<div dir="ltr">I tend to agree with Aaron and Justin. POU _reduces_ the agency of the patient and will therefore add both complexity and reduce the scalability of the protocol. <div><br></div><div>Adrian</div></div><div class="gmail_extra"><br><div class="gmail_quote">On Fri, May 12, 2017 at 9:23 AM, Justin Richer <span dir="ltr"><<a href="mailto:jricher@mit.edu" target="_blank">jricher@mit.edu</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
  
    
  
  <div text="#000000" bgcolor="#FFFFFF">
    <p>I'm not saying it's unimportant, and I'm not arguing against
      having a purpose of use mechanism, I'm arguing against where it
      was stuck previously. I don't think we should include it until we
      have decided exactly where it ought to go in the technical
      architecture. I really don't think having it as an RqP claim
      works, but defining something like a scope, or even an additional
      (optional) parameter like the "aud" parameter might work.<span class="HOEnZb"><font color="#888888"><br>
    </font></span></p><span class="HOEnZb"><font color="#888888">
    <p> -- Justin<br>
    </p></font></span><div><div class="h5">
    <br>
    <div class="m_4883584326862685371moz-cite-prefix">On 5/12/2017 4:19 AM, John Moehrke
      wrote:<br>
    </div>
    <blockquote type="cite">
      
