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HL7 WGM MAY 2017 - Madrid Spain Minutes

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MINUTES WGM Madrid 6th-12th May 2017

Tuesday Q1

Opening Security WG Meeting

Attendees:

  • John Moehrke John.Moehrke@gmail.com
  • Alexander Mense alexander.mense@hl7.at
  • Princess Trish Williams patricia.williams@flinders.edu.au
  • Kathleen Connor Kathleen.connor@comcast.net
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp
  • Bernd Blobel bernd.blobel@klinik.uni-regensburg.de
  • Kevin Shekleton kshekleton@cerner.com
  • Ashley Duncan a.duncan@furore.com
  • Reinhard Egalkrout reinhard.egelkrout@hl7.at
  • Karl Holzer karl.holzer@cgm.com


  • Introductions
  • Approval of agenda - John/Bernd 10/0/0
  • International Report outs
    • John attended the FHIR connectathon on Sat. Assisted tables, many thinking about security but few had actually integrated it yet.
    • Europe (Bernd & Alex):
      • Security and privacy crucial services for interoperability. Lack of trust is a problem in Germany and the increase in spending on it.
      • Law (not a directive) the EU General Data Protection Regulation (GDPR). The framework is a fixed legal definition. It reflects the new care paradigms, multi domain and multi policies (health and social data) and secondary use for e-business but protecting citizens across Europe. Policy must be written for the end-user (e.g. for a child it must be written so they can understand it). Detailed auditing schema has also been developed.
      • GDPR also right to access their data enforcing data portability to ensure readable electronic format on request.
      • Directive on security networks systems. Mainly focus on critical infrastructure to ensure continuity planning. Trace-ability of data also a requirement.
      • Austria uses opt-out but this may not align with the new GDPR.
    • Australia (Trish): Australia has finally passed mandatory computer security breach reporting laws. Opt-out for MyHealth Record (national health record summary) will now be adopted from 2019.
    • Japan (Hide): Transfer of information from one provider to another requires from patient and uses organizational authorization assertion. Divide healthcare and other networks due to level of threat surface (malware and ransomware). Next year starting whole systems (cross-network) use.

Discussion on Opt-in and Opt-out terminology: Sometimes it describes an event, or a state and this impacts the consent model and its interpretation e.g. implied-consent or explicit-consent. In simple process (share to one) it is acceptable, but in complex systems (secondary use and subsequent sharing).

  • HL7 Policy Advisory Committee update
    • Looking at ONC Standards Advisory and going through and evaluating where HL7 suggestions were amended or ignored. 21st Century Cures Act has impact for security and privacy. In addition to privacy a national trust framework for consumers is required by Cures Act, and the committee is reviewing approaches.
  • Liaison Reports: ISO, IHE, ONC
    • ISO
      • See presentation (Hide)
      • Trends for Standardization of Electronic Signatures -ISO17090-4 CAdes (ISO 14533-1:2012)/XAdES (ISO 14533-2:2012) profiles.
    • IHE
      • The digital signature profile to go to final text (after several years in development).
    • ONC
      • Patient choice for research and comping up with an implementation plan.
  • HL7 Project status and updates (Not completed in Q1):
    • FHIR Security - AuditEvent, Provenance, Security Labels
    • Trust Framework - Ballot Report and WGM Reconciliation Plans, Links to FHIR Security
    • SLS Revisions - WGM Development Plans, Links to FHIR Security
    • SOA Audit - Status, Development Plans, Links to FHIR Security
    • FHIR Privacy and Security Conformance Test Suite Development - Discussions planned for WGM

Tuesday Q2

Attendees:

  • John Moehrke John.Moehrke@gmail.com
  • Alexander Mense alexander.mense@hl7.at
  • Princess Trish Williams patricia.williams@flinders.edu.au
  • Kathleen Connor Kathleen.connor@comcast.net
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp
  • Bernd Blobel bernd.blobel@klinik.uni-regensburg.de


Trust Framework Work Session 

TF4FA R2 Ballot Reconcilation Spreadsheet]

