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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Thanks for responding in line. I have added some commentary with </span><span style='font-family:"Calibri","sans-serif";color:#7030A0'>a purple font</span><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'><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 href="nate-trust.org"><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D;text-decoration:none'><img border=0 width=205 height=48 id="Picture_x0020_1" src="cid:image001.jpg@01D1EB4D.8FE14790" alt="cid:image001.jpg@01D10761.5BE2FE00"></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"'> agropper@gmail.com [mailto:agropper@gmail.com] <b>On Behalf Of </b>Adrian Gropper<br><b>Sent:</b> Sunday, July 31, 2016 2:20 PM<br><b>To:</b> Aaron Seib, NATE<br><b>Cc:</b> openid-specs-heart@lists.openid.net; Dixie Baker<br><b>Subject:</b> Re: [Openid-specs-heart] Notification in HEART and/or UMA<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal>Thanks, Aaron - I think you get it just fine - how we explain it may still be a challenge - see inline<o:p></o:p></p><div><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal>On Sun, Jul 31, 2016 at 9:50 AM, Aaron Seib, NATE <<a 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'>Adrian,<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 class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>This is a very useful description of the HEART work: “HEART is all about giving everyone a choice of authorization server in the FHIR context.”<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 class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>I think it would be a great way to start a presentation about HEART that would provide a better understanding of what the project is about.<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 class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>Before we move onto the rest of the thread here – which I think is just as important to understanding what is being proposed - can we deconstruct the meaning of two components of this sentence?<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><span style='font-family:Symbol'>·</span><span style='font-size:7.0pt'> </span>What does it mean to ‘give everyone a choice of authorization server’?<o:p></o:p></p></div></div><div><p class=MsoNormal>It means that when I begin a relationship with a service provider they don't expect to tell me who my email provider should be. I get to choose Google or an email from my college or run my own mail server and the service provider just has to deal with that. By giving the person the choice of authorization server, the service provider has to make contact in the Inbox that's convenient to the person. Imagine if every merchant and service provider could tell you where to sign-in to check your messages from them. Oh, this is exactly how "secure messages" from our EHRs work today, never mind, you don't have to imagine. <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-family:"Calibri","sans-serif";color:#7030A0'>I am with you. So that we are not deluding ourselves or anyone that is trying to understand what this is all about would you agree that it is fair to say that unlike the availability of email servers Authorization servers are not very common? Or is that not accurate. They are common and we just don’t know that they are on every web-server in the country? This is a sincere question. I don’t think if someone held a gun to my head and told me they were going to pull the trigger if I couldn’t tell them where my Authorization Server is today.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#7030A0'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#7030A0'>If I wanted to how would I go about setting up my own Authorization server and how would I point people to it? How could we make it easy for all of my provider’s EMR’s to discover it and use it to disclose data to me?<o:p></o:p></span></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-family:Symbol'>·</span><span style='font-size:7.0pt'> </span>What does it mean to do so ‘in the FHIR Context’?<o:p></o:p></p></div></div></blockquote><div><p class=MsoNormal>FHIR is a standard for EHR interoperability. When a standard is available a service provider has the choice of using it or not. Email for example is an available standard but hospitals don't choose to use it even though the Office for Civil Rights has said unequivocally that patients have a right to request contact by plain insecure email. (There's still some kind of legal or regulatory challenge to be mounted on that front - but I digress.) Direct email was another standard that hospitals have chosen not to implement in a consumer-friendly way. Now we have the FHIR standard. We need to learn from our experience and the JASONs and the API Task Force and make sure that the FHIR implementations _can't_ discriminate between HIPAA covered endpoints and patient-controlled endpoints. If we make HEART work for patient-directed exchange and the hospitals pull another Direct maneuver, it needs to be obvious to the regulators and politicians. <br> <o:p></o:p></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>I am following you here too. In the FHIR context meaning that the Consumer App is using the FHIR standard to support interoperability the same way that the EHRs are.<o:p></o:p></span></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'>Next, I thought that this statement was very useful: ‘When she (<i>Alice</i>) engages with a FHIR service provider as a patient Alice provides three pieces of information:<o:p></o:p></p><p><span style='font-family:Symbol'>·</span><span style='font-size:7.0pt'> </span>an identity<o:p></o:p></p><p><span style='font-family:Symbol'>·</span><span style='font-size:7.0pt'> </span>a notification address<o:p></o:p></p><p style='margin-bottom:12.0pt'><span style='font-family:Symbol'>·</span><span style='font-size:7.0pt'> </span>a resource registration address<o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>I want to make sure I understand what you mean when you later describe a potentially ideal solution as ‘Alice to provide an identity that automagically links to her Notification and Authorization addresses.”