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4.4.1.665 Value Set http://hl7.org/fhir/ValueSet/security-labels

Vocabulary Work Group

Maturity Level: N

Normative (from v4.0.0)

Use Context: Any

This is a value set defined by the FHIR project.

Summary

Defining URL:	http://hl7.org/fhir/ValueSet/security-labels
Version:	4.3.0
Name:	All Security Labels
Title:	SecurityLabels
Definition:	A single value set for all security labels defined by FHIR.
Committee:	Vocabulary Work Group
OID:	2.16.840.1.113883.4.642.3.47 (for OID based terminology systems)
Source Resource	XML / JSON

This value set is used in the following places:

• Resource: Consent.provision.securityLabel (Coding / Extensible)
• Resource: DocumentReference.securityLabel (CodeableConcept / Extensible)
• Resource: AuditEvent.entity.securityLabel (Coding / Extensible)
• Resource: Meta.security (Coding / Extensible)

4.4.1.665.1 Content Logical Definition

4.4.1.665.2 Expansion

This expansion generated 28 May 2022

This value set contains 488 concepts

Expansion based on:

• ActUSPrivacyLaw v2.1.0 (CodeSystem)
• ActCode v6.1.0 (CodeSystem)
• http://terminology.hl7.org/CodeSystem/v3-Confidentiality version 2018-08-12
• ActReason v2.1.0 (CodeSystem)
• ObservationValue v2.1.0 (CodeSystem)

