Consent in Queries
This page documents an INM Workitem, i.e. an issue within scope of the INM Committee that either is still being discussed, or the resolution of which has not yet been included in an INM ballot.
There are use-cases for including Consentinformation in a query. DetectedIssueManagement may be based on having consent.
Suggestion is to add consent.id (a reference to the full consent model) in the ControlAct wrapper wrapper, and not to add support in the wrapper for the scanned consentform nor of a fullblown consent model. The full consent could be stored (and referenced) once uploaded into a registry, or it could be transmitted in the form of an Attachment class in Transmission Wrapper.
A query may be executed based on:
- a Legitimate Relationship (LR, an UK NHS term), or a Certificate of Care Relationship (Finnish term). Consent is explicit/implicit related to e.g. the fact the GP has a relationship with a Patient
- a (written) consent form, granting acces to data, created/signed by patient
- the identity of requester, we know/trust the requester, we have a contract with the particular requester
In those cases were consent information is conveyed in a query, what level of detail do we need?
- In queries, in Finland may need to send more that just the ID of the consent document instance, or the ID of the Certificate of Care Relationship. Consent may be in central reporsitory, in which case it may be referenced. May require a medical-records (or new, if consent is a mesage model instead of a document) interaction to convey the consent. Depends on level of trust.
- In the Netherlands the ID of the consent form may be sufficient, during an audit you (as a requester that referenced a consent ID in a query) better have the full document.
- In the US there are no national provider IDs, there is no PKI infrastructure. This, combined with HIPAA, makes the consent situation complex.
- In Canada business rules will vary across 13 provincial jurisdictions.
Note on Consent.txt: In terms of the consent model, a more accurate model might be to say that the consent is an instance of a consent definition, where the text of the definition reflects the "form". Alternatively, it could represent the complete filled in form, which would presumably address the subject, performer, etc.
Actions:
- w/ Bob Dolin, create controlAct R-MIM with Consent, suggest ways to pre-adopt it.
September2006 WGM, THU Q4: Motion by the MR/IM TC: The following items were agreed to by a vote of 5-0-1.
- We will add this to the open issues log for the consent DSTU.
- At the time we take the DSTU to normative ballot (in 18 months) this will be addressed.
- We will let the current DSTU pass and anything that is needed by a realm at this time can tke it on as a realm extension.
