National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

Extension: NDH Trust Framework

Official URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-trustFramework Version: 1.0.0-ballot
Active as of 2024-06-17 Computable Name: TrustFramework

A trust framework typically requires the use of signed artifacts and public certificates to ensure security, integrity, and trust in digital communications and transactions. For trust frameworks that use private PKI there is no need to use this extension unless the goals is to provide access to endpoints via the endpoint reference on any of the relevant resources (e.g., careteam, healthcareService).

Context of Use

This extension may be used on the following element(s):

  • Element ID Endpoint

Usage info

Usage:

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Complex Extension: A trust framework typically requires the use of signed artifacts and public certificates to ensure security, integrity, and trust in digital communications and transactions. For trust frameworks that use private PKI there is no need to use this extension unless the goals is to provide access to endpoints via the endpoint reference on any of the relevant resources (e.g., careteam, healthcareService).

  • trustFrameworkType: CodeableConcept: An Extension
  • qualifier: string: An Extension
  • signedArtifact: base64Binary: An Extension
  • publicCertificate: base64Binary: An Extension

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension NDH Trust Framework
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:trustFrameworkType S 1..1 Extension Trust Framework Type
..... extension 0..0
..... url 1..1 uri "trustFrameworkType"
..... value[x] 0..1 CodeableConcept Value of extension
Binding: Trust Framework Type Value Set (extensible)
.... extension:qualifier S 0..1 Extension A qualifier associates with an endpoint to provide additional context or information about that endpoint in a trust framework community. Qualifiers are used to help other members of the community understand the capabilities, compliance status, or other relevant characteristics of an endpoint.
..... extension 0..0
..... url 1..1 uri "qualifier"
..... value[x] 1..1 string Value of extension
.... extension:signedArtifact 0..1 Extension By utilizing a signed artifact, you can identify which Certificate Authority has issued the certificate for the entity that signed the artifact. Verifying the issuing Certificate Authority is crucial because it adds an additional layer of trust and security, ensuring that the entity involved in the data exchange is legitimate and that their digital identity has been properly validated.
..... extension 0..0
..... url 1..1 uri "signedArtifact"
..... value[x] 1..1 base64Binary Value of extension
.... extension:publicCertificate 0..1 Extension Public certificates help in affirming that an entity is indeed who they claim to be. These certificates are used to establish secure connections via the Mutual TLS (Transport Layer Security) protocol. Public certificates issued by Certificate Authorities are fundamental in establishing a secure and trustworthy digital environment. They enable secure communication, ensure data integrity, and facilitate authentication and trust across a wide range of online interactions.
..... extension 0..0
..... url 1..1 uri "publicCertificate"
..... value[x] 1..1 base64Binary Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-trustFramework"

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension NDH Trust Framework
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:trustFrameworkType S 1..1 Extension Trust Framework Type
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "trustFrameworkType"
..... value[x] 0..1 CodeableConcept Value of extension
Binding: Trust Framework Type Value Set (extensible)
.... extension:qualifier S 0..1 Extension A qualifier associates with an endpoint to provide additional context or information about that endpoint in a trust framework community. Qualifiers are used to help other members of the community understand the capabilities, compliance status, or other relevant characteristics of an endpoint.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "qualifier"
..... value[x] 1..1 string Value of extension
.... extension:signedArtifact 0..1 Extension By utilizing a signed artifact, you can identify which Certificate Authority has issued the certificate for the entity that signed the artifact. Verifying the issuing Certificate Authority is crucial because it adds an additional layer of trust and security, ensuring that the entity involved in the data exchange is legitimate and that their digital identity has been properly validated.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "signedArtifact"
..... value[x] 1..1 base64Binary Value of extension
.... extension:publicCertificate 0..1 Extension Public certificates help in affirming that an entity is indeed who they claim to be. These certificates are used to establish secure connections via the Mutual TLS (Transport Layer Security) protocol. Public certificates issued by Certificate Authorities are fundamental in establishing a secure and trustworthy digital environment. They enable secure communication, ensure data integrity, and facilitate authentication and trust across a wide range of online interactions.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "publicCertificate"
..... value[x] 1..1 base64Binary Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-trustFramework"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: A trust framework typically requires the use of signed artifacts and public certificates to ensure security, integrity, and trust in digital communications and transactions. For trust frameworks that use private PKI there is no need to use this extension unless the goals is to provide access to endpoints via the endpoint reference on any of the relevant resources (e.g., careteam, healthcareService).

