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Enforceable Specification of Privacy Peter Mork Jean Stanford CEM IR&D
© 2011 The MITRE Corporation. All rights reserved 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
© 2011 The MITRE Corporation. All rights reserved Background Paper consent forms prevent seamless health information exchange VA DoD
© 2011 The MITRE Corporation. All rights reserved Objective Support Meaningful & Granular Patient Consent Globally Accessible by: –Patients and –Record Holders Platform Adaptable Modular Design adapts to: –Technology Changes –Legal Changes
© 2011 The MITRE Corporation. All rights reserved 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
© 2011 The MITRE Corporation. All rights reserved Highlight Request Server (e.g., hData) Record Holder Server EHREHR BrowserBrowser Consent Server Consent DB Policy Reasoner Policy Enforcer
© 2011 The MITRE Corporation. All rights reserved Demonstration Allow Direct Care Providers X = Primary Care Provider Referral from X to Recipient Purpose = Treatment Allowed Categories MedicationsAllergies ¬ Mental Health Purpose = Treatment Dr. BlassResearch Purpose = Research Anonymized¬ Imagery ¬ Mental Health Purpose = Emergency ¬ Mental Health Dr. Walsh: Purpose = Treatment Dr. Walsh: Purpose = Treatment (Medications or Allergies) and not Mental Health
© 2011 The MITRE Corporation. All rights reserved 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/https://sourceforge.net/projects/kaironconsents/
© 2011 The MITRE Corporation. All rights reserved Future Plans Policy Maturity Accepted Practices Inchoate Technical Complexity Low High Preemptory Access Patient Review & Approve Integrate with State Mandates Intelligent Redaction Credential Matching Eliciting Patient Preferences Automated Enforcement Implemented Grand Challenges Under Development Integrate Care Relationships Audit
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