Add RESTful Query to ATNA

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Add RESTful Query to ATNA

Introduction

Event logging is a system facility that is used by healthcare applications and other applications. This supplement updates the Audit Trail and Node Authentication (ATNA) Profile. ATNA defines a standardized way to create and send audit records; however, it does not identify a standardized way to retrieve audit records collected by an Audit Record Repository. This supplement adds Retrieve capabilities to the Audit Record Repository (ARR). This profile defines a new actor, the Audit Consumer, and two new transactions:

  1. The Retrieve ATNA Audit Event [ITI-81] transaction allows an Audit Consumer to retrieve ATNA Audit Events stored within a target Audit Record Repository. This transaction is based on a FHIR RESTful search operation on AuditEvent resources.
  2. The Retrieve Syslog Event [ITI-82] transaction allows an Audit Consumer to search syslog messages stored in an Audit Record Repository. This transaction is defined as a 130 RESTful operation. The search parameters are based on syslog metadata.

Note that ATNA Audit Events are syslog events, so the Retrieve Syslog Event [ITI-82] transaction enables search of ATNA events based on syslog metadata values.

Actors and Transactions

Actros.PNG

Actors

Audit Record Repository

The Audit Record Repository receives event audit reports and stores them. It may be part of a federated network of repositories. It is expected to have analysis and reporting capabilities, but those capabilities are not specified as part of this profile. This profile does not specify the capacity of an Audit Record Repository, because the variety of deployment needs makes it impractical to set requirements for the event report volume or capacity needed. The Audit Repository shall support:

  1. Both audit transport mechanisms specified in ITI TF-2a: 3.20.
  2. Receipt of all IHE-specified audit message formats. Note that the message format is extensible to include both future IHE specifications (e.g., audit requirements for new IHE transactions) and private extensions.
  3. Local security and privacy service protections and user access controls.
  4. All messages complying with the Syslog RFCs shall be accepted. The Audit Repository may ignore or process messages in non-IHE message formats. This may be for backwards compatibility or other reasons.

Optionally the Audit Record Repository supports search capabilities as defined in ITI TF2c: 3.81 and ITI TF-2c: 3.82.

Audit Consumer

The Audit Consumer queries an Audit Record Repository for syslog and ATNA audit records using Syslog metadata and ATNA audit record content. Subsequent processing of the query result is not defined in this profile.

Transactions

Retrieve ATNA Audit Event

This transaction supports the retrieval of ATNA audit record from the Audit Record Repository in accordance with a set of search parameters that determine the retrieved event reports. This transaction enables an Audit Consumer to search audit events that an Audit Record Repository created via the Record Audit Event [ITI-20] transaction. This transaction is a profiling of a standard FHIR search of the AuditEvent resource.

Retrieve Syslog Event

This transaction supports the retrieval of syslog messages from the Audit Record Repository subject to parameters that limit the retrieval.

Use-Case of Reference: Patient access to his audit records process flow

During a hospitalization, Mr. Brown was asked to sign a consent to share documents produced during that clinical event with a research facility, so that researchers could analyze the efficiency of the applied treatment. Mr. Brown does not provide this consent because he is worried that his data could be used for marketing purposes. A nurse collects the patient’s consent document, but forgets to record his decision in the HIS system. Access to all the data collected during Mr. Brown’s hospitalization by clinicians involved in his care are tracked as “Export” or “Disclosure events for a “Treatment” purpose. An access to the data by the research facility would be tracked as “Export” or “Disclosure” events for a “Research” purpose. Mr. Brown’s healthcare facility provides on-line access to health information. Mr. Brown can use a web app to access this data (shared using XDS or XCA infrastructure). The web app can also display audit information related to those documents/studies. Audit records are collected by many ATNA Audit Record Repositories, but local policies or system configurations allows the web app to identify the right Audit Record Repository system that stores relevant records. Using the document and study identifiers, the web app can query the appropriate ATNA Audit Record Repository. The web app reports to Mr. Brown that his documents/studies had been disclosed or exported for both treatment and research purposes.


Process flow

Atnaprocessflow.PNG

Specification

Profile Status: Trial Implementation

Documents: Add RESTful Query to ATNA Supplement

Additional Supplements: Appendix Z on HL7 FHIR

Underlying Standards:

  • HL7 FHIR HL7 FHIR standard STU3 http://hl7.org/fhir/STU3/index.html
    • OperationOutcome
    • Bundle
    • AuditEvent
  • RFC2616 Hypertext Transfer Protocol – HTTP/1.1
  • RFC4627 The application/json Media Type for JavaScript Object Notation (JSON)
  • RFC3986 Uniform Resource Identifier (URI): Generic Syntax
  • RFC3339 Date and Time on the Internet: Timestamps
  • RFC6585 Additional HTTP Status Codes
  • RFC5424 The Syslog Protocol

FHIR Implementation Guide

Informatively this profile is also published on https://simplifier.net/AddRESTfulquerytoATN Simplifier as a set of FHIR conformance resources], that are also registered at https://registry.fhir.org

Note the following links are to current instances maintained in Simplifier. This URL may change over time, which is why the canonical URI is provided. The canonical URI can not be used for browser navigation, but can be used for lookup at registry or simplifier as search capability allows.

Prior conformance resources have been registered, they should now be marked retired

The conformance resources are also available on the Implementation Material folder.