      <div dir="ltr">PurposeOfUse is indeed a critical aspect in
        healthcare. It is the highest differentiation, higher than
        user-role. It indicates the broader context that the data is to
        be used within. For example a request for data in healthcare
        often is onbehalf of a broader use: Treatment, Coverage,
        Research, etc. It is not an attribute of the user, it is an
        attribute of the request for information. It is not uncommon for
        identity and context attributes to be conflated or simply
        communicated in one token; however that does not mean they
        really are the same, it just means that the environment has made
        a simplifying assumption to combine for ease of technology. It
        is most closely aligned with the broadest part of a OAuth scope.
        So it should be included in the request for authorization
        decision, and authorization token.</div>
      <div class="gmail_extra"><br clear="all">
        <div>
          <div class="m_4883584326862685371gmail_signature" data-smartmail="gmail_signature">
            <div dir="ltr">John Moehrke<br>
              Principal Engineering Architect: Standards -
              Interoperability, Privacy, and Security<br>
              CyberPrivacy – Enabling authorized communications while
              respecting Privacy<br>
              M <a href="tel:(920)%20564-2067" value="+19205642067" target="_blank">+1 920-564-2067</a><br>
              <a href="mailto:JohnMoehrke@gmail.com" target="_blank">JohnMoehrke@gmail.com</a><br>
              <a href="https://www.linkedin.com/in/johnmoehrke" target="_blank">https://www.linkedin.com/in/<wbr>johnmoehrke</a><br>
              <a href="https://healthcaresecprivacy.blogspot.com" target="_blank">https://healthcaresecprivacy.<wbr>blogspot.com</a><br>
              "Quis custodiet ipsos custodes?" ("Who watches the
              watchers?")</div>
          </div>
        </div>
        <br>
        <div class="gmail_quote">On Thu, May 11, 2017 at 3:29 PM, Justin
          Richer <span dir="ltr"><<a href="mailto:jricher@mit.edu" target="_blank">jricher@mit.edu</a>></span>
          wrote:<br>
          <blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
            <div style="word-wrap:break-word">The “pou” claim as it was
              specified in HEART does not fit this use case, then, and
              it’s appropriate that we removed it. This was a claim
              presented by the requesting party’s identity provider, and
              had nothing to do with the request being made by the
              client itself. That’s why I argued it wasn’t a good fit
              where it was. If we were to add it back in, it should go
              elsewhere in the protocol.
              <div><br>
              </div>
              <div> — Justin</div>
              <div><br>
                <div>
                  <div>
                    <blockquote type="cite"><span>
                        <div>On May 11, 2017, at 2:01 PM, Nancy Lush
                          <<a href="mailto:nlush@lgisoftware.com" target="_blank">nlush@lgisoftware.com</a>>
                          wrote:</div>
                        <br class="m_4883584326862685371m_7046718250433411500Apple-interchange-newline">
                      </span>
                      <div>
                        <div class="m_4883584326862685371m_7046718250433411500WordSection1" style="font-family:Helvetica;font-size:12px;font-style:normal;font-variant-caps:normal;font-weight:normal;letter-spacing:normal;text-align:start;text-indent:0px;text-transform:none;white-space:normal;word-spacing:0px"><span>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">Hello all,<span class="m_4883584326862685371m_7046718250433411500Apple-converted-space"> </span></span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">Per our last
                                meeting, I agreed to provide more
                                information on the need for the pou
                                claim.</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">The claim pou was
                                recently removed from the HEART specs
                                and needs to be restored.</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">I spoke with
                                Duane Decouteau from the VA team and
                                provide the following details:</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">Purpose of use
                                drives policy in many electronic
                                exchanges today.  The custodian
                                organization uses the claimed purpose of
                                use to interpret policy.  For instance,
                                if the pou is ‘Treatment’ a complete
                                record might be provided, but if the pou
                                is ‘Coverage’ the policy may limit what
                                is sent.  If the pou is ‘Research’ then
                                the custodian organization might need to
                                de-identify the data on the way out.</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">The pou is passed
                                as a claim within the request. It is a
                                determining factor in evaluating which
                                policies apply to a request.  Pou is
                                implemented in ehealth exchange as an
                                underlying principal.  Duane feels that
                                pou should be a cornerstone for patient
                                consent.  It is fully implemented now in
                                ehealth exchange at the VA, Kaiser and
                                others.</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt">The list of pou
                                values can be found at this link:  <span class="m_4883584326862685371m_7046718250433411500Apple-converted-space"> </span><span style="color:rgb(4,68,68)"><a href="https://www.hl7.org/fhir/v3/PurposeOfUse/vs.html" style="color:rgb(149,79,114);text-decoration:underline" target="_blank">https://www.hl7.org/fh<wbr>ir/v3/PurposeOfUse/vs.html</a></span></span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt;color:rgb(4,68,68)"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt;color:rgb(4,68,68)">Respectively,</span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt;color:rgb(4,68,68)">Nancy</span><span style="font-size:12pt"></span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt;color:rgb(31,56,100)"> </span></div>
                            <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif"><span style="font-size:12pt;color:rgb(31,56,100)"> </span></div>
                          </span>
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                                  <div style="border-style:none none solid;border-bottom-width:1.5pt;border-bottom-color:windowtext;padding:0in 0in 1pt">
                                    <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px;border:none;padding:0in"><span style="font-size:8pt;line-height:12.266667366027832px;color:rgb(31,56,100)"> </span></div>
                                  </div>
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:8pt;line-height:12.266667366027832px;color:rgb(31,56,100)"> </span></div>
                                </td>
                              </tr>
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                                <td style="width:1.45in;padding:0in 5.75pt;height:1pt" valign="top" width="139">
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><b><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(34,42,53)">Nancy
                                        Lush          </span></b><b><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(34,42,53)"></span></b></div>
                                </td>
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                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"><a href="mailto:nancy.lush@lgisoftware.com" style="color:rgb(149,79,114);text-decoration:underline" target="_blank">nancy.lush@lgisoftware.com</a></span><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"></span></div>
                                </td>
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                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><b><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(34,42,53)">Lush
                                        Group, Inc</span></b></div>
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                                <td style="width:152.3pt;padding:0in 5.75pt;height:1pt" valign="top" width="203">
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)">Office:
                                      <a href="tel:%28401%29%20423-9111" value="+14014239111" target="_blank">(401)
                                        423-9111</a></span><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"></span></div>
                                </td>
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                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)">28
                                      Narragansett Ave</span></div>
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)">PO
                                      Box 651</span><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"></span></div>
                                </td>
                                <td style="width:152.3pt;padding:0in 5.75pt;height:1pt" valign="top" width="203">
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"><a href="http://www.lgisoftware.com/" style="color:rgb(149,79,114);text-decoration:underline" target="_blank">www.lgisoftware.com</a></span><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)"></span></div>
                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)">Cell:<a href="tel:%28401%29%20965-9347" value="+14019659347" target="_blank">(401)
                                        965-9347</a></span></div>
                                </td>
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                                  <div style="margin:0in 0in 0.0001pt;font-size:11pt;font-family:Calibri,sans-serif;line-height:16.866666793823242px"><span style="font-size:10pt;line-height:15.333332061767578px;color:rgb(31,56,100)">Jamestown,
                                      RI 02835</span></div>
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<br></blockquote></div><br><br clear="all"><div><br></div>-- <br><div class="gmail_signature" data-smartmail="gmail_signature"><div dir="ltr"><div><div dir="ltr"><div dir="ltr"><div dir="ltr"><br><div dir="ltr">Adrian Gropper MD<span style="font-size:11pt"></span><br><br><span style="font-family:"Arial",sans-serif;color:#1f497d">PROTECT YOUR FUTURE - RESTORE Health Privacy!</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br>HELP us fight for the right to control personal health data.</span><span style="font-family:"Arial",sans-serif;color:#1f497d"><br></span></div></div></div></div></div></div></div>
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