  • trustFrameworkType: CodeableConcept: An Extension
  • qualifier: string: An Extension
  • signedArtifact: base64Binary: An Extension
  • publicCertificate: base64Binary: An Extension

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension NDH Trust Framework
... extension 1..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:trustFrameworkType S 1..1 Extension Trust Framework Type
..... extension 0..0
..... url 1..1 uri "trustFrameworkType"
..... value[x] 0..1 CodeableConcept Value of extension
Binding: Trust Framework Type Value Set (extensible)
.... extension:qualifier S 0..1 Extension A qualifier associates with an endpoint to provide additional context or information about that endpoint in a trust framework community. Qualifiers are used to help other members of the community understand the capabilities, compliance status, or other relevant characteristics of an endpoint.
..... extension 0..0
..... url 1..1 uri "qualifier"
..... value[x] 1..1 string Value of extension
.... extension:signedArtifact 0..1 Extension By utilizing a signed artifact, you can identify which Certificate Authority has issued the certificate for the entity that signed the artifact. Verifying the issuing Certificate Authority is crucial because it adds an additional layer of trust and security, ensuring that the entity involved in the data exchange is legitimate and that their digital identity has been properly validated.
..... extension 0..0
..... url 1..1 uri "signedArtifact"
..... value[x] 1..1 base64Binary Value of extension
.... extension:publicCertificate 0..1 Extension Public certificates help in affirming that an entity is indeed who they claim to be. These certificates are used to establish secure connections via the Mutual TLS (Transport Layer Security) protocol. Public certificates issued by Certificate Authorities are fundamental in establishing a secure and trustworthy digital environment. They enable secure communication, ensure data integrity, and facilitate authentication and trust across a wide range of online interactions.
..... extension 0..0
..... url 1..1 uri "publicCertificate"
..... value[x] 1..1 base64Binary Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-trustFramework"

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..* Extension NDH Trust Framework
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:trustFrameworkType S 1..1 Extension Trust Framework Type
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "trustFrameworkType"
..... value[x] 0..1 CodeableConcept Value of extension
Binding: Trust Framework Type Value Set (extensible)
.... extension:qualifier S 0..1 Extension A qualifier associates with an endpoint to provide additional context or information about that endpoint in a trust framework community. Qualifiers are used to help other members of the community understand the capabilities, compliance status, or other relevant characteristics of an endpoint.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "qualifier"
..... value[x] 1..1 string Value of extension
.... extension:signedArtifact 0..1 Extension By utilizing a signed artifact, you can identify which Certificate Authority has issued the certificate for the entity that signed the artifact. Verifying the issuing Certificate Authority is crucial because it adds an additional layer of trust and security, ensuring that the entity involved in the data exchange is legitimate and that their digital identity has been properly validated.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "signedArtifact"
..... value[x] 1..1 base64Binary Value of extension
.... extension:publicCertificate 0..1 Extension Public certificates help in affirming that an entity is indeed who they claim to be. These certificates are used to establish secure connections via the Mutual TLS (Transport Layer Security) protocol. Public certificates issued by Certificate Authorities are fundamental in establishing a secure and trustworthy digital environment. They enable secure communication, ensure data integrity, and facilitate authentication and trust across a wide range of online interactions.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0
..... url 1..1 uri "publicCertificate"
..... value[x] 1..1 base64Binary Value of extension
... url 1..1 uri "http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-trustFramework"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:trustFrameworkType.value[x]extensibleTrustFrameworkTypeVS (a valid code from Trust FrameworkType Code System)
http://hl7.org/fhir/us/ndh/ValueSet/TrustFrameworkTypeVS
from this IG

Notes:

A trust framework is a structured set of rules, policies, protocols, and standards that define how trust is established, managed, and maintained between different entities (such as organizations, systems, or users) involved in the exchange of healthcare information. It provides the guidelines and technical specifications to ensure secure, interoperable, and reliable data exchange. SMART, UDAP, and DirectTrust are examples of trust frameworks.

Sometimes, people refer to CareQuality, CommonWell, or TEFCA as trust frameworks, although they are actually trust communities. These communities agree to follow a trust framework to securely exchange health information. In practice, different communities may use the same trust framework with some additional rules. As a result, implementers may use the terms trust framework and trust community interchangeably.