Code	System	Display	Definition
U	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	unrestricted	Privacy metadata indicating that no level of protection is required to safeguard personal and healthcare information that has been disclosed by an authorized individual without restrictions on its use. **Examples:** Includes publicly available information e.g., business name, phone, email and physical address. *Usage Note:* The authorization to collect, access, use, and disclose this information may be stipulated in a contract of adhesion by a data user (e.g., via terms of service or data user privacy policies) in exchange for the data subject's use of a service. This metadata indicates that the receiver has no obligation to consider privacy policies other than its own when making access control decisions. This metadata indicates that the receiver has no obligation to consider privacy policies other than its own when making access control decisions. Confidentiality code total order hierarchy: Unrestricted (U) is less protective than *V, R, N, M,* and *L*, and is the lowest protection levels.
L	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	low	Privacy metadata indicating that a low level of protection is required to safeguard personal and healthcare information, which has been altered in such a way as to minimize the need for confidentiality protections with some residual risks associated with re-linking. The risk of harm to an individual's reputation and sense of privacy if disclosed without authorization is considered negligible, and mitigations are in place to address reidentification risk. *Usage Note:* The level of protection afforded anonymized and pseudonymized, and non-personally identifiable information (e.g., a limited data set) is dictated by privacy policies and data use agreements intended to engender trust that health information can be used and disclosed with little or no risk of re-identification. **Example:** Personal and healthcare information, which excludes 16 designated categories of direct identifiers in a HIPAA Limited Data Set. This information may be disclosed by HIPAA Covered Entities without patient authorization for a research, public health, and operations purposes if conditions are met, which includes obtaining a signed data use agreement from the recipient. See 45 CFR Section 164.514. This metadata indicates that the receiver may have an obligation to comply with a data use agreement with the discloser. The discloser may have obligations to comply with policies dictating the methods for de-identification. Confidentiality code total order hierarchy: Low (L) is less protective than *V, R, N,* and *M*, and subsumes *U*.
M	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	moderate	Privacy metadata indicating the level of protection required to safeguard personal and healthcare information, which if disclosed without authorization, would present a moderate risk of harm to an individual's reputation and sense of privacy. *Usage Note:* The level of protection afforded moderately confidential information is dictated by privacy policies intended to engender trust in a service provider. May include publicly available information in jurisdictions that restrict uses of that information without the consent of the data subject. Privacy policies mandating moderate levels of protection, which preempt less protective privacy policies. "Moderate" confidentiality policies differ from and would be preempted by the prevailing privacy policies mandating the normative level of protection for information used in the delivery and management of healthcare. Confidentiality code total order hierarchy: Moderate (M) is less protective than *V, R, and N*, and subsumes all other protection levels (i.e., *L* and *U*). **Examples:** Includes personal and health information that an individual authorizes to be collected, accessed, used or disclosed to a bank for a health credit card or savings account; to health oversight authorities; to a hospital patient directory; to worker compensation, disability, property and casualty or life insurers; and to personal health record systems, consumer-controlled devices, social media accounts and online Apps; or for marketing purposes
N	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	normal	Privacy metadata indicating the level of protection required to safeguard personal and healthcare information, which if disclosed without authorization, would present a considerable risk of harm to an individual's reputation and sense of privacy. *Usage Note:* The level of protection afforded normatively confidential information is dictated by the prevailing normative privacy policies, which are intended to engender patient trust in their healthcare providers. Privacy policies mandating normative levels of protection, which preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment). Confidentiality code total order hierarchy: Normal (N) is less protective than *V* and *R*, and subsumes all other protection levels (i.e., *M, L, and U*). **Map:**Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care when purpose of use is treatment: Default for normal clinical care access (i.e., most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations. **Examples:** n the US, this includes what HIPAA identifies as protected health information (PHI) under 45 CFR Section 160.103.
R	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	restricted	Privacy metadata indicating the level of protection required to safeguard potentially stigmatizing information, which if disclosed without authorization, would present a high risk of harm to an individual's reputation and sense of privacy. *Usage Note:* The level of protection afforded restricted confidential information is dictated by specially protective organizational or jurisdictional privacy policies, including at an authorized individual’s request, intended to engender patient trust in providers of sensitive services. Privacy policies mandating additional levels of protection by restricting information access preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment). Confidentiality code total order hierarchy: Restricted (R) is less protective than *V*, and subsumes all other protection levels (i.e., *N, M, L, and U*). **Examples:** Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient’s standing as an employee or a celebrity. May be used to indicate proprietary or classified information that is not related to an individual (e.g., secret ingredients in a therapeutic substance; or the name of a manufacturer).
V	http://terminology.hl7.org/CodeSystem/v3-Confidentiality	very restricted	Privacy metadata indicating the level of protection required under atypical cicumstances to safeguard potentially damaging or harmful information, which if disclosed without authorization, would (1) present an extremely high risk of harm to an individual's reputation, sense of privacy, and possibly safety; or (2) impact an individual's or organization's legal matters. *Usage Note:* The level of protection afforded very restricted confidential information is dictated by specially protective privacy or legal policies intended to ensure that under atypical circumstances additional protections limit access to only those with a high 'need to know' and the information is kept in highest confidence.. Privacy and legal policies mandating the highest level of protection by stringently restricting information access, preempt less protective privacy policies when the information is used in the delivery and management of healthcare including legal proceedings related to healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment but only under limited circumstances). Confidentiality code total order hierarchy: Very Restricted (V) is the highest protection level and subsumes all other protection levels s (i.e., *R, N, M, L, and UI*). **Examples:** Includes information about a victim of abuse, patient requested information sensitivity, and taboo subjects relating to health status that must be discussed with the patient by an attending provider before sharing with the patient. May also include information held under a legal hold or attorney-client privilege.
_InformationSensitivityPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	InformationSensitivityPolicy	A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description: Types of Sensitivity policy that apply to Acts or Roles. A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g., a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g., collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations. *Usage Note:* Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an employee's sensitivity code would make little sense for use outside of a policy domain. 'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title.
_ActInformationSensitivityPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	ActInformationSensitivityPolicy	Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." *Usage Note:* ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.
ETH	http://terminology.hl7.org/CodeSystem/v3-ActCode	substance abuse information sensitivity	Policy for handling alcohol or drug-abuse information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to alcohol or drug-abuse information that is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
GDIS	http://terminology.hl7.org/CodeSystem/v3-ActCode	genetic disease information sensitivity	Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
HIV	http://terminology.hl7.org/CodeSystem/v3-ActCode	HIV/AIDS information sensitivity	Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to HIV or AIDS information that is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
MST	http://terminology.hl7.org/CodeSystem/v3-ActCode	military sexual trauma information sensitivity	Policy for handling information related to sexual assault or repeated, threatening sexual harassment that occurred while the patient was in the military, which is afforded heightened confidentiality. Access control concerns for military sexual trauma is based on the patient being subject to control by a higher ranking military perpetrator and/or censure by others within the military unit. Due to the relatively unfettered access to healthcare information by higher ranking military personnel and those who have command over the patient, there is a need to sequester this information outside of the typical controls on access to military health records. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
PREGNANT	http://terminology.hl7.org/CodeSystem/v3-ActCode	pregnancy information sensitivity	Policy for handling information about an individual's current or past pregnancy status, deemed sensitive by the individual or by policy, which may be afforded heightened confidentiality. *Usage Note:* Information about a patient's current or past pregnancy status may be considered sensitive in circumstances in which that status could result in discrimination or stigmatization.
SCA	http://terminology.hl7.org/CodeSystem/v3-ActCode	sickle cell anemia information sensitivity	Policy for handling sickle cell disease information, which is afforded heightened confidentiality. Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system.
SDV	http://terminology.hl7.org/CodeSystem/v3-ActCode	sexual assault, abuse, or domestic violence information sensitivity	Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive. SDV code covers violence perpetrated by related and non-related persons. This code should be specific to physical and mental trauma caused by a related person only. The access control concerns are keeping the patient safe from the perpetrator who may have an abusive psychological control over the patient, may be stalking the patient, or may try to manipulate care givers into allowing the perpetrator to make contact with the patient. The definition needs to be clarified. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
SEX	http://terminology.hl7.org/CodeSystem/v3-ActCode	sexuality and reproductive health information sensitivity	Policy for handling sexuality and reproductive health information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexuality and reproductive health information that is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
SPI	http://terminology.hl7.org/CodeSystem/v3-ActCode	specially protected information sensitivity	Policy for handling information deemed specially protected by law or policy including substance abuse, substance use, psychiatric, mental health, behavioral health, and cognitive disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
BH	http://terminology.hl7.org/CodeSystem/v3-ActCode	behavioral health information sensitivity	Policy for handling information related to behavioral and emotional disturbances affecting social adjustment and physical health, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
COGN	http://terminology.hl7.org/CodeSystem/v3-ActCode	cognitive disability information sensitivity	Policy for handling information related to cognitive disability disorders and conditions caused by these disorders, which are afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code. Examples may include dementia, traumatic brain injury, attention deficit, hearing and visual disability such as dyslexia and other disorders and related conditions which impair learning and self-sufficiency. However, the cognitive disabilities to which this term may apply versus other behavioral health categories varies by jurisdiction and organizational policy in part due to overlap with other behavioral health conditions. Implementers should constrain to those diagnoses applicable in the domain in which this code is used.
DVD	http://terminology.hl7.org/CodeSystem/v3-ActCode	developmental disability information sensitivity	Policy for handling information related to developmental disability disorders and conditions caused by these disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code. A diverse group of chronic conditions that are due to mental or physical impairments impacting activities of daily living, self-care, language acuity, learning, mobility, independent living and economic self-sufficiency. Examples may include Down syndrome and Autism spectrum. However, the developmental disabilities to which this term applies versus other behavioral health categories varies by jurisdiction and organizational policy in part due to overlap with other behavioral health conditions. Implementers should constrain to those diagnoses applicable in the domain in which this code is used.
EMOTDIS	http://terminology.hl7.org/CodeSystem/v3-ActCode	emotional disturbance information sensitivity	Policy for handling information related to emotional disturbance disorders and conditions caused by these disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code. Typical used to characterize behavioral and mental health issues of adolescents where the disorder may be temporarily diagnosed in order to avoid the potential and unnecessary stigmatizing diagnoses of disorder long term.
MH	http://terminology.hl7.org/CodeSystem/v3-ActCode	mental health information sensitivity	Policy for handling information related to psychological disorders, which is afforded heightened confidentiality. Mental health information may be deemed specifically sensitive and distinct from physical health, substance use disorders, and behavioral disabilities and disorders in some jurisdictions. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
PSY	http://terminology.hl7.org/CodeSystem/v3-ActCode	psychiatry disorder information sensitivity	Policy for handling psychiatry psychiatric disorder information, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
PSYTHPN	http://terminology.hl7.org/CodeSystem/v3-ActCode	psychotherapy note information sensitivity	Policy for handling psychotherapy note information, which is afforded heightened confidentiality. *Usage Note:* In some jurisdiction, disclosure of psychotherapy notes requires patient consent. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
SUD	http://terminology.hl7.org/CodeSystem/v3-ActCode	substance use disorder information sensitivity	Policy for handling information related to alcohol or drug use disorders and conditions caused by these disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
ETHUD	http://terminology.hl7.org/CodeSystem/v3-ActCode	alcohol use disorder information sensitivity	Policy for handling information related to alcohol use disorders and conditions caused by these disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
OPIOIDUD	http://terminology.hl7.org/CodeSystem/v3-ActCode	opioid use disorder information sensitivity	Policy for handling information related to opioid use disorders and conditions caused by these disorders, which is afforded heightened confidentiality. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
STD	http://terminology.hl7.org/CodeSystem/v3-ActCode	sexually transmitted disease information sensitivity	Policy for handling sexually transmitted disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexually transmitted disease information that is deemed sensitive. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
TBOO	http://terminology.hl7.org/CodeSystem/v3-ActCode	taboo	Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. *Open Issue:* This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes.
VIO	http://terminology.hl7.org/CodeSystem/v3-ActCode	violence information sensitivity	Policy for handling information related to harm by violence, which is afforded heightened confidentiality. Harm by violence is perpetrated by an unrelated person. Access control concerns for information about mental or physical harm resulting from violence caused by an unrelated person may include manipulation of care givers or access to records that enable the perpetrator contact or locate the patient, but the perpetrator will likely not have established abusive psychological control over the patient. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
IDS	http://terminology.hl7.org/CodeSystem/v3-ActCode	Identifier Sensitivity	Policy for handling information related to an identifier of an information subject, which will be afforded heightened confidentiality. Usage Note: Such policies may govern the sensitivity of information related to an identifier of an act, such as the identifier of a contract; a role, such as a citizen, a patient, a practitioner, or an organization; or an entity such as a medical device due to potential impact on the privacy, well-being, safety or integrity of an information subject. For example, protection against identity fraud or counterfeit.
SICKLE	http://terminology.hl7.org/CodeSystem/v3-ActCode	sickle cell	Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." *Usage Note:* ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.
_EntitySensitivityPolicyType	http://terminology.hl7.org/CodeSystem/v3-ActCode	EntityInformationSensitivityPolicy	Types of sensitivity policies that may apply to a sensitive attribute on an Entity. *Usage Note:* EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
DEMO	http://terminology.hl7.org/CodeSystem/v3-ActCode	all demographic information sensitivity	Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
DOB	http://terminology.hl7.org/CodeSystem/v3-ActCode	date of birth information sensitivity	Policy for handling information related to an information subject's date of birth, which will be afforded heightened confidentiality.Policies may govern sensitivity of information related to an information subject's date of birth, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
GENDER	http://terminology.hl7.org/CodeSystem/v3-ActCode	gender and sexual orientation information sensitivity	Policy for handling information related to an information subject's gender and sexual orientation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's gender and sexual orientation, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
LIVARG	http://terminology.hl7.org/CodeSystem/v3-ActCode	living arrangement information sensitivity	Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
MARST	http://terminology.hl7.org/CodeSystem/v3-ActCode	marital status information sensitivity	Policy for handling information related to an information subject's marital status, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's marital status, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
PATLOC	http://terminology.hl7.org/CodeSystem/v3-ActCode	patient location	Policy for handling information related to an individual's location, which is deemed sensitive when the disclosure could impact the privacy, well-being, or safety of that subject, and requires additional protection. *Usage Note:* If there is a jurisdictional, organizational, or individual mandate, then use the applicable ActPrivacyLaw or ActConsentDirective code from the ActCode system to and specify the law in addition to this more generic code.
RACE	http://terminology.hl7.org/CodeSystem/v3-ActCode	race information sensitivity	Policy for handling information related to an information subject's race, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's race, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
REL	http://terminology.hl7.org/CodeSystem/v3-ActCode	religion information sensitivity	Policy for handling information related to an information subject's religious affiliation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's religion, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Notes:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
_RoleInformationSensitivityPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	RoleInformationSensitivityPolicy	Types of sensitivity policies that apply to Roles. *Usage Notes:* RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
B	http://terminology.hl7.org/CodeSystem/v3-ActCode	business information sensitivity	Policy for handling trade secrets such as financial information or intellectual property, which will be afforded heightened confidentiality. Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. *Usage Notes:* No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
EMPL	http://terminology.hl7.org/CodeSystem/v3-ActCode	employer information sensitivity	Policy for handling information related to an employer which is deemed classified to protect an employee who is the information subject, and which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to an employer, such as law enforcement or national security, the identity of which could impact the privacy, well-being, or safety of an information subject who is an employee. *Usage Notes:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
LOCIS	http://terminology.hl7.org/CodeSystem/v3-ActCode	location information sensitivity	Policy for handling information related to the location of the information subject, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to the location of the information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. *Usage Notes:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
SSP	http://terminology.hl7.org/CodeSystem/v3-ActCode	sensitive service provider information sensitivity	Policy for handling information related to a provider of sensitive services, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to providers who deliver sensitive healthcare services in order to protect the privacy, well-being, and safety of the provider and of patients receiving sensitive services. *Usage Notes:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
ADOL	http://terminology.hl7.org/CodeSystem/v3-ActCode	adolescent information sensitivity	Policy for handling information related to an adolescent, which will be afforded heightened confidentiality per applicable organizational or jurisdictional policy. An enterprise may have a policy that requires that adolescent patient information be provided heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. *Usage Note:* For use within an enterprise in which an adolescent is the information subject. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
CEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	celebrity information sensitivity	Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location. *Usage Note:* For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
VIP	http://terminology.hl7.org/CodeSystem/v3-ActCode	celebrity information sensitivity	Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location. *Usage Note:* For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
DIA	http://terminology.hl7.org/CodeSystem/v3-ActCode	diagnosis information sensitivity	Policy for handling information related to a diagnosis, health condition or health problem, which will be afforded heightened confidentiality. Diagnostic, health condition or health problem related information may be deemed sensitive by organizational policy, and require heightened confidentiality. *Usage Note:* For use within an enterprise that provides heightened confidentiality to diagnostic, health condition or health problem related information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
DRGIS	http://terminology.hl7.org/CodeSystem/v3-ActCode	drug information sensitivity	Policy for handling information related to a drug, which will be afforded heightened confidentiality. Drug information may be deemed sensitive by organizational policy, and require heightened confidentiality. *Usage Note:* For use within an enterprise that provides heightened confidentiality to drug information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
EMP	http://terminology.hl7.org/CodeSystem/v3-ActCode	employee information sensitivity	Policy for handling information related to an employee, which will be afforded heightened confidentiality. When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. *Usage Note:* Policy for handling information related to an employee, which will be afforded heightened confidentiality. Description: When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.
PDS	http://terminology.hl7.org/CodeSystem/v3-ActCode	patient default information sensitivity	Policy for specially protecting information reported by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive for another reason.) For example information reported by the patient about another person, e.g., a family member, may be deemed sensitive by default. Organizational policy may allow the sensitivity tag to be cleared on patient's request. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code. For example, VA deems employee information sensitive by default. Information about a patient who is being stalked or a victim of abuse or violence may be deemed sensitive by default per a provider organization's policies.
PHY	http://terminology.hl7.org/CodeSystem/v3-ActCode	physician requested information sensitivity	Policy for handling information about a patient, which a physician or other licensed healthcare provider deems sensitive. Once tagged by the provider, this may trigger alerts for follow up actions according to organizational policy or jurisdictional law. *Usage Note:* For use within an enterprise that provides heightened confidentiality to certain types of information designated by a physician as sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Use cases in which this code could be used are, e.g., in systems that lack the ability to automatically detect sensitive information and must rely on manual tagging; a system that lacks an applicable sensitivity tag, or for ad hoc situations where criticality of the situation requires that the tagging be done immediately by the provider before coding or transcription of consult notes can be completed, e.g., upon detection of a patient with suicidal tendencies or potential for violence.
PRS	http://terminology.hl7.org/CodeSystem/v3-ActCode	patient requested information sensitivity	Policy for specially protecting information reported by or about a patient, which the patient deems sensitive, and the patient requests that collection, access, use, or disclosure of that information be restricted. For example, a minor patient may request that information about reproductive health not be disclosed to the patient's family or to particular providers and payers. *Usage Note:* If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
COMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	compartment	This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field. Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."
ACOCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	accountable care organization compartment	A group of health care entities, which may include health care providers, care givers, hospitals, facilities, health plans, and other health care constituents who coordinate care for reimbursement based on quality metrics for improving outcomes and lowering costs, and may be authorized to access the consumer's health information because of membership in that group. Security Compartment Labels assigned to a consumer's information use in accountable care workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a an accountable care workflow who is requesting access to that information
CDSSCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	CDS system compartment	This compartment code may be used as a field value in an initiator's clearance to indicate permission for its Clinical Decision Support system (CDSS) to access and use an IT Resource with a security label having the same compartment value in the security category label field. This code permits a CDS system to algorithmically process information with this compartment tag for the purpose of alerting an unauthorized end user that masked information is needed to address an emergency or a patient safety issue, such as a contraindicated medication. The alert would advise the end user to "break the glass", to access the masked information in an accountable manner, or to ask the patient about possibly masked information. For example, releasing a list of sensitive medications with this compartment tag means that while the CDS system is permitted to use this list in its contraindication analysis, this sensitive information should not be shared directly with unauthorized end-users or end-user-facing Apps. Based on the results of the CDS system analysis (e.g., warnings about prescriptions) the end-user (e.g., a clinician) may still have the ability to access to the sensitive information by invoking "break-the-glass protocol". *Usage Note:* A security label with the CDS system compartment may be used in conjunction with other security labels, e.g., a label authorizing an end user with adequate clearance to access the same CDS system compartment tagged information. For example, a patient may restrict sharing sensitive information with most care team members except in an emergency or to prevent an adverse event, and may consent to sharing with their sensitive service care team providers, e.g., for mental health or substance abuse.
CTCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	care team compartment	Care coordination across participants in a care plan requires sharing of a healthcare consumer's information specific to that workflow. A care team member should only have access to that information while participating in that workflow or for other authorized uses. Security Compartment Labels assigned to a consumer's information use in care coordination workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a care team member workflow who is requesting access to that information
FMCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	financial management compartment	Financial management department members who have access to healthcare consumer information as part of a patient account, billing and claims workflows. Security Compartment Labels assigned to consumer information used in these workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a financial management workflow who is requesting access to that information.
HRCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	human resource compartment	A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow.
LRCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	legitimate relationship compartment	Providers and care givers who have an established relationship per criteria determined by policy are considered to have an established care provision relations with a healthcare consumer, and may be authorized to access the consumer's health information because of that relationship. Providers and care givers should only have access to that information while participating in legitimate relationship workflows or for other authorized uses. Security Compartment Labels assigned to a consumer's information use in legitimate relationship workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a legitimate relationship workflow who is requesting access to that information.
PACOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	patient administration compartment	Patient administration members who have access to healthcare consumer information as part of a patient administration workflows. Security Compartment Labels assigned to consumer information used in these workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a patient administration workflow who is requesting access to that information.
RESCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	research project compartment	A security category label field value, which indicates that access and use of an IT resource is restricted to members of a research project.
RMGTCOMPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	records management compartment	A security category label field value, which indicates that access and use of an IT resource is restricted to members of records management department or workflow.
_SECALTINTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	alteration integrity	Abstract security metadata observation values used to indicate mechanism used for authorized alteration of an IT resource (data, information object, service, or system capability)
ABSTRED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	abstracted	Security metadata observation values used to indicate the use of a more abstract version of the content, e.g., replacing exact value of an age or date field with a range, or remove the left digits of a credit card number or SSN.
AGGRED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	aggregated	Security metadata observation values used to indicate the use of an algorithmic combination of actual values with the result of an aggregate function, e.g., average, sum, or count in order to limit disclosure of an IT resource (data, information object, service, or system capability) to the minimum necessary.
ANONYED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	anonymized	Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by used to indicate the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. No key to relink the data is retained.
MAPPED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	mapped	Security metadata observation value used to indicate that the IT resource semantic content has been transformed from one encoding to another. *Usage Note:* "MAP" code does not indicate the semantic fidelity of the transformed content. To indicate semantic fidelity for maps of HL7 to other code systems, this security alteration integrity observation may be further specified using an Act valued with Value Set: MapRelationship (2.16.840.1.113883.1.11.11052). Semantic fidelity of the mapped IT Resource may also be indicated using a SecurityIntegrityConfidenceObservation.
MASKED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	masked	Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by indicating the mechanism by which software systems can make data unintelligible (that is, as unreadable and unusable by algorithmically transforming plaintext into ciphertext) such that it can only be accessed or used by authorized users. An authorized user may be provided a key to decrypt per license or "shared secret". *Usage Note:* "MASKED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has been further encrypted, and may be accessed only by an authorized user or receiver to which a decryption key is provided.
PSEUDED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	pseudonymized	Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability), by indicating the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject. *Rationale:* Personal data which has been processed to make it impossible to know whose data it is. Used particularly for secondary use of health data. In some cases, it may be possible for authorized individuals to restore the identity of the individual, e.g.,for public health case management. Based on ISO/TS 25237:2008 Health informatics—Pseudonymization
REDACTED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	redacted	Security metadata observation value used to indicate the mechanism by which software systems can filter an IT resource (data, information object, service, or system capability) to remove any portion of the resource that is not authorized to be access, used, or disclosed. *Usage Note:* "REDACTED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has filtered and not included in the content accessed or received.
SUBSETTED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	subsetted	Metadata observation used to indicate that some information has been removed from the source object when the view this object contains was constructed because of configuration options when the view was created. The content may not be suitable for use as the basis of a record update *Usage Note:* This is not suitable to be used when information is removed for security reasons - see the code REDACTED for this use.
SYNTAC	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	syntactic transform	Security metadata observation value used to indicate that the IT resource syntax has been transformed from one syntactical representation to another. *Usage Note:* "SYNTAC" code does not indicate the syntactical correctness of the syntactically transformed IT resource.
TRSLT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	translated	Security metadata observation value used to indicate that the IT resource has been translated from one human language to another. *Usage Note:* "TRSLT" does not indicate the fidelity of the translation or the languages translated. The fidelity of the IT Resource translation may be indicated using a SecurityIntegrityConfidenceObservation. To indicate languages, use the Value Set:HumanLanguage (2.16.840.1.113883.1.11.11526)
VERSIONED	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	versioned	Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) which indicates that the resource only retains versions of an IT resource for access and use per applicable policy *Usage Note:* When this code is used, expectation is that the system has removed historical versions of the data that falls outside the time period deemed to be the effective time of the applicable version.
_SECDATINTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	data integrity	Abstract security observation values used to indicate data integrity metadata. **Examples:** Codes conveying the mechanism used to preserve the accuracy and consistency of an IT resource such as a digital signature and a cryptographic hash function.
CRYTOHASH	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	cryptographic hash function	Security metadata observation value used to indicate the mechanism by which software systems can establish that data was not modified in transit. *Rationale:* This definition is intended to align with the ISO 22600-2 3.3.19 definition of cryptographic checkvalue: Information which is derived by performing a cryptographic transformation (see cryptography) on the data unit. The derivation of the checkvalue may be performed in one or more steps and is a result of a mathematical function of the key and a data unit. It is usually used to check the integrity of a data unit. **Examples:** * SHA-1 * SHA-2 (Secure Hash Algorithm)
DIGSIG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	digital signature	Security metadata observation value used to indicate the mechanism by which software systems use digital signature to establish that data has not been modified. *Rationale:* This definition is intended to align with the ISO 22600-2 3.3.26 definition of digital signature: Data appended to, or a cryptographic transformation (see cryptography) of, a data unit that allows a recipient of the data unit to prove the source and integrity of the data unit and protect against forgery e.g., by the recipient.
_SECINTCONOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	integrity confidence	Abstract security observation value used to indicate integrity confidence metadata. **Examples:** Codes conveying the level of reliability and trustworthiness of an IT resource.
HRELIABLE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	highly reliable	Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be very high.
RELIABLE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	reliable	Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be adequate.
UNCERTREL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	uncertain reliability	Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be uncertain.
UNRELIABLE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	unreliable	Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be inadequate.
_SECINTPRVOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	provenance	Abstract security metadata observation value used to indicate the provenance of an IT resource (data, information object, service, or system capability). **Examples:** Codes conveying the provenance metadata about the entity reporting an IT resource.
_SECINTPRVABOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	provenance asserted by	Abstract security provenance metadata observation value used to indicate the entity that asserted an IT resource (data, information object, service, or system capability). **Examples:** Codes conveying the provenance metadata about the entity asserting the resource.
CLINAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	clinician asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a clinician.
DEVAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	device asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a device.
HCPAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	healthcare professional asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a healthcare professional.
PACQAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	patient acquaintance asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient acquaintance.
PATAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	patient asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient.
PAYAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	payer asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a payer.
PROAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	professional asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a professional.
SDMAST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	substitute decision maker asserted	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a substitute decision maker.
_SECINTPRVRBOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	provenance reported by	Abstract security provenance metadata observation value used to indicate the entity that reported the resource (data, information object, service, or system capability). **Examples:** Codes conveying the provenance metadata about the entity reporting an IT resource.
CLINRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	clinician reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a clinician.
DEVRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	device reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a device.
HCPRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	healthcare professional reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a healthcare professional.
PACQRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	patient acquaintance reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient acquaintance.
PATRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	patient reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient.
PAYRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	payer reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a payer.
PRORPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	professional reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a professional.
SDMRPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	substitute decision maker reported	Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a substitute decision maker.
_SECINTSTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	integrity status	Abstract security observation values used to indicate integrity status metadata. **Examples:** Codes, such as those in the HL7 DocumentClassification code system conveying the workflow status of resource as authenticated, legally authenticated, and in progress.
SecurityPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	security policy	Types of security policies that further specify the ActClassPolicy value set. **Examples:** * obligation to encrypt * refrain from redisclosure without consent
AUTHPOL	http://terminology.hl7.org/CodeSystem/v3-ActCode	authorization policy	Authorisation policies are essentially security policies related to access-control and specify what activities a subject is permitted or forbidden to do, to a set of target objects. They are designed to protect target objects so are interpreted by access control agents or the run-time systems at the target system. A positive authorisation policy defines the actions that a subject is permitted to perform on a target. A negative authorisation policy specifies the actions that a subject is forbidden to perform on a target. Positive authorisation policies may also include filters to transform the parameters associated with their actions. (Based on PONDERS)
ACCESSCONSCHEME	http://terminology.hl7.org/CodeSystem/v3-ActCode	access control scheme	An access control policy specific to the type of access control scheme, which is used to enforce one or more authorization policies. *Usage Note:* Access control schemes are the type of access control policy, which is comprised of access control policy rules concerning the provision of the access control service. There are two categories of access control policies, rule-based and identity-based, which are identified in CCITT Rec. X.800 aka ISO 7498-2. Rule-based access control policies are intended to apply to all access requests by any initiator on any target in a security domain. Identity-based access control policies are based on rules specific to an individual initiator, a group of initiators, entities acting on behalf of initiators, or originators acting in a specific role. Context can modify rule-based or identity-based access control policies. Context rules may define the entire policy in effect. Real systems will usually employ a combination of these policy types; if a rule-based policy is used, then an identity-based policy is usually in effect also. An access control scheme may be based on access control lists, capabilities, labels, and context or a combination of these. An access control scheme is a component of an access control mechanism or "service") along with the supporting mechanisms required by that scheme to provide access control decision information (ADI) supplied by the scheme to the access decision facility (ADF also known as a PDP). (Based on ISO/IEC 10181-3:1996) **Examples:** * Attribute Based Access Control (ABAC) * Discretionary Access Control (DAC) * History Based Access Control (HBAC) * Identity Based Access Control (IBAC) * Mandatory Access Control (MAC) * Organization Based Access Control (OrBAC) * Relationship Based Access Control (RelBac) * Responsibility Based Access Control (RespBAC) * Risk Adaptable Access Control (RAdAC) >
