Privacy Consent on FHIR (PCF)
1.1.1-current - ci-build International flag

Privacy Consent on FHIR (PCF), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.1.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.PCF/ and changes regularly. See the Directory of published versions

Example Consent: Consent allowing NORMAL and focused Mental Health data access

Generated Narrative: Consent ex-consent-advanced-normal-focused-psy

status: Active

scope: Privacy Consent

category: Consent

patient: Jack Smith Male, DoB: 1923-07-25

dateTime: 2022-06-13

performer: Jack Smith Male, DoB: 1923-07-25

organization: Organization somewhere org

source: DocumentReference: status = current; type = Release of information consent; description = The captured signed document

Policies

-Uri
*http://example.org/policies/basePrivacyConsentPolicy.txt

provision

type: Opt In

securityLabel: Confidentiality N: normal

purpose: ActReason TREAT: treatment, ActReason HPAYMT: healthcare payment, ActReason HOPERAT: healthcare operations

provision

type: Opt In

Actors

-RoleReference
*information recipientPractitioner: telecom = Practitioner@example.com

securityLabel: ActCode PSY: psychiatry disorder information sensitivity

Notes:

IUA Access Token

Provided an ITI-71 results in a PERMIT access token issued. That token would have the following residual element to inform the Consent Enforcement Point that it needs to restrict the results.

Given that the token will express the permit portion, the residual would need to express the refinement. This case allows treatment access to normal data, and carves out mental health data as accessible only to Practitioner. The oAuth token would be expressing a general permit for most users to the given patient data. Possibly with scope restrictions based on other business rules, such as a subset of actions (CRUDE) and resources.

The token would need to include an ihe_pcf extension to point at this consent, and that would include a residual to express the refinement. Shown as followed:

For Users that are not Practitioner, the token result will be no different than consent to allow NORMAL data access

For the User Practitioner, the token result will be:

  • The restriction to the given purpose (Treatment, Payment, and Operations) would be expressed in the ihe_iua extension
    • The other ihe_iua extension parameters are not shown below
  • The restriction to just normal data would need to be expressed:
    • First as a forbid everything
    • Second as a permit normal data
    • Third is to permit Mental Health data
"extensions" : {
  "ihe_iua" : {
    ...
    "purpose_of_use" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "TREAT"
      },{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "HPAYMT"
      },{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "HOPERAT"
    }]
  }
  "ihe_pcf" : {
    "patient_id" : "http://example.org/fhir/Patient/ex-patient",
    "doc_id" : ["http://example.org/fhir/Consent/ex-consent-intermediate-authoredby"],
    "residual" : [
      {
        "type" : "forbid",
      },{
        "type" : "permit",
        "securityLabel" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
            "code" : "N"
        }]
      },{
        "type" : "permit",
        "securityLabel" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
            "code" : "PSY"
        }]
      }
    ]
  }
}