John Bradley convened the meeting.

He presented the Note Well language. The purpose is to protect against encumbered work product.

John himself is in observer mode and will only help with procedural issues because his contribution agreement doesn’t yet cover this WG.

The group reviewed the provisional agenda:

Introduction to OIDF
Roll call
Review and adoption of charter (moved up from the original plan)
Election of co-chairs
Introductory comments to HEART
Logistics
Timeline
AOB

Introduction to OIDF: John B, in his treasurer role, invited people to join OIDF.

Roll call: Debbie as convener conducted roll against a spreadsheet constructed by John B.

Present:

Allen Byerly
Warren Kolber
Catherine Schulten
Adrian Gropper
Deborah Bucci
Nat Sakimura
Eve Maler

Absent:

Majeed Almadan
Vladimir Dzhuvinov
Michael Varley
Mike Jones
Don Thibeau

Quorum was reached.

Process question: Are those with agreements for other groups able to participate in this group without taking special action? No, they must fill out contribution forms for their own protection.

MOTION: Accept Debbie Bucci and Eve Maler as co-chairs of the WG. PASSED by unanimous consent.

Debbie in her new role as co-chair thanked everyone for their support of the effort. Conversations with MIT, data aggregators, health app creators, HIEs, and FHIR contributors have been productive, and the federal advisory committees’ recognition of the importance of OAuth and related technologies has been helpful.

Eve reviewed the charter (http://openid.net/wg/heart/charter/).

Question about method of work: What is the canonical place for discussion: email list vs. telecon vs. other? IETF is email list because it’s a written record. Recording calls is an option, but that’s not particularly accessible. Some other OIDF groups use a hybrid approach. Sufficient controversy to create an issue around this has been rare; the process seeks consensus. Formal voting is the most accurate method in the OIDF case.

Initial contributions: The Mitre Corporation contributed draft profiles (http://secure-restful-interface-profile.github.io/pages/). To see the “HEART Venn” referred to by Debbie, see these IIW XIX session notes:

http://iiw.idcommons.net/Health_–Relationship–_Turst:_Come_hare_about_the_new_HEART_WG_at_Open_ID_Foundation

MOTION: Moved by Eve, seconded by Adrian: Accept WG charter. PASSED by unanimous consent.

First work effort: use cases. Ground rules: identify real-life use cases, implementable in the next couple of years. Separate general profiles that are reusable/layered outside of healthcare and identify special needs, such as FHIR. Be iterative.

Justin posted links to the profiles, surrounding documentation, and pilot results to the HEART list. The use case involved a patient, a veteran named Steve, logging in to a portal for his doctor, Dr. Pat Feelgood, using his own externally hosted personal digital identity. In that pilot, his identity was bound to a particular medical record, and they left that not fully profiled. He’d like to tackle that in HEART. He can use that identity to authorize data access to an app that he trusts. This involves OAuth and OIDC. The veteran is able to reuse his existing identity in a flexible and user-focused way.

The next thing they wanted to show is how to use this across three different secure domains. Steve, on vacation, is on an accident and is in an ER not affiliated with his PCP. So the ER has to pull his VA record. He has to log in using OIDC and his personal digital identity into a VA-controlled authorization server, and approve access to the ER using OAuth. This is an intersection of three distinct security domains to allow access to medical records that are under end user Steve’s control. Dr. Feelgood also needs to log in to the ER directly to get records left for her there. There’s a “hole” left for how to manage this.

All three legs of the provider-provider-patient triangle are important, and need to use the same protocols and security mechanisms.

This is all an extension of the RHex protocol developed some years ago, where they considered both provider-provider and patient-provider requirements.

If someone is in a car accident, and they’re alert and awake but and they’re not in a part of town where their medical records are kept, what are the consequences? Justin recommends focusing on “alert patient” scenarios vs. “break-the-glass” scenarios so that we don’t go down unconscious-in-the-ER ratholes, which are like the “Godwin’s law” of health IT use cases. Eve does want to include use cases that include asynchronous consent, but understands the tendency Justin describes. Debbie agrees that delegation is an important element of what we want to solve.

Right now we’re discovering relevant use cases, and maybe we’re not solving them all.

NOTE: We’re not meeting next Monday because it’s a holiday for many of us. We will meet next on Monday, January 26.