DELEPOL	http://terminology.hl7.org/CodeSystem/v3-ActCode	delegation policy	Delegation policies specify which actions subjects are allowed to delegate to others. A delegation policy thus specifies an authorisation to delegate. Subjects must already possess the access rights to be delegated. Delegation policies are aimed at subjects delegating rights to servers or third parties to perform actions on their behalf and are not meant to be the means by which security administrators would assign rights to subjects. A negative delegation policy identifies what delegations are forbidden. A Delegation policy specifies the authorisation policy from which delegated rights are derived, the grantors, which are the entities which can delegate these access rights, and the grantees, which are the entities to which the access rights can be delegated. There are two types of delegation policy, positive and negative. (Based on PONDERS)
ObligationPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	obligation policy	Conveys the mandated workflow action that an information custodian, receiver, or user must perform. *Usage Notes:* Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
ANONY	http://terminology.hl7.org/CodeSystem/v3-ActCode	anonymize	Custodian system must remove any information that could result in identifying the information subject.
AOD	http://terminology.hl7.org/CodeSystem/v3-ActCode	accounting of disclosure	Custodian system must make available to an information subject upon request an accounting of certain disclosures of the individual’s protected health information over a period of time. Policy may dictate that the accounting include information about the information disclosed, the date of disclosure, the identification of the receiver, the purpose of the disclosure, the time in which the disclosing entity must provide a response and the time period for which accountings of disclosure can be requested.
AUDIT	http://terminology.hl7.org/CodeSystem/v3-ActCode	audit	Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.
AUDTR	http://terminology.hl7.org/CodeSystem/v3-ActCode	audit trail	Custodian system must monitor and maintain retrievable log for each user and operation on information.
CPLYPOL	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with policy	Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information. *Usage Note:* CPLYPOL may be used as a security label code to inform senders and receivers of the tagged information to comply with applicable policy without specifying the specific policy type(s).
CPLYCC	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with confidentiality code	Custodian security system must retrieve, evaluate, and comply with the information handling directions of the Confidentiality Code associated with an information target. *Usage Note:* CPLYCC may be used as a security label code to inform senders and receivers of information tagged with a Confidentiality Code to comply with applicable level of protection required by the assigned confidentiality code.
CPLYCD	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with consent directive	Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives. *Usage Note:* CPLYCD may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActConsent code or an ActCode\_ActPolicyType\_ActPrivacyPolicy\_ActConsentDirective code to comply with applicable consent directives.
CPLYCUI	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with controlled unclassified information policy	Custodian security system must retrieve, evaluate, and comply with applicable Controlled Unclassified Information (CUI) policies associated with the target information. *Usage Note:* In the US, CPLYCUI may be used as a security label code to inform recipients of information designated by a US Federal Agency as Controlled Unclassified Information (CUI) to comply with the applicable laws, regulations, executive orders, and other guidances, such as included in DURSAs, to persist, mark, and enforce required CUI controls Background: In accordance with US 32 CFR Part 2002 and US Executive Order 13556 Controlled Unclassified Information, US Federal Agencies and their contractors are charged with classifying and marking certain information they create as Controlled Unclassified Information (CUI). The following definitions, which are provided for context, are based on terms defined by the CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html * CUI is defined as "information in any form that the Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls." * Designating CUI occurs when an authorized holder, consistent with 32 CFR Part 2002 and the CUI Registry, determines that a specific item of information falls into a CUI category or subcategory. * The designating agency is the executive branch agency that designates or approves the designation of a specific item of information as CUI. * The authorized holder who designates the CUI must make recipients aware of the information's CUI status when disseminating that information. * • Disseminating occurs when authorized holders provide access, transmit, or transfer CUI to other authorized holders through any means, whether internal or external to the agency. Once designated as CUI, US Federal Agencies and their contractors must assign CUI marks as prescribed by the National Archives and Records Administration (NARA) CUI Registry, and display marks as prescribed by the CUI Marking Handbook. CUI markings must be displayed on hard copy, on containers, electronic media, and to end users for IT systems. When HL7 content is designated as CUI, these computable markings can be interoperably conveyed using HL7 security label CUI tags, and may be included in HL7 text and narrative elements as human readable markings. **Impact of CUI markings:** CUI Custodians must enforce CUI security controls per applicable CUI policies. Federal agencies and their contractors must adhere to FISMA and NIST SP 800-53 security controls. Custodians, who are not Federal agencies or agency contractors, and are receivers of CUI, must adhere to NIST SP 800-171 security controls and those dictated by the Authorities indicated by the assigned CUI markings. For most participants in US healthcare information exchange, including Federal Agencies and their contractors, additional controls are required by HIPAA Security standards for health information US 42 USC 1320d-2(d)(2) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf Federal Agencies and their contractors may be the CUI classifier of original CUI content; or a CUI derivative classifier, which reclassifies CUI content that has been aggregated with other CUI or Unclassified Uncontrolled Information (U) or dissembled from a larger CUI content; or declassifiers, depending on the designating agency's policies. Applicable CUI policies include the following and any future applicable updates to policies or laws related to CUI: * Executive Order 13556 https://www.federalregister.gov/articles/2010/11/09/2010-28360/controlled-unclassified-information * US 32 CFR Part 2002 https://www.govinfo.gov/content/pkg/CFR-2017-title32-vol6/pdf/CFR-2017-title32-vol6-part2002.pdf * NIST SP 800-171 https://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-171r1.pdf * NIST SP 800-171A https://doi.org/10.6028/NIST.SP.800-171A * CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf * CUI Registry - Health Information Category https://www.archives.gov/cui/registry/category-detail/health-info * CUI Registry: Limited Dissemination Controls https://www.archives.gov/cui/registry/limited-dissemination * CUI Policy and Guidance https://www.archives.gov/cui/registry/policy-guidance
CPLYJPP	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with jurisdictional privacy policy	Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information. *Usage Note:* CPLYJPP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActPrivacyPolicy\_ActPrivacyLaw code or an ActCode\_ActPolicyType\_ActInformationPolicy.JurisIP code to comply with applicable jurisdictional privacy policy.
CPLYJSP	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with jurisdictional security policy	Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional security policies associated with the target information. *Usage Note:* CPLYJSP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType.SecurityPolicy code to comply with applicable jurisdictional security policy.
CPLYOPP	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with organizational privacy policy	Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information. *Usage Note:* CPLYOPP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActInformationPolicy.OrgIP code to comply with applicable organizational privacy policy.
CPLYOSP	http://terminology.hl7.org/CodeSystem/v3-ActCode	comply with organizational security policy	Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information. *Usage Note:* CPLYOSP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType.SecurityPolicy code to comply with applicable organizational security policy.
DECLASSIFYLABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	declassify security label	Custodian security system must declassify information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as unclassified in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.
DEID	http://terminology.hl7.org/CodeSystem/v3-ActCode	deidentify	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
DELAU	http://terminology.hl7.org/CodeSystem/v3-ActCode	delete after use	Custodian system must remove target information from access after use.
DOWNGRDLABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	downgrade security label	Custodian security system must downgrade information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as classified at a less protected level in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.
DRIVLABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	derive security label	Custodian security system must assign and bind security labels derived from compilations of information by aggregation or disaggregation in order to classify information compiled in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.
ENCRYPT	http://terminology.hl7.org/CodeSystem/v3-ActCode	encrypt	Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext. *Usage Notes:* A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.)
ENCRYPTR	http://terminology.hl7.org/CodeSystem/v3-ActCode	encrypt at rest	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage.
ENCRYPTT	http://terminology.hl7.org/CodeSystem/v3-ActCode	encrypt in transit	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while "in transit" or being transported by any means.
ENCRYPTU	http://terminology.hl7.org/CodeSystem/v3-ActCode	encrypt in use	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while in use such that operations permitted on the target information are limited by the license granted to the end user.
HUAPRV	http://terminology.hl7.org/CodeSystem/v3-ActCode	human approval	Custodian system must require human review and approval for permission requested.
LABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	assign security label	Custodian security system must assign and bind security labels in order to classify information created in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding. *Usage Note:* In security systems, security policy label assignments do not change, they may supersede prior assignments, and such reassignments are always tracked for auditing and other purposes.
MASK	http://terminology.hl7.org/CodeSystem/v3-ActCode	mask	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".
MINEC	http://terminology.hl7.org/CodeSystem/v3-ActCode	minimum necessary	Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use. *Usage Note:* Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use.
PERSISTLABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	persist security label	Custodian security system must persist the binding of security labels to classify information received or imported by information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding.
PRIVMARK	http://terminology.hl7.org/CodeSystem/v3-ActCode	privacy mark	Custodian must create and/or maintain human readable security label tags as required by policy. Map: Aligns with ISO 22600-3 Section A.3.4.3 description of privacy mark: "If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label."
CUIMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI Mark	An originator must mark, persist, display, and convey computable and renderable Controlled Unclassified Information (CUI) marks as required by policy. A recipient must consume, persist, display, and reconvey CUI marks on information received based on agreements with the originator.. **Examples:** * As CUI custodians, Federal Agencies and their contractors must mark, persist, display, and convey these marks. * All CUI receivers must consume, persist, display, and reconvey CUI markings on information further disclosed *Usage Note:* In accordance with US 32 CFR Part 2002 and US Executive Order 13556 Controlled Unclassified Information, US Federal Agencies and their contractors are charged with classifying and marking certain information they create as Controlled Unclassified Information (CUI). The following definitions, which are provided for context, are based on terms defined by the CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html * CUI is defined as "information in any form that the Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls" * Designating CUI occurs when an authorized holder, consistent with US 32 CFR Part 2002 and the CUI Registry, determines that a specific item of information falls into a CUI category or subcategory. * The designating agency is the executive branch agency that designates or approves the designation of a specific item of information as CUI. * The authorized holder who designates the CUI must make recipients aware of the information’s CUI status when disseminating that information. * Disseminating occurs when authorized holders provide access, transmit, or transfer CUI to other authorized holders through any means, whether internal or external to the agency. Once designated as CUI, US Federal Agencies and their contractors must assign CUI marks as prescribed by the National Archives and Records Administration (NARA) CUI Registry, and display marks as prescribed by the CUI Marking Handbook. CUI markings must be displayed on hard copy, on containers, electronic media, and to end users for IT systems. When HL7 content is designated as CUI, these computable markings can be interoperably conveyed using HL7 security label CUI tags, and may be included in HL7 text and narrative elements as human readable markings. **Impact of CUI markings:** CUI Custodians must enforce CUI security controls per applicable CUI policies. Federal agencies and their contractors must adhere to FISMA and NIST SP 800-53 security controls. Custodians, who are not Federal agencies or agency contractors, and are receivers of CUI, must adhere to NIST SP 800-171 security controls and those dictated by the Authorities indicated by the assigned CUI markings. For most participants in US healthcare information exchange, including Federal Agencies and their contractors, additional controls are required by HIPAA Security standards for health information US 42 USC 1320d-2(d)(2) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf Federal Agencies and their contractors may be the CUI classifier of original CUI content; or a CUI derivative classifier, which reclassifies CUI content that has been aggregated with other CUI or Unclassified Uncontrolled Information (U) or dissembled from a larger CUI content; or declassifiers, depending on the designating agency's policies. Applicable CUI policies include the following and any future applicable updates to policies or laws related to CUI: * Executive Order 13556 https://www.federalregister.gov/articles/2010/11/09/2010-28360/controlled-unclassified-information * US 32 CFR Part 2002 https://www.govinfo.gov/content/pkg/CFR-2017-title32-vol6/pdf/CFR-2017-title32-vol6-part2002.pdf * NIST SP 800-171 https://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-171r1.pdf * NIST SP 800-171A https://doi.org/10.6028/NIST.SP.800-171A * CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf * CUI Registry - Health Information Category https://www.archives.gov/cui/registry/category-detail/health-info * CUI Registry: Limited Dissemination Controls https://www.archives.gov/cui/registry/limited-dissemination * CUI Policy and Guidance https://www.archives.gov/cui/registry/policy-guidance
PSEUD	http://terminology.hl7.org/CodeSystem/v3-ActCode	pseudonymize	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.
REDACT	http://terminology.hl7.org/CodeSystem/v3-ActCode	redact	Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users.
UPGRDLABEL	http://terminology.hl7.org/CodeSystem/v3-ActCode	upgrade security label	Custodian security system must declassify information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as classified at a more protected level in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.
PrivacyMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	privacy mark	An abstract code for human readable marks indicating, e.g., the level of confidentiality protection, an authorized compartment, the integrity, or the handling instruction required by applicable policy. Such markings must be displayed as directed by applicable policy on electronically rendered information content and any electronic transmittal envelope or container; or on hardcopy information and any physical transmittal envelope or container. Examples of protocols for marking displays on electronic or hardcopy rendered content: Across the top or "banner" of each page ; as a watermark placed diagonally cross each page; at the bottom or "footer" of each page; and may be displayed at the beginning of any portion within the content that required markings different than other portions of the content. The banner or top of page marking typically acts as a "high watermark" by including all of the markings made on any marked portions within the entirety of the information content. *Usage Note:* A "Privacy Mark" is a Security Control Observation (SECCONOBS) named tag set as specified by the HL7 Privacy and Security Classification System (HCS). A Privacy Mark Named Tag Set is valued with a Privacy Mark leaf code "tag", which is a member of the Security Control Observation Value (\_SecurityObservationValue) tag set. Related Security Control Observation named tag sets are Purpose of Use, Obligation Policy, and Refrain Policy, each with their own Security Control Observation Value tag sets. Foundational standard definitions: ISO 22600-3 Section A.3.4.3 - If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label. IEEE Security Glossary Compendium 93- CESG Memorandum No.1 Issue 1.2 Oct 1992 - Human readable word or phrase acting as an indicator of all or part of the security constraints that apply to a document so marked. NOTE: A machine readable representation of a marking. *Comment:* While policies requiring creators, processors, custodians, senders or recipients apply, enforce, and persist applicable Privacy Marks may be dictated by a jurisdiction, organization or personal privacy, security, or integrity policy, those required to comply may be governed under different policies, so compliance may need to be enforced through trust contracts. For example, information content marked with GDPR related policies may require adherence by processors or recipients outside of the European Union. For this reason, this code system is likely to evolve with the inclusion of multiple policy domains needing to communicate encoded policies in a standard, interoperable manner.
ControlledUnclassifiedInformation	http://terminology.hl7.org/CodeSystem/v3-ActCode	ControlledUnclassifiedInformation	Information the US Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls. However, CUI does not include classified information (see definition above) or information a non-executive branch entity possesses and maintains in its own systems that did not come from, or was not created or possessed by or for, an executive branch agency or an entity acting for an agency. Law, regulation, or Government-wide policy may require or permit safeguarding or dissemination controls in three ways: Requiring or permitting agencies to control or protect the information but providing no specific controls, which makes the information CUI Basic; requiring or permitting agencies to control or protect the information and providing specific controls for doing so, which makes the information CUI Specified; or requiring or permitting agencies to control the information and specifying only some of those controls, which makes the information CUI Specified, but with CUI Basic controls where the authority does not specify. Based on CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html . *Usage Note:* Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf. For definitions of key terms see CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.
CONTROLLED	http://terminology.hl7.org/CodeSystem/v3-ActCode	CONTROLLED	A displayed mark, required to be rendered as "CONTROLLED", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf.
CUI	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI	A displayed mark, required to be rendered as "CUI", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf.
CUIHLTH	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI//HLTH	A displayed mark, required to be rendered as "CUI//HLTH", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf
CUIHLTHP	http://terminology.hl7.org/CodeSystem/v3-ActCode	(CUI//HLTH)	A displayed mark, required to be rendered as "(CUI//HLTH)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf
CUIP	http://terminology.hl7.org/CodeSystem/v3-ActCode	(CUI)	A displayed mark, required to be rendered as "(CUI)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf
CUIPRVCY	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI//PRVCY	A displayed mark, required to be rendered as "CUI//PRVCY", indicating that the electronic or hardcopy controlled unclassified basic privacy information is private and must be protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of privacy regulation governing CUI Basic marking include 20 CFR 401.100 related to SSA disclosure of personal, program, and non-program information. https://www.govinfo.gov/content/pkg/CFR-2017-title20-vol2/pdf/CFR-2017-title20-vol2-sec401-100.pdf.
CUIPRVCYP	http://terminology.hl7.org/CodeSystem/v3-ActCode	(CUI//PRVCY)	A displayed mark, required to be rendered as "(CUI//PRVCY)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of privacy regulation governing CUI Basic marking include 20 CFR 401.100 related to SSA disclosure of personal, program, and non-program information. https://www.govinfo.gov/content/pkg/CFR-2017-title20-vol2/pdf/CFR-2017-title20-vol2-sec401-100.pdf.
