MHealthDossier Guide

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This page is HISTORIC, and not representative of current MHD. Please go to Mobile access to Health Documents (MHD)

HL7 FHIR

The HL7 FHIR initiative has looked at MHD profile and prototyped a FHIR version. I think this would be a great chance for IHE and HL7 to work together on this.

User Authentication

There has been much discussion around user authentication and application authorization. There is a profile proposal for this coming year on this topic. The biggest problem is that the standards in the RESTful pattern are not mature. The leading contender is OAuth. OAuth 2.0 just finished standardization.

SAML can be used, but one must use the SAML SSO Profile.

OAuth 1.0 can be made to work. Take a look at Keith’s blog. He has implemented this and blogged the details, and put the code he wrote into the public.

OAuth 2.0 is more likely to be the way to go.

Google has a good toolkit in this space.

In the USA there was a government sponsored profiling effort this summer. I think that IHE is going to pick this up and further develop it.

John's blog on the topic

Possible white paper outline

Guidance to using the Mobile access to Health Documents (MHD) profile

  • Introduction
  • Common Technology
    • Patient Identification
    • Patient ID resolution from one identifier domain to another (PIX)
    • Fully specified Patient ID vs without domain identifier
    • Pseudonym Patient ID – used to mask real patient ID (e.g. in an ATOM feed)
    • How to go from demographics to a patient ID
      • Scoped out
      • Could be through:
        • Device configuration
        • Prior workflow – browser navigation
        • Application setup –
        • PHR like application initial configuration could resolve the patient ID as part of the application setup
        • Other application
        • Future profile
          • ATOM feed of workflow items to a careprovider, with the content containing a MHD URL.
    • Metadata JSON encoding
      • DocumentEntry and SubmissionSet, Folders, Relationships
    • ATOM encoding
    • JSON body
    • Date-Time conversions and interpretations
    • Use of the submission set
    • Encoding of arguments
    • Error handling
  • Service Side
    • Examples in Java or pseudocode
    • How to implement PIX inside the service
    • How to implement GET DocumentEntry given that you only get the EntryUUID and PatientID
    • As a Proxy service grouped with XDS Document Source
    • As a Proxy service grouped with XDS Document Consumer
    • As a Proxy service grouped with XCA Initiating
    • As a service interface to a Direct Project HISP
    • Including a RID Information Source (?)
    • Security and Privacy Considerations
  • Client Side
      • Examples in JavaScript
    • Generally how to use MHD client side
      • Discovery of documents
      • Using the ATOM feed
    • Retrieve a Document
      • Not in scope to describe how to consume the document (CDA)
      • Retrieve a Display Ready (RID)
      • Create of a Document
    • Security and Privacy Considerations
      • Risks of retrieving and storing local health information
      • Client responsibility to identity
  • Security and Privacy
    • Operational issues
      • To what degree is the device itself involved in authentication. Is it a second-factor
      • To what degree is device location (GPS, WiFi identifiers)
    • User Authentication
      • Use of OpenID
      • Use of OAuth
      • Use of HTTPS
    • Audit Logging
      • To use ATNA formally or not?
      • On the Client
      • Only on the Server
      • Both
  • Conclusion