Medical Use Cases Based on

1
Medical Use Cases Based on

• HL7 Clinical Document Architecture (an ANSII
  standard) based on XML
• Medical considerations
• Legislation and Executive Branch rules regarding
  privacy (HIPAA)

2
HL7 CDA Form

• Header administrative information
• Body clinical record

3
Ms AXS her abusive ex

• Dont let him know my contact info
• a) She gets help with tendonitis from a physical
  therapist
• Therapist gets record the restrictions follow
• b) Billing info goes to outside payer
• Restrictions are transmitted with info (even when
  the info leaves the originator, the restrictions
  persist)

4
Patient grants only primary care physician access
to psych notes

• Primary care physician grants overall record
  access to a covering doctor or practice, but
  blocks access to the psych notes.

5
Patient restricts access to HIV test results

• The patient arrives at the emergency room with a
  severe trauma. The restrictions are overridden
  to provide the best treatment.

6
Patient is a care giver in a medical system

• For the whole record, the patient grants access
  only to the primary care giver.
• If billing is done in house, the billing staff is
  granted access to the record of services and
  charges.

7
Summary of Requirements

• ACLs selectors yielding fine grained access
  control
• Persistence of access semantics over
  organizational boundaries
• Override mechanism(s) such as super user
• Ability to change access over time and context