CUISP-HLTH	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI//SP-HLTH	A displayed mark, required to be rendered as "CUI//SP-HLTH", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI in which the authorizing law, regulation, or Government-wide policy contains specific handling controls that it requires or permits agencies to use that differ from those for CUI Basic. The CUI Registry indicates which laws, regulations, and Government-wide policies include such specific requirements. CUI Specified controls may be more stringent than, or may simply differ from, those required by CUI Basic; the distinction is that the underlying authority spells out the controls for CUI Specified information and does not for CUI Basic information. CUI Basic controls apply to those aspects of CUI Specified where the authorizing laws, regulations, and Government-wide policies do not provide specific guidance. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of healthcare regulation governing CUI Specified marking include HIPAA Transaction and Code Sets and references the Congressional requirement that HHS promulgate Privacy, and Security rules https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf.
CUISP-HLTHP	http://terminology.hl7.org/CodeSystem/v3-ActCode	(CUI//SP-HLTH)	A displayed mark, required to be rendered as "(CUI//SP-HLTH)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of healthcare regulation governing CUI Specified marking include HIPAA Transaction and Code Sets and references the Congressional requirement that HHS promulgate Privacy, and Security rules https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf
CUISP-PRVCY	http://terminology.hl7.org/CodeSystem/v3-ActCode	CUI//SP-PRVCY	A displayed mark, required to be rendered as "CUI//SP-PRVCY", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of privacy regulation governing CUI Specified marking is OMB M-17-12� This Memorandum sets forth the policy for Federal agencies to prepare for and respond to a breach of personally identifiable information (PII). It includes a framework for assessing and mitigating the risk of harm to individuals potentially affected by a breach, as well as guidance on whether and how to provide notification and services to those individuals. https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2017/m-17-12\_0.pdf.
CUISP-PRVCYP	http://terminology.hl7.org/CodeSystem/v3-ActCode	(CUI//SP-PRVCY)	A displayed mark, required to be rendered as "(CUI//SP-PRVCY)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html. *Usage Note:* Examples of privacy regulation governing CUI Specified marking is OMB M-17-12� This Memorandum sets forth the policy for Federal agencies to prepare for and respond to a breach of personally identifiable information (PII). It includes a framework for assessing and mitigating the risk of harm to individuals potentially affected by a breach, as well as guidance on whether and how to provide notification and services to those individuals. https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2017/m-17-12\_0.pdf.
UUI	http://terminology.hl7.org/CodeSystem/v3-ActCode	(U)	A displayed mark, required to be rendered as "(U)", indicating that a portion of an electronic or hardcopy information is neither Executive Order 13556 nor classified information authorities cover as protected. Although this information is not controlled or classified, agencies must still handle it in accordance with Federal Information Security Modernization Act (FISMA) requirements. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html *Usage Note:* Regulatory Source: 32 CFR § 2002.20 Marking. Federal Register Page 63344 63344 (ii) Authorized holders permitted to designate CUI must portion mark both CUI and uncontrolled unclassified portions. CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf CUI Portion Marking: Portion marking of CUI is optional in a fully unclassified document, but is permitted and encouraged to facilitate information sharing and proper handling of the information. Agency heads may approve the required use of CUI Portion marking on all CUI generated within their agency. As such, users should consult their agency CUI policy when creating CUI documents. When CUI Portion Markings are used and a portion does not contain CUI a “U� is placed in parentheses to indicate that the portion contains Uncontrolled Unclassified Information. (Page 14) CUI Portion Markings are placed at the beginning of the portion to which they apply and must be used throughout the entire document. They are presented in all capital letters and separated as indicated in this handbook and the CUI Registry. The presence of EVEN ONE item of CUI in a document requires CUI marking of that document. Because of this, CUI Portion Markings can be of great assistance in determining if a document contains CUI and therefore must be marked as such. Remember: When portion markings are used and any portion does not contain CUI, a “(U)� is placed in front of that portion to indicate that it contains Uncontrolled - or non-CUI - Unclassified Information. (Page 15)
SecurityLabelMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	Security Label Mark	An abstract code for displayed Security Label tags. *Usage Note:* These marks may be based on any of the HL7 Security Labeling related codes from various code systems and values sets, which are organized according to the HL7 Privacy and Security Classification System into HL7 Security Observation Type Named Tag Sets and valued with codes associated with the HL7 Security Observation Value Tag Set Names.
ConfidentialMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	confidential mark	A displayed mark rendered as "Confidential", which indicates to end users that the electronic or hardcopy information they are viewing must be protected at a level of protection as dictated by applicable policy. May be used to indicate proprietary or classified information that is, for example, business, intelligence, or project related, e.g., secret ingredients in a therapeutic substance; location of disaster health facilities and providers, or the name of a manufacturer or project contractor. Example use cases include a display to alert authorized business system users that they are viewing additionally protected proprietary and business confidential information deemed proprietary under an applicable jurisdictional or organizational policy. *Usage Note:* The ConfidentialMark (confidential mark) description is based on the HL7 Confidentiality Concept Domain: Types of privacy metadata classifying an IT resource (data, information object, service, or system capability) according to its level of sensitivity, which is based on an analysis of applicable privacy policies and the risk of financial, reputational, or other harm to an individual or entity that could result if made available or disclosed to unauthorized individuals, entities, or processes. *Usage Note:* Confidentiality codes may be used in security labels and privacy markings to classify IT resources based on sensitivity to indicate the obligation of a custodian or receiver to ensure that the protected resource is not made available or disclosed to individuals, entities, or processes (security principals) unless authorized per applicable policies. Confidentiality codes may also be used in the clearances of initiators requesting access to protected resources. Map: Definition aligns with ISO 7498-2:1989 - Confidentiality is the property that information is not made available or disclosed to unauthorized individuals, entities, or processes.
COPYMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	copy of original mark	A displayed mark indicating that the electronic or hardcopy information is a copy of an authoritative source for the information. The copy is not considered authoritative but is a duplicate of the authoritative content. *Usage Note:* Applicable policy will dictate how the COPY mark will be displayed. Typical renderings include the marking appearing at the top or "banner" of electronic or hardcopy pages, or as watermarks set diagonally across each page.
DeliverToAddresseeOnlyMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	deliver only to addressee mark	A displayed mark on an electronic transmission or physical container such as an electronic transmittal wrapper, batch file, message header, or a physical envelop or package indicating that the contents, whether electronic or hardcopy information, must only be delivered to the authorized recipient(s) named in the address. *Usage Note:* Required by US 32 CRF Part 2002 for container storing or transmitting CUI.
RedisclosureProhibitionMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	prohibition against redisclosure mark	A displayed mark rendered to end users as a prescribed text warning that the electronic or hardcopy information shall not be further disclosed without consent of the subject of the information. For example, in order to warn a recipient of 42 CFR Part 2 information of the redisclosure restrictions, the rule mandates that end users receive a written prohibition against redisclosure unless authorized by patient consent or otherwise permitted by Part 2. See 42 CFR § 2.32 Prohibition on re-disclosure. (a)Notice to accompany disclosure. Each disclosure made with the patient's written consent must be accompanied by one of the following written statements: (1) This information has been disclosed to you from records protected by federal confidentiality rules ( 42 CFR part 2). The federal rules prohibit you from making any further disclosure of information in this record that identifies a patient as having or having had a substance use disorder either directly, by reference to publicly available information, or through verification of such identification by another person unless further disclosure is expressly permitted by the written consent of the individual whose information is being disclosed or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose (see § 2.31). The federal rules restrict any use of the information to investigate or prosecute with regard to a crime any patient with a substance use disorder, except as provided at §§ 2.12(c)(5) and 2.65; or (2) 42 CFR part 2 prohibits unauthorized disclosure of these records. https://www.law.cornell.edu/cfr/text/42/2.32 *Usage Note:* Example of marking requirement from SAMHSA FAQ Response to question 13: Would a logon or splash page notification on an HIO’s portal that contains the Part 2 notice prohibiting redisclosure be sufficient to meet Part 2’s requirement that disclosures made with patient consent be accompanied by such a statement? No. Part 2 requires each disclosure made with written patient consent to be accompanied by a written statement that the information disclosed is protected by federal law and that the recipient cannot make any further disclosure of it unless permitted by the regulations (42 CFR § 2.32). A logon page is the page where a user logs onto a computer system; a splash page is an introductory page to a web site. A logon or splash page notification on a HIO's portal including the statement as required by § 2.32 would not be sufficient notification regarding prohibitions on redisclosure since it would not accompany a specific disclosure. The notification must be tied to the Part 2 information being disclosed in order to ensure that the recipient of that information knows that specific information is protected by Part 2 and cannot be redisclosed except as authorized by the express written consent of the person to whom it pertains or as otherwise permitted by Part 2. https://www.samhsa.gov/about-us/who-we-are/laws-regulations/confidentiality-regulations-faqs
RestrictedConfidentialityMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	restricted confidentiality mark	A displayed mark rendered to end users as "Restricted Confidentiality", which indicates that the electronic or hardcopy information they are viewing, must be protected at a restricted level of confidentiality protection as defined by HL7 Confidentiality code "R" (restricted). Examples: Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient's standing as an employee or a celebrity. Use cases include a display to alert authorized EHR users that they are viewing additionally protected health information deemed sensitive by an applicable jurisdictional, organizational, or personal privacy policy. *Usage Note:* The definition is based on HL7 Confidentiality code "R" (restricted), which is described as: Privacy metadata indicating highly sensitive, potentially stigmatizing information, which presents a high risk to the information subject if disclosed without authorization. May be pre-empted by jurisdictional law, e.g., for public health reporting or emergency treatment. Foundational definitions of Confidentiality: From HL7 Confidentiality Concept Domain: Types of privacy metadata classifying an IT resource (data, information object, service, or system capability) according to its level of sensitivity, which is based on an analysis of applicable privacy policies and the risk of financial, reputational, or other harm to an individual or entity that could result if made available or disclosed to unauthorized individuals, entities, or processes. Usage Note from HL7 Confidentiality code "R": Confidentiality codes may be used in security labels and privacy markings to classify IT resources based on sensitivity to indicate the obligation of a custodian or receiver to ensure that the protected resource is not made available or disclosed to individuals, entities, or processes (security principals) unless authorized per applicable policies. Confidentiality codes may also be used in the clearances of initiators requesting access to protected resources. This metadata indicates that the receiver may be obligated to comply with applicable, prevailing (default) jurisdictional privacy law or disclosure authorization. Map: Definition aligns with ISO 7498-2:1989 - Confidentiality is the property that information is not made available or disclosed to unauthorized individuals, entities, or processes. Map: Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care: Default for normal clinical care access (i.e. most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations.
DRAFTMark	http://terminology.hl7.org/CodeSystem/v3-ActCode	Draft Mark	A displayed mark indicating that the electronic or hard-copy information is still under development and is not yet considered to be ready for normal use.
RefrainPolicy	http://terminology.hl7.org/CodeSystem/v3-ActCode	refrain policy	Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances. *Usage Notes:* ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.
NOAUTH	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without subject authorization	Prohibition on disclosure without information subject's authorization.
NOCOLLECT	http://terminology.hl7.org/CodeSystem/v3-ActCode	no collection	Prohibition on collection or storage of the information.
NODSCLCD	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without consent directive	Prohibition on disclosure without organizational approved patient restriction.
NODSCLCDS	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without information subject's consent directive	Prohibition on disclosure without a consent directive from the information subject.
NOINTEGRATE	http://terminology.hl7.org/CodeSystem/v3-ActCode	no integration	Prohibition on Integration into other records.
NOLIST	http://terminology.hl7.org/CodeSystem/v3-ActCode	no unlisted entity disclosure	Prohibition on disclosure except to entities on specific access list.
NOMOU	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without MOU	Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU).
NOORGPOL	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without organizational authorization	Prohibition on disclosure without organizational authorization.
NOPAT	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure to patient, family or caregivers without attending provider's authorization	Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization. *Usage Note:* The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access. Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance. FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE\_PATIENT. * displayName: Document non visible par le patient * codingScheme: 1.2.250.1.213.1.1.4.13 French use case: A label for documents that the author chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone).
NOPERSISTP	http://terminology.hl7.org/CodeSystem/v3-ActCode	no collection beyond purpose of use	Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.
NORDSCLCD	http://terminology.hl7.org/CodeSystem/v3-ActCode	no redisclosure without consent directive	Prohibition on redisclosure without patient consent directive.
NORDSLCD	http://terminology.hl7.org/CodeSystem/v3-ActCode	no redisclosure without consent directive	Prohibition on redisclosure without patient consent directive.
NORDSCLCDS	http://terminology.hl7.org/CodeSystem/v3-ActCode	no redisclosure without information subject's consent directive	Prohibition on redisclosure without a consent directive from the information subject.
NORDSCLW	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without jurisdictional authorization	Prohibition on disclosure without authorization under jurisdictional law.
NORELINK	http://terminology.hl7.org/CodeSystem/v3-ActCode	no relinking	Prohibition on associating de-identified or pseudonymized information with other information in a manner that could or does result in disclosing information intended to be masked.
NOREUSE	http://terminology.hl7.org/CodeSystem/v3-ActCode	no reuse beyond purpose of use	Prohibition on use of the information beyond the purpose of use initially authorized.
NOVIP	http://terminology.hl7.org/CodeSystem/v3-ActCode	no unauthorized VIP disclosure	Prohibition on disclosure except to principals with access permission to specific VIP information.
ORCON	http://terminology.hl7.org/CodeSystem/v3-ActCode	no disclosure without originator authorization	Prohibition on disclosure except as permitted by the information originator.
HMARKT	http://terminology.hl7.org/CodeSystem/v3-ActReason	healthcare marketing	To perform one or more operations on information for marketing services and products related to health care.
HOPERAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	healthcare operations	To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.
CAREMGT	http://terminology.hl7.org/CodeSystem/v3-ActReason	care management	To perform analytics, evaluation and other secondary uses of treatment and healthcare related information to manage the quality, efficacy, patient safety, population health, and cost effectiveness of healthcare delivery. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment. *Usage Note:* The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service. *Map:* Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services." There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.
DONAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	donation	To perform one or more operations on information used for cadaveric organ, eye or tissue donation.
FRAUD	http://terminology.hl7.org/CodeSystem/v3-ActReason	fraud	To perform one or more operations on information used for fraud detection and prevention processes.
GOV	http://terminology.hl7.org/CodeSystem/v3-ActReason	government	To perform one or more operations on information used within government processes.
HACCRED	http://terminology.hl7.org/CodeSystem/v3-ActReason	health accreditation	To perform one or more operations on information for conducting activities related to meeting accreditation criteria.
HCOMPL	http://terminology.hl7.org/CodeSystem/v3-ActReason	health compliance	To perform one or more operations on information used for conducting activities required to meet a mandate.
HDECD	http://terminology.hl7.org/CodeSystem/v3-ActReason	decedent	To perform one or more operations on information used for handling deceased patient matters.
HDIRECT	http://terminology.hl7.org/CodeSystem/v3-ActReason	directory	To perform one or more operation operations on information used to manage a patient directory. **Examples:** * facility * enterprise * payer * health information exchange patient directory
HDM	http://terminology.hl7.org/CodeSystem/v3-ActReason	healthcare delivery management	To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment. *Usage Note:* Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking. *Map:* Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care." However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.
HLEGAL	http://terminology.hl7.org/CodeSystem/v3-ActReason	legal	To perform one or more operations on information for conducting activities required by legal proceeding.
HOUTCOMS	http://terminology.hl7.org/CodeSystem/v3-ActReason	health outcome measure	To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.
HPRGRP	http://terminology.hl7.org/CodeSystem/v3-ActReason	health program reporting	To perform one or more operations on information used for conducting activities to meet program accounting requirements.
HQUALIMP	http://terminology.hl7.org/CodeSystem/v3-ActReason	health quality improvement	To perform one or more operations on information used for conducting administrative activities to improve health care quality.
HSYSADMIN	http://terminology.hl7.org/CodeSystem/v3-ActReason	health system administration	To perform one or more operations on information to administer the electronic systems used for the delivery of health care.
LABELING	http://terminology.hl7.org/CodeSystem/v3-ActReason	labeling	To perform one or more operations on information to assign, persist, and manage labels to healthcare data to characterize various aspects, such as its security classification, sensitivity, compartment, integrity, and provenance; applicable privacy, consent, security, provenance, and trust policies; and handling caveats such as purpose of use, obligations, and refrain policies. Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification. Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked.
METAMGT	http://terminology.hl7.org/CodeSystem/v3-ActReason	metadata management	To perform one or more operations on information to assign, persist, and manage metadata to healthcare data to characterize various aspects used for its indexing, discovery, retrieval, and processing by systems, applications, and end users. For example, master index identifier, media type, and location.
MEMADMIN	http://terminology.hl7.org/CodeSystem/v3-ActReason	member administration	To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.
MILCDM	http://terminology.hl7.org/CodeSystem/v3-ActReason	military command	To perform one or more operations on information for conducting activities required by military processes, procedures, policies, or law.
PATADMIN	http://terminology.hl7.org/CodeSystem/v3-ActReason	patient administration	To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.
PATSFTY	http://terminology.hl7.org/CodeSystem/v3-ActReason	patient safety	To perform one or more operations on information in processes related to ensuring the safety of health care.
PERFMSR	http://terminology.hl7.org/CodeSystem/v3-ActReason	performance measure	To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.
RECORDMGT	http://terminology.hl7.org/CodeSystem/v3-ActReason	records management	To perform one or more operations on information used within the health records management process.
SYSDEV	http://terminology.hl7.org/CodeSystem/v3-ActReason	system development	To perform one or more operations on information to design, develop, implement, test, or deploy a healthcare system or application.
HTEST	http://terminology.hl7.org/CodeSystem/v3-ActReason	test health data	To perform one or more operations on information that is simulated or synthetic health data used for testing system capabilities outside of a production or operational system environment. *Usage Note:* Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications.
TRAIN	http://terminology.hl7.org/CodeSystem/v3-ActReason	training	To perform one or more operations on information used in training and education.
HPAYMT	http://terminology.hl7.org/CodeSystem/v3-ActReason	healthcare payment	To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.
CLMATTCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	claim attachment	To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.
COVAUTH	http://terminology.hl7.org/CodeSystem/v3-ActReason	coverage authorization	To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
COVERAGE	http://terminology.hl7.org/CodeSystem/v3-ActReason	coverage under policy or program	To perform one or more operations on information for conducting activities related to coverage under a program or policy.
ELIGDTRM	http://terminology.hl7.org/CodeSystem/v3-ActReason	eligibility determination	To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment.
ELIGVER	http://terminology.hl7.org/CodeSystem/v3-ActReason	eligibility verification	To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g., government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays.
ENROLLM	http://terminology.hl7.org/CodeSystem/v3-ActReason	enrollment	To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices.
MILDCRG	http://terminology.hl7.org/CodeSystem/v3-ActReason	military discharge	To perform one or more operations on information for the process of releasing military personnel from their service obligations, which may include determining service merit, discharge benefits, and disability assessment.
REMITADV	http://terminology.hl7.org/CodeSystem/v3-ActReason	remittance advice	To perform one or more operations on information about the amount remitted for a health care claim.
HRESCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	healthcare research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data iincludes basic and applied research such as biomedical, population origin or ancestry, translational research, and disease, discipline, specialty specific healthcare research and clinical trial research.
BIORCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	biomedical research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified biomedical basic or applied research. For example, research on rare plants to determine whether biologic properties may be useful for pharmaceutical development. May be used in combination with clinical trial and other healthcare research purposes of use.
CLINTRCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	clinical trial research	To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.
CLINTRCHNPC	http://terminology.hl7.org/CodeSystem/v3-ActReason	clinical trial research without patient care	To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge without provision of patient care. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, a clinical trial conducted on laboratory specimens collected from a specified patient population.
CLINTRCHPC	http://terminology.hl7.org/CodeSystem/v3-ActReason	clinical trial research with patient care	To perform one or more operations on information for conducting scientific investigations with patient care in accordance with clinical trial protocols to obtain health care knowledge. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, an "off-label" drug used for cancer therapy administer to a specified patient population.
PRECLINTRCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	preclinical trial research	To perform one or more operations on information in preparation for conducting scientific investigation to obtain health care knowledge, such as research on animals or review of patient health records, to determine the feasibility of a clinical trial study; assist with protocol design; or in preparation for institutional review board or ethics committee approval process. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research.
DSRCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	disease specific healthcare research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified conditions, diagnosis, or disease healthcare research. For example, conducting cancer research by testing reaction of tumor cells to certain biologics. May be used in combination with clinical trial and other healthcare research purposes of use.
POARCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	population origins or ancestry healthcare research	To perform one or more operations on information, including genealogical pedigrees, historical records, surveys, family health data, health records, and genetic information, for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to population origins and/or ancestry healthcare research. For example, gathering genetic specimens from a specific population in order to determine the ancestry and population origins of that group. May be used in combination with clinical trial and other healthcare research purposes of use.
TRANSRCH	http://terminology.hl7.org/CodeSystem/v3-ActReason	translational healthcare research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge related to evidence based medicine during the course of providing healthcare treatment. Sometimes referred to as "bench to bedside", which is the iterative feedback loop between healthcare research and clinical trials with input from information collected in the course of routine provision of healthcare. For example, by extending a patient encounter to conduct a survey related to a research topic such as attitudes about use of a wellness device that a patient agreed to use. May be used in combination with clinical trial and other healthcare research purposes of use.
PATRQT	http://terminology.hl7.org/CodeSystem/v3-ActReason	patient requested	To perform one or more operations on information in response to a patient's request.
FAMRQT	http://terminology.hl7.org/CodeSystem/v3-ActReason	family requested	To perform one or more operations on information in response to a request by a family member authorized by the patient.
PWATRNY	http://terminology.hl7.org/CodeSystem/v3-ActReason	power of attorney	To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.
SUPNWK	http://terminology.hl7.org/CodeSystem/v3-ActReason	support network	To perform one or more operations on information in response to a request by a person authorized by the patient.
PUBHLTH	http://terminology.hl7.org/CodeSystem/v3-ActReason	public health	To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
DISASTER	http://terminology.hl7.org/CodeSystem/v3-ActReason	disaster	To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone.
THREAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	threat	To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.
TREAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	treatment	To perform one or more operations on information for provision of health care.
CLINTRL	http://terminology.hl7.org/CodeSystem/v3-ActReason	clinical trial	To perform health care as part of the clinical trial protocol.
COC	http://terminology.hl7.org/CodeSystem/v3-ActReason	coordination of care	To perform one or more actions on information in order to organize the provision and case management of an individual’s healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care. *Usage Note:* Use when describing these functions: 1. Monitoring a person’s goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care. The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment. For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare. *Map:* Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."
ETREAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	Emergency Treatment	To perform one or more operations on information for provision of immediately needed health care for an emergent condition.
BTG	http://terminology.hl7.org/CodeSystem/v3-ActReason	break the glass	To perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access. *Map:* Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.
ERTREAT	http://terminology.hl7.org/CodeSystem/v3-ActReason	emergency room treatment	To perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use. Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure. There is a semantic gap in concepts. This classification term is described as activities “to inform persons� rather than the rationale for performing actions/operations on information related to the activity.
POPHLTH	http://terminology.hl7.org/CodeSystem/v3-ActReason	population health	To perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program.
_ActCoverageAssessmentObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ActCoverageAssessmentObservationValue	Codes specify the category of observation, evidence, or document used to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program. The type of evidence is coded as observation values.
_ActFinancialStatusObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ActFinancialStatusObservationValue	Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.
ASSET	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	asset	Codes specifying asset indicators used to assess or establish eligibility for coverage under a policy or program.
ANNUITY	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	annuity	Indicator of annuity ownership or status as beneficiary.
PROP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	real property	Indicator of real property ownership, e.g., deed or real estate contract.
RETACCT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	retirement investment account	Indicator of retirement investment account ownership.
TRUST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trust	Indicator of status as trust beneficiary.
INCOME	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	income	Code specifying income indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay or pension check, child support payments received or provided, and taxes paid.
CHILD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	child support	Indicator of child support payments received or provided.
DISABL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	disability pay	Indicator of disability income replacement payment.
INVEST	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	investment income	Indicator of investment income, e.g., dividend check, annuity payment; real estate rent, investment divestiture proceeds; trust or endowment check.
PAY	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	paid employment	Indicator of paid employment, e.g., letter of hire, contract, employer letter; copy of pay check or pay stub.
RETIRE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	retirement pay	Indicator of retirement payment, e.g., pension check.
SPOUSAL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	spousal or partner support	Indicator of spousal or partner support payments received or provided; e.g., alimony payment; support stipulations in a divorce settlement.
SUPPLE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	income supplement	Indicator of income supplement, e.g., gifting, parental income support; stipend, or grant.
TAX	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	tax obligation	Indicator of tax obligation or payment, e.g., statement of taxable income.
LIVEXP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	living expense	Codes specifying living expense indicators used to assess or establish eligibility for coverage under a policy or program.
CLOTH	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	clothing expense	Indicator of clothing expenses.
FOOD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	food expense	Indicator of transportation expenses.
HEALTH	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	health expense	Indicator of health expenses; including medication costs, health service costs, financial participations, and health coverage premiums.
HOUSE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	household expense	Indicator of housing expense, e.g., household appliances, fixtures, furnishings, and maintenance and repairs.
LEGAL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	legal expense	Indicator of legal expenses.
MORTG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	mortgage	Indicator of mortgage amount, interest, and payments.
RENT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	rent	Indicator of rental or lease payments.
SUNDRY	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	sundry expense	Indicator of transportation expenses.
TRANS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	transportation expense	Indicator of transportation expenses, e.g., vehicle payments, vehicle insurance, vehicle fuel, and vehicle maintenance and repairs.
UTIL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	utility expense	Indicator of transportation expenses.
ELSTAT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	eligibility indicator	Code specifying eligibility indicators used to assess or establish eligibility for coverage under a policy or program eligibility status, e.g., certificates of creditable coverage; student enrollment; adoption, marriage or birth certificate.
ADOPT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	adoption document	Indicator of adoption.
BTHCERT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	birth certificate	Indicator of birth.
CCOC	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	creditable coverage document	Indicator of creditable coverage.
DRLIC	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	driver license	Indicator of driving status.
FOSTER	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	foster child document	Indicator of foster child status.
MEMBER	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	program or policy member	Indicator of status as covered member under a policy or program, e.g., member id card or coverage document.
MIL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	military identification	Indicator of military status.
MRGCERT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	marriage certificate	Indicator of marriage status.
PASSPORT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	passport	Indicator of citizenship.
STUDENRL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	student enrollment	Indicator of student status.
HLSTAT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	health status	Code specifying non-clinical indicators related to health status used to assess or establish eligibility for coverage under a policy or program, e.g., pregnancy, disability, drug use, mental health issues.
DISABLE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	disabled	Indication of disability.
DRUG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	drug use	Indication of drug use.
IVDRG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	IV drug use	Indication of IV drug use .
PGNT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	pregnant	Non-clinical report of pregnancy.
LIVDEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	living dependency	Code specifying observations related to living dependency, such as dependent upon spouse for activities of daily living.
RELDEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	relative dependent	Continued living in private residence requires functional and health care assistance from one or more relatives.
SPSDEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	spouse dependent	Continued living in private residence requires functional and health care assistance from spouse or life partner.
URELDEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	unrelated person dependent	Continued living in private residence requires functional and health care assistance from one or more unrelated persons.
LIVSIT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	living situation	Code specifying observations related to living situation for a person in a private residence.
ALONE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	alone	Living alone. Maps to PD1-2 Living arrangement (IS) 00742 \[A\]
DEPCHD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	dependent children	Living with one or more dependent children requiring moderate supervision.
DEPSPS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	dependent spouse	Living with disabled spouse requiring functional and health care assistance
DEPYGCHD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	dependent young children	Living with one or more dependent children requiring intensive supervision
FAM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	live with family	Living with family. Maps to PD1-2 Living arrangement (IS) 00742 \[F\]
RELAT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	relative	Living with one or more relatives. Maps to PD1-2 Living arrangement (IS) 00742 \[R\]
SPS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	spouse only	Living only with spouse or life partner. Maps to PD1-2 Living arrangement (IS) 00742 \[S\]
UNREL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	unrelated person	Living with one or more unrelated persons.
SOECSTAT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	socio economic status	Code specifying observations or indicators related to socio-economic status used to assess to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program.
ABUSE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	abuse victim	Indication of abuse victim.
HMLESS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	homeless	Indication of status as homeless.
ILGIM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	illegal immigrant	Indication of status as illegal immigrant.
INCAR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	incarcerated	Indication of status as incarcerated.
PROB	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	probation	Indication of probation status.
REFUG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	refugee	Indication of refugee status.
UNEMPL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	unemployed	Indication of unemployed status.
_AllergyTestValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	AllergyTestValue	Indicates the result of a particular allergy test. E.g. Negative, Mild, Moderate, Severe
A0	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	no reaction	**Description:**Patient exhibits no reaction to the challenge agent.
A1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	minimal reaction	**Description:**Patient exhibits a minimal reaction to the challenge agent.
A2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	mild reaction	**Description:**Patient exhibits a mild reaction to the challenge agent.
A3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	moderate reaction	**Description:**Patient exhibits moderate reaction to the challenge agent.
A4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	severe reaction	**Description:**Patient exhibits a severe reaction to the challenge agent.
_CompositeMeasureScoring	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CompositeMeasureScoring	Observation values that communicate the method used in a quality measure to combine the component measure results included in an composite measure.
ALLORNONESCR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	All-or-nothing Scoring	Code specifying that the measure uses all-or-nothing scoring. All-or-nothing scoring places an individual in the numerator of the composite measure if and only if they are in the numerator of all component measures in which they are in the denominator.
LINEARSCR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Linear Scoring	Code specifying that the measure uses linear scoring. Linear scoring computes the fraction of component measures in which the individual appears in the numerator, giving equal weight to each component measure.
OPPORSCR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Opportunity Scoring	Code specifying that the measure uses opportunity-based scoring. In opportunity-based scoring the measure score is determined by combining the denominator and numerator of each component measure to determine an overall composite score.
WEIGHTSCR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Weighted Scoring	Code specifying that the measure uses weighted scoring. Weighted scoring assigns a factor to each component measure to weight that measure's contribution to the overall score.
_CoverageLimitObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CoverageLimitObservationValue	**Description:**Coded observation values for coverage limitations, for e.g., types of claims or types of parties covered under a policy or program.
_CoverageLevelObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CoverageLevelObservationValue	**Description:**Coded observation values for types of covered parties under a policy or program based on their personal relationships or employment status.
ADC	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	adult child	**Description:**Child over an age as specified by coverage policy or program, e.g., student, differently abled, and income dependent.
CHD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	child	**Description:**Dependent biological, adopted, foster child as specified by coverage policy or program.
DEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	dependent	**Description:**Person requiring functional and/or financial assistance from another person as specified by coverage policy or program.
DP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	domestic partner	**Description:**Persons registered as a family unit in a domestic partner registry as specified by law and by coverage policy or program.
ECH	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	employee	**Description:**An individual employed by an employer who receive remuneration in wages, salary, commission, tips, piece-rates, or pay-in-kind through the employeraTMs payment system (i.e., not a contractor) as specified by coverage policy or program.
FLY	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	family coverage	**Description:**As specified by coverage policy or program.
IND	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	individual	**Description:**Person as specified by coverage policy or program.
SSP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	same sex partner	**Description:**A pair of people of the same gender who live together as a family as specified by coverage policy or program, e.g., Naomi and Ruth from the Book of Ruth; Socrates and Alcibiades
_CoverageItemLimitObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CoverageItemLimitObservationValue	**Description:**Coded observation values for types or instances of items for which coverage is provided under a policy or program, e.g., a type of vehicle or a named work of art.
_CoverageLocationLimitObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CoverageLocationLimitObservationValue	**Description:**Coded observation values for types or instances of locations for which coverage is provided under a policy or program, e.g., in the covered party home, in state or in the country.
_CriticalityObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CriticalityObservationValue	A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.
CRITH	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high criticality	Worst case result of a future exposure is assessed to be life-threatening or having high potential for organ system failure.
CRITL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low criticality	Worst case result of a future exposure is not assessed to be life-threatening or having high potential for organ system failure.
CRITU	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	unable to assess criticality	Unable to assess the worst case result of a future exposure.
_EmploymentStatus	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	_EmploymentStatus	Concepts representing whether a person does or does not currently have a job or is not currently in the labor pool seeking employment.
