1. Alice calls the practice and schedules her initial appointment.

A. The Scheduler does not find an existing account for Alice and creates a new account.

                             i.       Local account – Alice may not know

                            ii.       Could bind an external account/identity to it – binding ceremony

                          iii.       Object at database/table – that point to Alice OIDC + Public key or other stuff

B. The Scheduler creates an appointment with the PCP Alice has selected.

2. Alice arrives at the practice and registers with the front desk.

A. Alice provides the Registrar with her driver’s license and insure card(s).

                             i.        – id proofing process

                            ii.       online eligibility checking – what is covered? payment

                          iii.       collect and scan – but how about verification ?

B. The Registrar scan the cards and updates Alice’s account.

                             i.       Id proofing

                            ii.       Can this ID process be re-used “known to the practice?”  How can we represent that within the protocols?

                          iii.       FITS into vectors of trust in IETF work

1.1.1.2.B.iii.1. Verify holder of claims/document with identity– high level of confidence

1.1.1.2.B.iii.2. Onboarding ceremony can bind and verify separately

1.1.1.2.B.iii.3. Quick photograph and imbed into record for evidence of practice.

                           iv.       How does the profiles represent the level of trusts – two levels of proofing  - trust elevation  -

1.1.1.2.B.iv.1. (bill concerns) Login to phr - portals will create login account – Alice has a choice – PCP or PHR - potential to use multiple accounts with different levels of trust – how does the levels of trust get described across relying parties/resource servers (?) How do we know Alice is Alice?

1.1.1.2.B.iv.2. Alice should have the choice to use whatever. Identity to bind external accounts with local accounts is powerful

1.1.1.2.B.iv.3. When alice goes to specialist – why would alice need an additional proofing? Specialist can always do their own binding process.

1.1.1.2.B.iv.4. Who is the system of record – not bound in OAUTH world. Alice could prove in multi- ways.

1.1.1.2.B.iv.5. FHIR Referral message – between provider – I am referring to alice –I know here as 1234 – she used cred (issuer/subject) – if you trust me - let her in – save binding ceremony. Who’s to trust bits of information –

1.1.1.2.B.iv.6. If FHIR API increases patient engagement going forward …once Alice has set up credential –next system –if level of trust – should be able to transfer /share information.

                            v.       More info – vectors of trust and binding … take advantage of capabilities that did not exist in paper world