re just saying that consent could live somewhere else. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So there could be a resource set that is the virtual clipboard. You give the authorization for the resource set, and I might include the location of my consent and my advanced directives as part of that. Would that be included as part of the token?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I think John’s idea of having consent as a resource that is also shared with Dr. Bob is a great idea.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John, how did you envision us using confidentiality codes, and where is that placed?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Security tags are in the metadata of the resource. You can have rules that a patient can record that says “Any data relevant to HIV is blocked” then you use the tag to indicate whether data is hiv-related, allowing it to be blocked. There is some question as to how the tag gets there, but that’s more of an operational issue.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The security labeling service looks at consent and disclosure. The enforcement system needs to look at those confidentiality codes.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Resources could have metadata associated with them.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">UMA resources have no concept of consent metadata at the AS. So, we would be looking at either changing or extending the UMA protocol. Whereas if we store consent as an UMA resource, we can work within the existing protocol.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I propose that we use these tags as scope values. So when someone wants an UMA resource, they may be issued a token that says ‘hiv-blocked’. The name of the resource is a metadata element. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So if we defined a resource set, could that scope apply to all the resources in that set? Because you’re saying the same meta is all the attributes?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The existence of a specific value in the metadata is what defines that. There is a confidentiality code set that is a range of risk from low risk to high risk. There’s a different set for things like hiv or alcohol abuse. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So we could add a confidentiality scope. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We could. Scopes are actually “out of scope” for this project as a whole. Any AS and RP can agree to use whatever scopes they want. Dr. Bob, for legal reasons, will probably need more information about the consent than just a binary. He would need to know when it was collected, by whom, in what jurisdiction, etc. I think it makes more sense to store that as a protected resource and proactively push information about it to Dr. Bob if it changes.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I think it’s important to separate access management from Dr. Bob’s ability to look up consent records for legal purposes.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So how would Alice use confidentiality codes?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Alice would use confidentiality codes to structure her access management rules at the AS. But this is profiling scopes, which we’re not doing.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Aren’t we making suggestions about how to use FHIR?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Nancy:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I’m concerned about the physician only getting part of the information.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">That’s always been the way it is. Patients withhold information, and doctors know that.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">FHIR also has a return code indicating that information has been withheld due to policy.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">As part of the FHIR API UMA profile, could we require that all resources at least have a confidentiality code?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">That would be an implementation decision. We can allow clients to request that type of access. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We could have a guide to tell them how to do it if they need to.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">I don’t understand why we wouldn’t require it, if the attribute is on all FHIR resources.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Because it’s not necessarily implemented on all resources.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We could make it SHOULD.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The best approach is to always allow the client to request it, define what it means when the client requests it, but don’t require servers to strictly define their data in terms of this.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Kathleen:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Why would a client ask for “send me something with a confidentiality code”?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Why wouldn’t a client ask for “I want information about hiv status”?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Is “confidentiality code” not implemented everywhere?</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Sarah:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Yeah, but we’re not necessarily talking about institutional data. We could be talking about her fitbit information. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Things could be set to “normal” by default.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">It may not be consent, but it’s a step in the right direction.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Which is why it’s important to allow clients to request it, but not require it.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">John:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">FHIR does not require it. Everything is optional.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">The core charter of this working group is not to profile the FHIR protocol itself, but to profile security aspects around using FHIR.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We’re talking about using it as a scope, because we don’t have any idea how to do consent.</span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Justin:</span></p><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">We could certainly define it. That would allow the client to request specific access. It also allows Alice to write policies at the AS. But we shouldn’t require the RS to implement those specific controls universally. Be liberal in what you accept. Be strict in what you produce. The RS should be able to handle all FHIR metadata. </span></p><br><p dir="ltr" style="line-height:1.38;margin-top:0pt;margin-bottom:0pt"><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">Debbie:</span></p><span style="font-size:14.6667px;font-family:Arial;color:rgb(0,0,0);vertical-align:baseline;white-space:pre-wrap;background-color:transparent">So an AS could handle HEART profiles or other profiles, but that AS might be handling scopes for FHIR-specific APIs. The resource sets are defined by the resource server, right? So the resource server would use that as part of the resource set?</span></span><div><font color="#000000" face="Arial"><span style="font-size:14.6667px;white-space:pre-wrap"><br clear="all"></span></font><div><div class="gmail_signature" data-smartmail="gmail_signature"><div dir="ltr"><div style="color:rgb(136,136,136)">Sarah Squire</div><div style="color:rgb(136,136,136)">Engage Identity</div><div style="color:rgb(136,136,136)"><a href="http://engageidentity.com/" style="color:rgb(17,85,204)" target="_blank">http://engageidentity.com</a></div></div></div></div>
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