Employed	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Employed	Individuals who, during the last week: a) did any work for at least 1 hour as paid or unpaid employees of a business or government organization; worked in their own businesses, professions, or on their own farms; or b) were not working, but who have a job or business from which the individual was temporarily absent because of vacation, illness, bad weather, childcare problems, maternity or paternity leave, labor-management dispute, job training, or other family or personal reasons, regardless of whether or not they were paid for the time off or were seeking other jobs.
NotInLaborForce	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Not In Labor Force	Persons not classified as employed or unemployed, meaning those who have no job and are not looking for one.
Unemployed	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Unemployed	Persons who currently have no employment, but are available for work and have made specific efforts to find employment.
_GeneticObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	GeneticObservationValue	**Description:** The domain contains genetic analysis specific observation values, e.g. Homozygote, Heterozygote, etc.
Homozygote	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	HOMO	**Description:** An individual having different alleles at one or more loci regarding a specific character
_MeasurementImprovementNotation	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Measurement Improvement Notation	Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
DecrIsImp	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Decreased score indicates improvement	Improvement is indicated as a decrease in the score or measurement (e.g. Lower score indicates better quality)
IncrIsImp	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Increased score indicates improvement	Improvement is indicated as an increase in the score or measurement (e.g. Higher score indicates better quality)
_ObservationMeasureScoring	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ObservationMeasureScoring	Observation values used to indicate the type of scoring (e.g. proportion, ratio) used by a health quality measure.
COHORT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	cohort measure scoring	A measure in which either short-term cross-section or long-term longitudinal analysis is performed over a group of subjects defined by a set of common properties or defining characteristics (e.g., Male smokers between the ages of 40 and 50 years, exposure to treatment, exposure duration).
CONTVAR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	continuous variable measure scoring	A measure score in which each individual value for the measure can fall anywhere along a continuous scale (e.g., mean time to thrombolytics which aggregates the time in minutes from a case presenting with chest pain to the time of administration of thrombolytics).
PROPOR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	proportion measure scoring	A score derived by dividing the number of cases that meet a criterion for quality (the numerator) by the number of eligible cases within a given time frame (the denominator) where the numerator cases are a subset of the denominator cases (e.g., percentage of eligible women with a mammogram performed in the last year).
RATIO	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ratio measure scoring	A score that may have a value of zero or greater that is derived by dividing a count of one type of data by a count of another type of data (e.g., the number of patients with central lines who develop infection divided by the number of central line days).
_ObservationMeasureType	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ObservationMeasureType	Observation values used to indicate what kind of health quality measure is used.
COMPOSITE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	composite measure type	A measure that is composed from one or more other measures and indicates an overall summary of those measures.
EFFICIENCY	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	efficiency measure type	A measure related to the efficiency of medical treatment.
EXPERIENCE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	experience measure type	A measure related to the level of patient engagement or patient experience of care.
OUTCOME	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	outcome measure type	A measure that indicates the result of the performance (or non-performance) of a function or process.
INTERM-OM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	intermediate clinical outcome measure	A measure that evaluates the change over time of a physiologic state observable that is associated with a specific long-term health outcome.
PRO-PM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	patient reported outcome performance measure	A measure that is a comparison of patient reported outcomes for a single or multiple patients collected via an instrument specifically designed to obtain input directly from patients.
PROCESS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	process measure type	A measure which focuses on a process which leads to a certain outcome, meaning that a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.
APPROPRIATE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	appropriate use process measure	A measure that assesses the use of one or more processes where the expected health benefit exceeds the expected negative consequences.
RESOURCE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	resource use measure type	A measure related to the extent of use of clinical resources or cost of care.
STRUCTURE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	structure measure type	A measure related to the structure of patient care.
_ObservationPopulationInclusion	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ObservationPopulationInclusion	Observation values used to assert various populations that a subject falls into.
DENEX	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	denominator exclusions	Patients who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.
DENEXCEP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	denominator exceptions	Denominator exceptions are those conditions that should remove a patient, procedure or unit of measurement from the denominator only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories: * Medical reasons * Patient reasons * System reasons
DENOM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	denominator	It can be the same as the initial patient population or a subset of the initial patient population to further constrain the population for the purpose of the eMeasure. Different measures within an eMeasure set may have different Denominators. Continuous Variable eMeasures do not have a Denominator, but instead define a Measure Population.
IP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	initial population	The initial population refers to all entities to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs.
IPP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	initial patient population	The initial patient population refers to all patients to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs. Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.
MSRPOPL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	measure population	Measure population is used only in continuous variable eMeasures. It is a narrative description of the eMeasure population. (e.g., all patients seen in the Emergency Department during the measurement period).
NUMER	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	numerator	Numerators are used in proportion and ratio eMeasures. In proportion measures the numerator criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. In ratio measures the numerator is related, but not directly derived from the denominator (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).
NUMEX	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	numerator exclusions	Numerator Exclusions are used only in ratio eMeasures to define instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion.)
_PartialCompletionScale	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	PartialCompletionScale
G	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Great extent	Value for Act.partialCompletionCode attribute that implies 81-99% completion
LE	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Large extent	Value for Act.partialCompletionCode attribute that implies 61-80% completion
ME	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Medium extent	Value for Act.partialCompletionCode attribute that implies 41-60% completion
MI	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Minimal extent	Value for Act.partialCompletionCode attribute that implies 1-20% completion
N	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	None	Value for Act.partialCompletionCode attribute that implies 0% completion
S	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Some extent	Value for Act.partialCompletionCode attribute that implies 21-40% completion
_SecurityObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	SecurityObservationValue	Observation values used to indicate security observation metadata.
_SECCATOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	security category	Abstract security observation values used to indicate security category metadata. **Examples:** Codes conveying: * privacy law * information sensitivity * consent directive types
_SECCLASSOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	security classification	Abstract security observation values used to indicate security classification metadata. **Examples:** Confidentiality Codes
_SECCONOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	security control	Abstract security observation values used to indicate security control metadata. **Examples:** Codes conveying dissemination controls, information handling caveats, purpose of use, refrain policies, and obligations to which custodians and information receivers must comply.
_SECINTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	security integrity	Abstract security observation values used to indicate security integrity metadata. **Examples:** Codes conveying integrity status, integrity confidence, and provenance.
SECTRSTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	security trust observation	Observation value used to indicate aspects of trust applicable to an IT resource (data, information object, service, or system capability).
TRSTACCRDOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trust accreditation observation	Values for security trust accreditation metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
TRSTAGREOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trust agreement observation	Values for security trust agreement metadata observation made about privacy and security requirements with which a security domain must comply. \[ISO IEC 10181-1\] \[ISO IEC 10181-1\]
TRSTCERTOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trust certificate observation	Values for security trust certificate metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\] For example, a Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. A particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. Another example is Cross Certification with Federal Bridge.
TRSTFWKOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	none supplied 5	Values for security trust framework metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]
TRSTLOAOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trust assurance observation	Values for security trust assurance metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
LOAAN	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	authentication level of assurance value	The value assigned as the indicator of the digital quality or reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\] For example, the degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]
LOAAN1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low authentication level of assurance	Indicator of low digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\] Low authentication level of assurance indicates that the relying party may have little or no confidence in the asserted identity's validity. Level 1 requires little or no confidence in the asserted identity. No identity proofing is required at this level, but the authentication mechanism should provide some assurance that the same claimant is accessing the protected transaction or data. A wide range of available authentication technologies can be employed and any of the token methods of Levels 2, 3, or 4, including Personal Identification Numbers (PINs), may be used. To be authenticated, the claimant must prove control of the token through a secure authentication protocol. At Level 1, long-term shared authentication secrets may be revealed to verifiers. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAN2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic authentication level of assurance	Indicator of basic digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\] Basic authentication level of assurance indicates that the relying party may have some confidence in the asserted identity's validity. Level 2 requires confidence that the asserted identity is accurate. Level 2 provides for single-factor remote network authentication, including identity-proofing requirements for presentation of identifying materials or information. A wide range of available authentication technologies can be employed, including any of the token methods of Levels 3 or 4, as well as passwords. Successful authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, and online guessing attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are required. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAN3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium authentication level of assurance	Indicator of medium digital quality or reliability of the digital reliability of verification and validation of the process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\] Medium authentication level of assurance indicates that the relying party may have high confidence in the asserted identity's validity. Level 3 is appropriate for transactions that need high confidence in the accuracy of the asserted identity. Level 3 provides multifactor remote network authentication. At this level, identity-proofing procedures require verification of identifying materials and information. Authentication is based on proof of possession of a key or password through a cryptographic protocol. Cryptographic strength mechanisms should protect the primary authentication token (a cryptographic key) against compromise by the protocol threats, including eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks. A minimum of two authentication factors is required. Three kinds of tokens may be used: * "soft" cryptographic token, which has the key stored on a general-purpose computer, * "hard" cryptographic token, which has the key stored on a special hardware device, and * "one-time password" device token, which has symmetric key stored on a personal hardware device that is a cryptographic module validated at FIPS 140-2 Level 1 or higher. Validation testing of cryptographic modules and algorithms for conformance to Federal Information Processing Standard (FIPS) 140-2, Security Requirements for Cryptographic Modules, is managed by NIST. Authentication requires that the claimant prove control of the token through a secure authentication protocol. The token must be unlocked with a password or biometric representation, or a password must be used in a secure authentication protocol, to establish two-factor authentication. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are used for all operations. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAN4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high authentication level of assurance	Indicator of high digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\] High authentication level of assurance indicates that the relying party may have very high confidence in the asserted identity's validity. Level 4 is for transactions that need very high confidence in the accuracy of the asserted identity. Level 4 provides the highest practical assurance of remote network authentication. Authentication is based on proof of possession of a key through a cryptographic protocol. This level is similar to Level 3 except that only “hard� cryptographic tokens are allowed, cryptographic module validation requirements are strengthened, and subsequent critical data transfers must be authenticated via a key that is bound to the authentication process. The token should be a hardware cryptographic module validated at FIPS 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. This level requires a physical token, which cannot readily be copied, and operator authentication at Level 2 and higher, and ensures good, two-factor remote authentication. Level 4 requires strong cryptographic authentication of all parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Strong approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	authentication process level of assurance value	The value assigned as the indicator of the digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]
LOAAP1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low authentication process level of assurance	Indicator of the low digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\] Low authentication process level of assurance indicates that (1) long-term shared authentication secrets may be revealed to verifiers; and (2) assertions and assertion references require protection from manufacture/modification and reuse attacks. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAP2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic authentication process level of assurance	Indicator of the basic digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\] Basic authentication process level of assurance indicates that long-term shared authentication secrets are never revealed to any other party except Credential Service Provider (CSP). Sessions (temporary) shared secrets may be provided to independent verifiers by CSP. Long-term shared authentication secrets, if used, are never revealed to any other party except Verifiers operated by the Credential Service Provider (CSP); however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 1 requirements, assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAP3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium authentication process level of assurance	Indicator of the medium digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\] Medium authentication process level of assurance indicates that the token can be unlocked with password, biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication. Long-term shared authentication secrets are never revealed to any party except the Claimant and Credential Service Provider (CSP). Authentication requires that the Claimant prove, through a secure authentication protocol, that he or she controls the token. The Claimant unlocks the token with a password or biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication (through proof of possession of a physical or software token in combination with some memorized secret knowledge). Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 2 requirements, assertions are protected against repudiation by the Verifier.
LOAAP4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high authentication process level of assurance	Indicator of the high digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\] High authentication process level of assurance indicates all sensitive data transfer are cryptographically authenticated using keys bound to the authentication process. Level 4 requires strong cryptographic authentication of all communicating parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the Claimant prove through a secure authentication protocol that he or she controls the token. All protocol threats at Level 3 are required to be prevented at Level 4. Protocols shall also be strongly resistant to man-in-the-middle attacks. Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. Approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	assertion level of assurance value	The value assigned as the indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.
LOAAS1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low assertion level of assurance	Indicator of the low quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions and assertion references require protection from modification and reuse attacks. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAS2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic assertion level of assurance	Indicator of the basic quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required for all assertion protocols. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAS3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium assertion level of assurance	Indicator of the medium quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions are protected against repudiation by the verifier. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOAAS4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high assertion level of assurance	Indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Strongly resistant to man-in-the-middle attacks. "Bearer" assertions are not used. "Holder-of-key" assertions may be used. RP maintains records of the assertions. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]
LOACM	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	token and credential management level of assurance value)	Indicator of the digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOACM1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low token and credential management level of assurance	Indicator of the low digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Little or no confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include weak identity binding to tokens and plaintext passwords or secrets not transmitted across a network. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOACM2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic token and credential management level of assurance	Indicator of the basic digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Some confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verification must prove claimant controls the token; token resists online guessing, replay, session hijacking, and eavesdropping attacks; and token is at least weakly resistant to man-in-the middle attacks. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOACM3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium token and credential management level of assurance	Indicator of the medium digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it’s binding to an identity. High confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Ownership of token verifiable through security authentication protocol and credential management protects against verifier impersonation attacks. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOACM4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high token and credential management level of assurance	Indicator of the high digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it’s binding to an identity. Very high confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verifier can prove control of token through a secure protocol; credential management supports strong cryptographic authentication of all communication parties. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOAID	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	identity proofing level of assurance	Indicator of the quality or reliability in the process of ascertaining that an individual is who he or she claims to be.
