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Type:
Change Request
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Resolution: Not Persuasive with Modification
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Priority:
Medium
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US Da Vinci HRex (FHIR)
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Financial Mgmt
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Profile overview [deprecated]
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•Push •Pull •Request
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Richard Esmond / Marti Velezis : 9-0-0
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Enhancement
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Non-substantive
Existing Wording: HRexPush (POST and PUT)
https://build.fhir.org/ig/HL7/davinci-ehrx/Push_(POST_and_PUT).html
Hrex PUSH
https://build.fhir.org/ig/HL7/davinci-ehrx/Push_(Unsolicited_Communication).html>
HRex GET
https://build.fhir.org/ig/HL7/davinci-ehrx/Pull_(GET).html
Authorization
The Information Server adheres to business rules that govern which patients can be queried by authorized Information Clients, and what information can be returned to Information Clients.
HRex leverages core FHIR security principles (https://www.hl7.org/fhir/security.html) and SMART on FHIR (http://docs.smarthealthit.org/).
From <https://build.fhir.org/ig/HL7/davinci-ehrx/Pull_(GET).html>
Comment:
At each of the HRex interactions [links in existing wording cell] this IG states that HRex leverages to HL7 FHIR Security principles and SMART on FHIR. This generic citation to abstract guidance and OAuth 2.0 authorization profile is far from sufficient for the types of use cases in CDex and PDex that are implemented using HRex interactions.
Generally, each of the Hrex Interactions merits Security and Privacy considerations comparable to Member Mediated Exchange @ http://hl7.org/implement/standards/fhir/us/davinci-pdex/2019Jun/2-2_Member_Consent.html and 7 Member-Authorized OAuth2 Exchange @ http://hl7.org/implement/standards/fhir/us/davinci-pdex/2019Jun/7_Member-Authorized_OAuth2_Exchange.html as applicable to these diverse use cases and the US policy domains in which these interactions are envisioned to occur. That said, even these guidance do not address the requirement that an individual must sign a Right of Access directive according to OCR [https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html#newlyreleasedfaqs]
The IG authors should set up time with the Security and CBCP WGs to help them with the gaps in this IG and those IGs inheriting from HRex to sort out the privacy and security requirements needed to progress this and relying IGs. Much more work on S&P is needed, such as the authors devoted to the Member_Consent, to progress HRex.
Summary:
At each of the HRex interactions , this IG states that HRex leverages to HL7 FHIR Security principles and SMART on FHIR which is far from sufficient.
- is voted on by
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BALLOT-9798 Negative - Kenneth Rubin : 2019-Sep-FHIR IG HRex R1
- Balloted