<o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>If I am reading it correctly – I think you are asking if an email address supplied by Alice would be sufficient for the identity – I just want to make sure I understand the question. If I am keeping up there would be some way that Alice associates this email address with her choice of Authorization server (that a FHIR based resource server could use to resolve her privacy preferences) and incidentally be where the FHIR based Resource Server would send notifications about the disclosures it made based on her privacy preferences found in the Authorization Server of her choice in association with the email address she chooses.<o:p></o:p></p></div></div></blockquote><div><p class=MsoNormal>Yes. It's a standard called WebFinger that is already in OpenID Connect. HEART can build on WebFinger. There are other identity-related standards we can consider if necessary.<span style='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'>Ok – you this is another component I think – can we start from the position that no one outside of our tribe really understands how you could relate an email address to an OpenID Connect (what instance, server?). Somehow I give you the email address as a parameter and using WebFinger I can discover the other parameters I need to know about you to enable consumer directed exchange is all I would need. Is WebFinger just an API – how does it know all this stuff? Doesn’t there need to be a registration step somewhere along the line for WebFinger to discover the rest given my email address?<o:p></o:p></span></p><p class=MsoNormal> <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;margin-bottom:12.0pt'>Thank you – this would be the kind of detail that I think we could share with a folks like NATE’s members et al.<o:p></o:p></p></div></div></blockquote><div><p class=MsoNormal style='margin-bottom:12.0pt'>I think HEART's patient-directed exchange is a huge opportunity for may of NATE's members. Somebody will need to make and sell those authorization servers :-)<o:p></o:p></p><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>There is no reason to think that some of them wouldn’t if it would help their users get their data in a secure privacy preserving way. That is all they have ever wanted to do.<o:p></o:p></span></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;margin-bottom:12.0pt'> <o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>Aaron<o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'> <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 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 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 href="http://nate-trust.org" target="_blank"><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D;text-decoration:none'><img border=0 width=205 height=48 id="_x0000_i1025" src="cid:image001.jpg@01D1EB4D.8FE14790" alt="cid:image001.jpg@01D10761.5BE2FE00"></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 [mailto:<a href="mailto:openid-specs-heart-bounces@lists.openid.net" target="_blank">openid-specs-heart-bounces@lists.openid.net</a>] <b>On Behalf Of </b>Adrian Gropper<br><b>Sent:</b> Saturday, July 30, 2016 1:47 PM<br><b>To:</b> <a href="mailto:openid-specs-heart@lists.openid.net" target="_blank">openid-specs-heart@lists.openid.net</a><br><b>Cc:</b> Dixie Baker<br><b>Subject:</b> [Openid-specs-heart] Notification in HEART and/or UMA</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><div><div><div><div><div><div><div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>A new thread to consider Danny's very important reminder of how HEART will deal with Notification. <br><br>From Alice's perspective, when she engages with a FHIR service provider as a patient Alice provides three pieces of information:<o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>- an identity<o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'>- a notification address<o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>- a resource registration address<o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>That's a lot to ask. We're all used to providing an email address as an identity and a notification endpoint. We're also used to the typical OAuth authorization screen that sometimes appears after we use a federated identity such as Gmail. What we're not used-to, yet, is being given a choice of OAuth authorization server the same way we have a choice of notification address. HEART is all about giving everyone a choice of authorization server in the FHIR context. It's the essence of being patient-centered and why the HEART charter says: "build, buy, or outsource" the AS.<o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>The ideal situation IMHO would be for Alice to provide an identity that automagically links to her Notification and Authorization addresses. If that identity is an email address, then we have a simple, voluntary, and well-established way to explain HEART and to bootstrap the rest of the patient registration or consent to health information exchange process. Is there any realistic alternative to email? <o:p></o:p></p></div><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'>It's not clear at this time whether UMA will add a Notification endpoint to the UMA spec. If it does, then HEART can just use that. If it doesn't then HEART will need to deal with Notification some other way. Either way, HEART will need to explain to FHIR resource servers how they are expected to bootstrap discovery of Alice's authorization server and, incidentally, her Notification address.<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><div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><br> <o:p></o:p></p></div></div></div></div></div></div></div></div></div></div></blockquote></div><p class=MsoNormal><o:p> </o:p></p></div></div></div></body></html>