Tuesday Q3

Attendees: CBCC (hosting) FHIR-I Joint on FHIR Consent Resource

Tuesday Q4

Attendees:

  • Alexander Mense alexander.mense@hl7.at
  • Ashley Duncan a.duncan@furore.com
  • Bernd Blobel bernd.blobel@klinik.uni-regensburg.de
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp
  • Kathleen Connor Kathleen.connor@comcast.net
  • Marilyn Harthoorn m.harthoorn@furore.com


Security WG Project Meeting

Wednesday Q1

Attendees: See EHR WG Minutes

Joint w/ EHR, CBCC, FHIR, SOA, Security

  • 1. ISO 21089:2017 Trusted End-to-End Information Flows - approved and preparing for publication.
  • 2. Development of Privacy, Security, Provenance and Digital Ledger Technology Conformance Testing Suite
    • a. Kathleen Connor, John Moehrke
    • b. With Mario Hyland – AEGIS – HL7 Testing Partner
      • i. AEGIS Touchdown Project FHIR testing platform
    • c. Use Case: US VA Cascading OAuth Server
      • i. Expectation is that WGs will bring any test cases [e.g., Cascading OAuth for Patient Right of Access] have been developed or input to test cases
    • d. Use Case: Provenance – e.g., US S&I DPROV System Events
  • 3. FHIR STU-3
    • a. Record Lifecycle Events IG
    • b. Implementer’s Safety Checklist
    • c. W5 Report – Key Metadata Alignment across FHIR Resources
  • 4. EU General Data Protection Regulation (GDPR)

)

    • b. Paradigm change for health systems – context of adaptable policy design as well as systems design. Including – demographic changes, expectations, fundamental right for equal care, technological developments and so on.
    • c. Intent of a single framework across Europe.

Wednesday Q2

Attendees: See SOA Minutes

Joint w/ SOA

  • PASS Audit topics (joint w Security, CBCC, SOA)
  • Two projects with SEC/SOA
    • Project 914 PASS Audit
      • Front page incorrect 2 Negatives (John / Keith) remaining in ballot from Jan 2017. But only 1 listed on stats http://www.hl7.org/ctl.cfm?action=ballots.tallydetail&ballot_id=1488&ballot_cycle_id=542&ballot_voter_id=8783
      • ACTION: Trish to ask Kathleen for reconciliation in the spreadsheet- clarify status of the -negative and how they need to be resolved. Trish to report back to SOA. RESPONSE: All comments were reconciled and the negative commenters asked to withdraw - however, as it is an informative document there is no necessity to withdraw votes. I expect that this is how it will remain - even though there is a discrepancy between the total (1 negative) and 2 listed in the detail below!
    • Post-ballot comments new version has an extended name, no change to the project number.



    • For noting: New project 1316 Integrated Information Models and Tools(IIM&T)
      • Taking EHR system functional model and describing it in CIMI modelling terminology
      • The original model included Security but the new project is not sponsored yet by SEC WG.

Wednesday Q3

Attendees:

  • John Moehrke John.Moehrke@gmail.com
  • Alexander Mense alexander.mense@hl7.at
  • Princess Trish Williams patricia.williams@flinders.edu.au
  • Kathleen Connor Kathleen.connor@comcast.net
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp
  • Bernd Blobel bernd.blobel@klinik.uni-regensburg.de
  • Kevin Shekleton kshekleton@cerner.com
  • Karl Holzer karl.holzer@cgm.com
  • Chris Grenz chris.grenz@analysts.com
  • David Hay david.hay25@gmail.com
  • afarkas@infoway.ca
  • wjones46@dxc.com
  • v.peretokin@furore.com
  • Richard Kavanagh richard.kavanagh@nhs.net
  • Dennis Patterson dennis.patterson@cerner.com
  • Adam Hatherly adam.hatherly@nhs.net
  • Oliver Krauss oliver.krauss@fh-hageberg.at
  • Oliver Egger oliver.egger@ahdis.ch
  • Drew Torres drew.torres@cerner.com
  • isaac@epic.com
  • Josh Mandel Joshua.Mandel@childrens.harvard.edu