LOAID1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low identity proofing level of assurance	Indicator of low digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires that a continuity of identity be maintained but does not require identity proofing. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOAID2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic identity proofing level of assurance	Indicator of some digital quality or reliability in the process of ascertaining that that an individual is who he or she claims to be. Requires identity proofing via presentation of identifying material or information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOAID3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium identity proofing level of assurance	Indicator of high digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires identity proofing procedures for verification of identifying materials and information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOAID4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high identity proofing level of assurance	Indicator of high digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires identity proofing procedures for verification of identifying materials and information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOANR	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	non-repudiation level of assurance value	Indicator of the digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]
LOANR1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low non-repudiation level of assurance	Indicator of low digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]
LOANR2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic non-repudiation level of assurance	Indicator of basic digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]
LOANR3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium non-repudiation level of assurance	Indicator of medium digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]
LOANR4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high non-repudiation level of assurance	Indicator of high digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]
LOARA	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	remote access level of assurance value	Indicator of the digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. \[Based on NIST SP 800-63-2\]
LOARA1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low remote access level of assurance	Indicator of low digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. \[Based on NIST SP 800-63-2\]
LOARA2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic remote access level of assurance	Indicator of basic digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. \[Based on NIST SP 800-63-2\]
LOARA3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium remote access level of assurance	Indicator of medium digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. \[Based on NIST SP 800-63-2\]
LOARA4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high remote access level of assurance	Indicator of high digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]
LOATK	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	token level of assurance value	Indicator of the digital quality or reliability of single and multi-token authentication. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOATK1	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	low token level of assurance	Indicator of the low digital quality or reliability of single and multi-token authentication. Permits the use of any of the token methods of Levels 2, 3, or 4. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOATK2	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	basic token level of assurance	Indicator of the basic digital quality or reliability of single and multi-token authentication. Requires single factor authentication using memorized secret tokens, pre-registered knowledge tokens, look-up secret tokens, out of band tokens, or single factor one-time password devices. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOATK3	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	medium token level of assurance	Indicator of the medium digital quality or reliability of single and multi-token authentication. Requires two authentication factors. Provides multi-factor remote network authentication. Permits multi-factor software cryptographic token. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
LOATK4	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	high token level of assurance	Indicator of the high digital quality or reliability of single and multi-token authentication. Requires token that is a hardware cryptographic module validated at validated at Federal Information Processing Standard (FIPS) 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. Level 4 token requirements can be met by using the PIV authentication key of a FIPS 201 compliant Personal Identity Verification (PIV) Card. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]
TRSTMECOBV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	none supplied 6	Values for security trust mechanism metadata observation made about a security architecture system component that supports enforcement of security policies.
_SeverityObservation	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	SeverityObservation	Potential values for observations of severity.
H	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	High	Indicates the condition may be life-threatening or has the potential to cause permanent injury.
L	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Low	Indicates the condition may result in some adverse consequences but is unlikely to substantially affect the situation of the subject.
M	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Moderate	Indicates the condition may result in noticable adverse adverse consequences but is unlikely to be life-threatening or cause permanent injury.
_SubjectBodyPosition	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	_SubjectBodyPosition	Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.
LLD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	left lateral decubitus	Lying on the left side.
PRN	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	prone	Lying with the front or ventral surface downward; lying face down.
RLD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	right lateral decubitus	Lying on the right side.
SFWL	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Semi-Fowler's	A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.
SIT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	sitting	Resting the body on the buttocks, typically with upper torso erect or semi erect.
STN	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	standing	To be stationary, upright, vertical, on one's legs.
SUP	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	supine
RTRD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	reverse trendelenburg	Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered.
TRD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	trendelenburg	Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised.
_VerificationOutcomeValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	verification outcome	Values for observations of verification act results **Examples:** Verified, not verified, verified with warning.
ACT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	active coverage	**Definition:** Coverage is in effect for healthcare service(s) and/or product(s).
ACTPEND	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	active - pending investigation	**Definition:** Coverage is in effect for healthcare service(s) and/or product(s) - Pending Investigation
ELG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	eligible	**Definition:** Coverage is in effect for healthcare service(s) and/or product(s).
INACT	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	inactive	**Definition:** Coverage is not in effect for healthcare service(s) and/or product(s).
INPNDINV	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	inactive - pending investigation	**Definition:** Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Investigation.
INPNDUPD	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	inactive - pending eligibility update	**Definition:** Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Eligibility Update.
NELG	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	not eligible	**Definition:** Coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.
_WorkSchedule	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	_WorkSchedule	Concepts that describe an individual's typical arrangement of working hours for an occupation.
DS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	daytime shift	A person who is scheduled for work during daytime hours (for example between 6am and 6pm) on a regular basis.
EMS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	early morning shift	Consistent Early morning schedule of 13 hours or less per shift (between 2 am and 2 pm)
ES	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	evening shift	A person who is scheduled for work during evening hours (for example between 2pm and midnight) on a regular basis.
NS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	night shift	Scheduled for work during nighttime hours (for example between 9pm and 8am) on a regular basis.
RSWN	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	rotating shift with nights	Scheduled for work times that change periodically between days, and/or evenings, and includes some night shifts.
RSWON	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	rotating shift without nights	Scheduled for work days/times that change periodically between days, but does not include night or evening work.
SS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	split shift	Shift consisting of two distinct work periods each day that are separated by a break of a few hours (for example 2 to 4 hours)
VLS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	very long shift	Shifts of 17 or more hours.
VS	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	variable shift	Irregular, unpredictable hours scheduled on a short notice (for example, less than 2 day notice): inconsistent schedule, on-call, as needed, as available.
_AnnotationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	AnnotationValue
_ECGAnnotationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ECGAnnotationValue
_CommonClinicalObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	common clinical observation	**Description:**Used in a patient care message to value simple clinical (non-lab) observations.
_CommonClinicalObservationAssertionValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CommonClinicalObservationAssertionValue	**Definition:** The non-laboratory, non-DI (diagnostic imaging) coded observation if no value is also required to convey the full meaning of the observation. This may be a single concept code or a complex expression.
_CommonClinicalObservationResultValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CommonClinicalObservationResultValue	**Definition:** The non-laboratory, non-diagnostic imaging coded result of the coded observable or "question" represented by the paired concept from the the NonLabDICodedObservationType domain. \] **Examples:**An APGAR result, a functional assessment, etc. The value must not require a specific unit of measure.
_CoverageChemicalDependencyValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CoverageChemicalDependencyValue	**Definition:** The category of addiction used for coverage purposes that may refer to a substance, the consumption of which may result in physical or emotional harm.
_IndividualCaseSafetyReportValueDomains	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Individual Case Safety Report Value Domains	This domain is established as a parent to a variety of value domains being defined to support the communication of Individual Case Safety Reports to regulatory bodies. Arguably, this aggregation is not taxonomically pure, but the grouping will facilitate the management of these domains.
_CaseSeriousnessCriteria	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	CaseSeriousnessCriteria	A code that provides information on the overall effect or outcome of the adverse reaction/adverse event reported in the ICSR. Note the criterion applies to the case as a whole and not to an individual reaction. Example concepts are: death, disability, hospitalization, congenital anomaly/ birth defect, and other medically important condition.
_DeviceManufacturerEvaluationInterpretation	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	DeviceManufacturerEvaluationInterpretation	A code set that includes codes that are used to characterize the outcome of the device evaluation process. The code defines the manufacturer's conclusions following the evaluation. Examples include: inadequate alarms, device maintenance contributed to event, device failed just prior to use, user error caused event
_DeviceManufacturerEvaluationMethod	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	DeviceManufacturerEvaluationMethod	Code assigned to indicate a relevant fact within the context of the evaluation of a reported product. There are a number of concept types including the status of the evaluation, the type of evaluation findings, and the type of activity carried out as part of the evaluation process. Examples include: Actual device involved in incident was evaluated, electrical tests performed, visual examination.
_DeviceManufacturerEvaluationResult	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	DeviceManufacturerEvaluationResult	Code assigned to indicate an outcome of the manufacturer's investigation of a product for which a defect has been reported. Examples include:.component/subassembly failure: air cleaner, computer-, imaging system-, microprocessor-controlled device problem: cache memory, design -- not fail safe.
_PertinentReactionRelatedness	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Pertinent Reaction Relatedness	A code to capture the reporter's assessment of the extent to which the reaction is related to the suspect product reported in the ICSR. Example concepts include: related, not related, possibly related and unlikely related.
_ProductCharacterization	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Product Characterization	A code that characterizes the role that the primary reporter felt that the suspect intervention -- either a substance administration or a device related procedure - played in the incident being reported. This code will capture the primary reporter's assessment of the role that the suspect product played in the incident reported in the ICSR. Examples include: Suspect, Concomitant, Interacting, Re-challenge.
_ReactionActionTaken	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	ReactionActionTaken	Code used to indicate the action taken by practitioner in response to the problem (whether drug or device related) that is reported in the ICSR. Examples include: failing device replaced, medication stopped, medication dose adjusted.
_SubjectReaction	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	Subject Reaction	A code to capture the kind of reaction that was suffered by the investigated subject, and that is being reported in the ICSR. At this point, SNOMED or MedDRA have been suggested as code systems to be used for providing this information. Example concepts include hives, swelling, rash, anaphylactic shock.
_SubjectReactionEmphasis	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	SubjectReactionEmphasis	Code that captures the emphasis that the reporter placed on this reaction. Examples include: highlighted by the reporter, NOT serious, Not highlighted by the reporter, NOT serious, Highlighted by the reporter, SERIOUS, Not highlighted by the reporter, SERIOUS.
_SubjectReactionOutcome	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	SubjectReactionOutcome	Code that captures the type of outcome from an individual outcome of a reaction to the suspect product reported in the ICSR. Examples include: Recovered/resolved. Recovering/resolving, Not recovered/not resolved, Recovered/resolved with sequelae, Fatal.
_InjuryObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	InjuryObservationValue	Values for observations of injuries.
_IntoleranceValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	IntoleranceValue	Codes identifying pariticular groupings of allergens and other agents which cause allergies and intolerances. E.g. the drug, allergen group, food or environmental agent which triggers the intolerance
_IssueTriggerObservationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	IssueTriggerObservationValue	The combined domain for different types of coded observation issue triggers, such as diagnoses, allergies, etc.
_OtherIndicationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	OtherIndicationValue	Indicates an observed reason for a medical action other than an indication or symptom. E.g. Need for a contrast agent prior to a diagnostic image, need for anesthesia prior to surgery, etc.
_IndicationValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	IndicationValue	Indicates the specific observation result which is the reason for the action (prescription, lab test, etc.). E.g. Headache, Ear infection, planned diagnostic image (requiring contrast agent), etc.
_DiagnosisValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	DiagnosisValue	Diagnosis Value
_SymptomValue	http://terminology.hl7.org/CodeSystem/v3-ObservationValue	SymptomValue	Indicates an observed abnormality in the patientaTMs condition, but does not assert causation. E.g. Runny nose, swelling, flaky skin, etc.
_ActUSPrivacyLaw	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	ActUSPrivacyLaw	*Definition:* A jurisdictional mandate in the U.S. relating to privacy. *Usage Note:* ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies. May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.
42CFRPart2	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	42 CFR Part2	42 CFR Part 2 stipulates the right of an individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program. *Definition:* Non-disclosure of health information relating to health care paid for by a federally assisted substance abuse program without patient consent. *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
CommonRule	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	Common Rule	U.S. Federal regulations governing the protection of human subjects in research (codified at Subpart A of 45 CFR part 46) that has been adopted by 15 U.S. Federal departments and agencies in an effort to promote uniformity, understanding, and compliance with human subject protections. Existing regulations governing the protection of human subjects in Food and Drug Administration (FDA)-regulated research (21 CFR parts 50, 56, 312, and 812) are separate from the Common Rule but include similar requirements. *Definition:* U.S. federal laws governing research-related privacy policies. *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.
HIPAANOPP	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	HIPAA notice of privacy practices	The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Subpart E) permits access, use and disclosure of certain personal health information (PHI as defined under the law) for purposes of Treatment, Payment, and Operations, and requires that the provider ask that patients acknowledge the Provider's Notice of Privacy Practices as permitted conduct under the law. *Definition:* Notification of HIPAA Privacy Practices. *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.
HIPAAPsyNotes	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	HIPAA psychotherapy notes	The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Section 164.508) requires authorization for certain uses and disclosure of psychotherapy notes. *Definition:* Authorization that must be obtained for disclosure of psychotherapy notes. *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
HIPAASelfPay	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	HIPAA self-pay	Section 13405(a) of the Health Information Technology for Economic and Clinical Health Act (HITECH) stipulates the right of an individual to have disclosures regarding certain health care items or services for which the individual pays out of pocket in full restricted from a health plan. *Definition:* Non-disclosure of health information to a health plan relating to health care items or services for which an individual pays out of pocket in full. *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Title38Section7332	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	Title 38 Section 7332	Title 38 Part 1-protected information may only be disclosed to a third party with the special written consent of the patient except where expressly authorized by 38 USC 7332. VA may disclose this information for specific purposes to: VA employees on a need to know basis - more restrictive than Privacy Act need to know; contractors who need the information in order to perform or fulfill the duties of the contract; and researchers who provide assurances that the information will not be identified in any report. This information may also be disclosed without consent where patient lacks decision-making capacity; in a medical emergency for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention; for eye, tissue, or organ donation purposes; and disclosure of HIV information for public health purposes. *Definition:* Title 38 Part 1 - §1.462 Confidentiality restrictions. (a) General. The patient records to which §§1.460 through 1.499 of this part apply may be disclosed or used only as permitted by these regulations and may not otherwise be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority. Any disclosure made under these regulations must be limited to that information which is necessary to carry out the purpose of the disclosure. SUBCHAPTER III--PROTECTION OF PATIENT RIGHTS Sec. 7332. Confidentiality of certain medical records (a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b). *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Title38Part1	http://terminology.hl7.org/CodeSystem/v3-ActUSPrivacyLaw	Title 38 Section 7332	Title 38 Part 1-protected information may only be disclosed to a third party with the special written consent of the patient except where expressly authorized by 38 USC 7332. VA may disclose this information for specific purposes to: VA employees on a need to know basis - more restrictive than Privacy Act need to know; contractors who need the information in order to perform or fulfill the duties of the contract; and researchers who provide assurances that the information will not be identified in any report. This information may also be disclosed without consent where patient lacks decision-making capacity; in a medical emergency for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention; for eye, tissue, or organ donation purposes; and disclosure of HIV information for public health purposes. *Definition:* Title 38 Part 1 - §1.462 Confidentiality restrictions. (a) General. The patient records to which §§1.460 through 1.499 of this part apply may be disclosed or used only as permitted by these regulations and may not otherwise be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority. Any disclosure made under these regulations must be limited to that information which is necessary to carry out the purpose of the disclosure. SUBCHAPTER III--PROTECTION OF PATIENT RIGHTS Sec. 7332. Confidentiality of certain medical records (a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b). *Usage Note:* May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page: