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PERMISSION ONTOLOGY FOR INFORMED CONSENT AND HIPAA COMPLIANCE. Maria Adela Grando PhD mgrando@ucsd.edu Division Biomedical Informatics, University California San Diego. CTSA ONTOLOGY WORKSHOP - Febrary 11st 2013, Orlando-. STATE OF THE ART.
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PERMISSION ONTOLOGY FOR INFORMED CONSENT AND HIPAA COMPLIANCE Maria Adela Grando PhD mgrando@ucsd.edu Division Biomedical Informatics, University California San Diego CTSA ONTOLOGY WORKSHOP - Febrary 11st 2013, Orlando-
STATE OF THE ART • Mostly, the research enterprise relies on paper-based Informed Consent documents which contains permissions given by subjects to share specimens and clinical data for future research. • It is rare that consent forms are collected electronically. • There is potential to use electronic Informed Consents for: • providing compliance with subject’s permissions, while maximizing access to resources
informed CONsent for clinical record and Sample use in research (iCONS) I share my blood samples with non-profit US researchers As a Stanford researcher can I get blood samples? Healthcare Institution Look-up Registry I can check publications generated from my data and samples Query User U requests Data D and sample S to perform operation O on subjects like I under constraints C Clinical Data Warehouse Research Institution Home Permission Repository Electronic IC I authorize U to perform operation O over my data D or sample S under certain constraints C Informed Consent Management System Resource Mediator Results User U receives data D and sample S in compliance with subject’s permission Patient I User U BioSample Repository Permission Ontology
PERMISSION ONTOLOGY • For describing permissions obtained from subjects who signed an Informed Consent or HIPAA form, in a uniform, machine-interpretable, implementation-independent way • To enable interoperability and sharing of Informed Consent permissions and HIPAA constraintsbetween clinical data warehouses and bio-repositories, independently of their implementation choices.
SNAPSHOT PERMISSION ONTOLOGY A <subject> has <permission> or <obligation> to perform an <operation> over <biological specimens> or <medical records> under constraints
RESOURCE MEDIATOR • We have built for UCSD Moores Cancer Center Biorepositorya Resource Mediator Prototype, for: • Providing researchers access to clinical data and biospecimens resulting from the research study “Collection and Banking of Tissue, Blood and Urine for Use in Cancer Research” • We have tested the prototype with: • de-identified patient cases (700 patients, 2635 medical record entries) • 8 randomly chosen (from 33) researchers’ requests for data and samples
RESOURCE MEDIATOR 1) Are the resources available? 2) Is in compliance with subject’s permissions and HIPAA constraints? Can I have access to blood samples and diagnostic data from patients with breast cancer?
RESOURCE MEDIATOR We have provided ontology-reasoning for determining compliance with IC permissions and HIPAA constraints: User Urequest access to patient treatment history User U is denied by HIPAA access to alcohol abuse treatment history User U has IC permission to access cancer treatment history User U has IC permission to access cancer treatment history
CONCLUSIONS • There is a need for: • a standard to maximize the availability of resources while providing compliance with subject’s Informed Consent permissions and HIPAA constraints • We propose: • an Electronic Informed Consent Management System, • aPermission Ontology, • a Resource Mediator based on an hybrid approach combining the proposed Permission Ontology and a XACML-policy engine
FUTURE WORK Institution A Clinical Data Warehouse BioSample Repository IC Form + HIPAA Permission Repository Query User U requests Data D and sample S to perform Operation Oon subjects like I under constraints C Research Institution Resource Mediator Institution B Clinical Data Warehouse BioSample Repository Results User U receives data D and sample S in compliance with subject’s User U IC Form + HIPAA Permission Repository Permission Ontology
ACKNOWLEDGEMENT 5 year NIH-founded National Center for Biomedical Computing, started in September 2010.
Collaborators Development Team • Aziz Boxwala (Project management) • Joanne Barker (Health Communications) • Mona Wong (App Development) • Jeff Sale (App Development) • Elizabeth Johnstone (Literature review) Advisors • Richard Schwab (MCC Biorepository) • Michael Caligiuri (HRPP chair) • Scott Vandenberg (Director, Tissue Repository) • Michael Kalichman (Director, Center for Ethics) • Angela McMahill (Research Compliance Officer)
MATERIAL FOR THOUGHT… • Permission Ontology available at NCBO Bioportal: http://bioportal.bioontology.org/ • M. A. Grando, R. Schwab, A. Boxwala, N. Alipanah, ”Ontological approach for the management of informed consent permissions“ (2012), accepted for 2nd IEEE Conference on Healthcare informatics, Imaging, and Systems Biology, September 27-28, UCSD, San Diego. To appear. Available on request.