Might I suggest that the ConsentDirective project include a "Basic-ConsentDirective" that supports blanket consents without exceptions. Essentially the common HIE policies from BPPC. These would be scoped to sharing beyond the original organization and purpose for which the health information was created. This form of a Consent Directive would need only (identifier, issued, applies, subject, authority, domain, type=consent, subtype=<some vocabulary>, and possibly friendly and legal). This Basic Consent Directive would support the following HIE subtypes:

1) Opt-In – Agree to publish "All" healthcare information. Agree to Use and Disclosure to "any" authorized individual of a "Treatment" or "Payment" organization "For the Purpose" of "Treatment" or "Payment". No Redisclosure allowed without further authorization. This agreement does not authorize other accesses.

2) Opt-Out allowing break-glass – Agree to publish "All" healthcare information. Agree to Use and Disclosure to "any" authorized individual of a Treatment organization for specifically "Emergency Treatment" PurpoeOfUse, and Payment of those treatment. This agreement does not authorize other accesses.

3) Opt-In summary access only – Agree to publish "All" healthcare information. Agree to Use and Disclosure to "any" authorized individual of a "Treatment" or "Payment" organization "For the Purpose" of "Treatment" or "Payment"; to only the medications and allergies summary. No Redisclosure allowed without further authorization. This agreement does not authorize other accesses.

4) Opt-In break-glass summary access only – Agree to publish "All" healthcare information. Agree to Use and Disclosure to "any" authorized individual of a "Treatment" organization "For the Purpose" of "Emergency Treatment" and Payment of those treatment; to only the medications and allergies summary. No Redisclosure allowed without further authorization. This agreement does not authorize other accesses.

5) Opt-Out no break-glass – Agree to publish "All" healthcare information. This agreement does not authorize any accesses.

6) Opt-Out completely – Agree to publish "No" healthcare information beyond originating organization intended use.