Security WG deep FHIR topics

  • SMART on FHIR
    • Scope of SMART in FHIR is intended to be international, and the protocol from SMART App Launch framework – which can be launched from inside or outside the EHR.
    • Data profiles can be specified nationally or internationally.
    • SMART App Launch: design principles
      • Give what is needed for secure interoperability
        • E.g. OAuth (bearer tokens) and OICD
      • Focus on vanilla features of standard frameworks.
    • What is an App Launch?
      • Health data – access token (e.g. FHIR API) and Contextual data (end user identity).
      • OAuth normal flow used.
      • Limiting access approach – OAuth scopes – granular permissions (relates to FHIR resources types)
    • Authorisation Risk Assessment (Argonaut Project) – provides guiding developer facing documentation and worth reading. For example – Residual Risks would include EHR Developer and App Developer Responsibilities, and Public Client support via CORS.
    • bit.ly/smart-app-launch-hl7

Wednesday Q4

Attendees:

  • Alexander Mense alexander.mense@hl7.at
  • Princess Trish Williams patricia.williams@flinders.edu.au
  • Kathleen Connor Kathleen.connor@comcast.net
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp
  • Bernd Blobel bernd.blobel@klinik.uni-regensburg.de

Security WG Project Meeting

  • Continue TF4FA Reconciliation

Thursday Q1

Attendees:

Security Joint with CBCC,FHIR-I

  • Josh assigned FHIR Core team
  • Continued: FHIR Connectathon Privacy and Security testing scenarios
  • how might GraphDefinition be used with Provenance? How might it be used in an Audit Analysis/Reporting?
  • how might a client that get subsetted/redacted data be enabled to do Update/Patch?
    • Subsetted by _summary
    • Subsetted by some client request (not yet available, is this a FHIR-I work item?)
      • Some mechanism that is based on profiles, where client asks data to be subsetted to the constraints in a profile
    • Subsetted by redaction rules -- where communicating the redaction result
    • So That - when an update happens, the server knows that the client is NOT asking to have the elements missing be removed from the server copy.
    • What might be issues?
  • Can we use a general subsetting type of a profile to enable more complete de-identification algorithms.

Thursday Q2

Attendees:

  • John Moehrke John.Moehrke@gmail.com
  • Alexander Mense alexander.mense@hl7.at
  • Princess Trish Williams patricia.williams@flinders.edu.au
  • Kathleen Connor Kathleen.connor@comcast.net
  • Hideyuki Miyohara miyohara.hideyuki@ap.mitsubishi-electric.co.jp


WorkGroup discussion on directions from TSC

  • Look at Mission and Charter and does the WG name reflect what the SEC WG does.
    • Discussion included consideration of adding Privacy to the WG name. However, we enforce policies on consent and provenance etc, but not defining the Patient Consent interaction with the patient.
    • Also we focus on technical controls. ISO calls WG4 Security, Privacy and Safety.
    • Consensus that the name should remain the same. The mission and charter can articulate the narrative of policy and controls and contribute and enable other standards in HL7.
    • The SCOPE for the WG was discussed and revised. Refer to the new Mission and Charter document. Alex to continue revision and organize vote and post.
    • Decision Making Processes [v6.0] reviewed and reconfirmed. Motion to readopt DMP (Kathleen proposed/John seconded) Passed 4/0/0.
  • Discussion on meetings for next WGM and liaison with other WGs -for instance Health Care Devices, Mobile Health.
    • For the next WGM, Security WG will email to Co-Chairs to offer a Sec representative to attend a session with them, at their request. This will be offered for Tues Q4 or Wed Q2 (existing Joint with SOA with a Sec Representative will still occur). The first 4 requests will be accepted. This is a trial for the next WGM, and will be reassessed at the next meeting. Trish sent email 11/5/17.
  • Re-instate calls - Alex to do.

Security WG Project Meeting

  • July Harmonization Proposals: Signature Types
    • Addition to FHIR Agent value set
    • POU additions - HTEST, Research Consent POUs
    • Prose Object code system
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