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Enforceable Specification of Privacy. Peter Mork Jean Stanford. CEM IR&D. Problem. Growing need for Health Information Exchange Continuity of care Decreased costs Public health reporting Facilitate clinical research Health Information Exchange requires patient consent: Paper-based
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Enforceable Specification of Privacy Peter MorkJean Stanford CEM IR&D
Problem • Growing need for Health Information Exchange • Continuity of care • Decreased costs • Public health reporting • Facilitate clinical research • Health Information Exchange requires patient consent: • Paper-based • One form per transaction • Non-transferrable • Signed with limited time to think
Background DoD VA Paper consent forms prevent seamless health information exchange
Objective • Support Meaningful & Granular Patient Consent • Globally Accessible by: • Patients and • Record Holders • Platform Adaptable • Modular Design adapts to: • Technology Changes • Legal Changes
Activities • Developed rules language for consent: • Basic constructs = purpose, topics, datatypes, time, etc. • Two forms of negation • Terminological hierarchies • Reusable knowledge components • Policy reasoner: • Input = Patient preferences + request • Output = Minimized rule tree • Policy enforcement: • Conversion to XACML • Prototype of EHR with XACML engine
Highlight Request Server (e.g., hData) Browser Record Holder Server Consent Server EHR Policy Enforcer Consent DB Policy Reasoner
Demonstration Dr. Walsh: Purpose = Treatment (Medications or Allergies) and not Mental Health
Impacts • Sponsor Engagements: • Office of the National Coordinator • Substance Abuse and Mental Health Services Administration • Department of Veteran’s Affairs • Other Engagements: • Healthcare Information and Management Systems Society • GE Healthcare • United Health • Open Source: • https://sourceforge.net/projects/kaironconsents/
Future Plans High Integrate with State Mandates Automated Enforcement Intelligent Redaction Eliciting Patient Preferences Integrate Care Relationships Implemented Technical Complexity Under Development Patient Review & Approve Grand Challenges Credential Matching Preemptory Access Audit Low Accepted Practices Policy Maturity Inchoate