The US Healthcare system is very complex. In some cases, major health systems manage all of their providers, labs, tests, and procedures in an interconnected network of medical systems. Alternatively, care often occurs in a community system where the hospital, private practice, and lab centers may reside on completely different electronic medical systems. In the case of medical emergencies, it's likely that participants of the larger health care system may seek treatment in a community emergency setting as well.
Many of these systems and providers have web and/or mobile portals as a means to provide patients with access to their own health data and ultimately support patients in the self management of their illness.
Alice is a globetrotting nurse and humanitarian who has lived an adventurous and extraordinary life. The nature of that lifestyle had taken its toll on her. For a time, she settled in small town in the US. Now that her children are grown, she has volunteered as a nurse with an international health organization and will be deployed outside the US for the next few years. Alice is not part of a major health system; thus, a majority of her care occurs in a community setting. Alice wants to be proactive and ensure that all her medical information is up to date, is electronically accessible, and can be assembled on demand as needed.
Alice has a complex medical history that requires her to see multiple providers, obtain frequent lab and diagnostic tests, use health monitoring devices, and take a number of medications as part of her health maintenance. Alice has addictive behaviors and has undergone treatment at a substance abuse center. The center continues to monitor her condition on a semiannual basis. She is of special interest to the center given that she spent some time in a war zone. During that experience, she received physical injuries that continue to cause her pain today and stress-related symptoms, and contracted HIV treating the wounded. As she has aged, she is also being treated for high blood pressure and type 2 diabetes.
In preparation for her travels, she has designated her son to be her delegate in the case of emergencies and he is aware of both her consent preference and advance directives.
Authorization Problems Summary
U2.1 Alice wants to selectively choose which pieces of their health information can be exchanged among her providers.
U2.2 Alice wants to quickly assemble information from across various medical resources.
U2.3 Alice wants to control and share pertinent device data as part of her medical record.
U2.4 Alice wants to delegate control of her health information to her son.
U2.5 Alice wants to pre-authorize the exchange of information where possible and is able to authorize in real time if necessary
U2.6 Although Alice has declared her preferences, her authorization may conflict with other security domains such as state and international policies.