This value set includes codes based on the following rules:

• Include these codes as defined in http://hl7.org/fhir/v3/Confidentiality version 1.0.2

  Code	Display	Definition
  _Confidentiality	Confidentiality	A specializable code and its leaf codes used in Confidentiality value sets to value the Act.Confidentiality and Role.Confidentiality attribute in accordance with the definition for concept domain "Confidentiality".
  B	business	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. However, no patient related information may ever be of this confidentiality level. Deprecation Comment: Replced by ActCode.B
  D	clinician	Description: Only clinicians may see this item, billing and administration persons can not access this item without special permission. Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
  I	individual	Description: Access only to individual persons who are mentioned explicitly as actors of this service and whose actor type warrants that access (cf. to actor type code). Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
  ETH	substance abuse related	Description: Alcohol/drug-abuse related item Deprecation Comment:Replced by ActCode.ETH
  HIV	HIV related	Description: HIV and AIDS related item Deprecation Comment:Replced by ActCode.HIV
  PSY	psychiatry relate	Description: Psychiatry related item Deprecation Comment:Replced by ActCode.PSY
  SDV	sexual and domestic violence related	Description: Sexual assault / domestic violence related item Deprecation Comment:Replced by ActCode.SDV
  C	celebrity	Description: Celebrities are people of public interest (VIP) including employees, whose information require special protection. Deprecation Comment:Replced by ActCode.CEL
  S	sensitive	Description: Information for which the patient seeks heightened confidentiality. Sensitive information is not to be shared with family members. Information reported by the patient about family members is sensitive by default. Flag can be set or cleared on patient's request. Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
  T	taboo	Description: Information not to be disclosed or discussed with patient except through physician assigned to patient in this case. This is usually a temporary constraint only, example use is a new fatal diagnosis or finding, such as malignancy or HIV. Deprecation Note:Replced by ActCode.TBOO
  L	low	Definition: Privacy metadata indicating that the information has been de-identified, and there are mitigating circumstances that prevent re-identification, which minimize risk of harm from unauthorized disclosure. The information requires protection to maintain low sensitivity. Examples: Includes anonymized, pseudonymized, or non-personally identifiable information such as HIPAA limited data sets. Map: No clear map to ISO 13606-4 Sensitivity Level (1) Care Management: RECORD_COMPONENTs that might need to be accessed by a wide range of administrative staff to manage the subject of care's access to health services. Usage Note: This metadata indicates the receiver may have an obligation to comply with a data use agreement.
  M	moderate	Definition: Privacy metadata indicating moderately sensitive information, which presents moderate risk of harm if disclosed without authorization. Examples: Includes allergies of non-sensitive nature used inform food service; health information a patient authorizes to be used for marketing, released to a bank for a health credit card or savings account; or information in personal health record systems that are not governed under health privacy laws. Map: Partial Map to ISO 13606-4 Sensitivity Level (2) Clinical Management: Less sensitive RECORD_COMPONENTs that might need to be accessed by a wider range of personnel not all of whom are actively caring for the patient (e.g. radiology staff). Usage Note: This metadata indicates that the receiver may be obligated to comply with the receiver's terms of use or privacy policies.
  N	normal	Definition: Privacy metadata indicating that the information is typical, non-stigmatizing health information, which presents typical risk of harm if disclosed without authorization. Examples: In the US, this includes what HIPAA identifies as the minimum necessary protected health information (PHI) given a covered purpose of use (treatment, payment, or operations). Includes typical, non-stigmatizing health information disclosed in an application for health, workers compensation, disability, or life insurance. 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. Usage Note: This metadata indicates that the receiver may be obligated to comply with applicable jurisdictional privacy law or disclosure authorization.
  R	restricted	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. 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. 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.. Usage Note: This metadata indicates that the receiver may be obligated to comply with applicable, prevailing (default) jurisdictional privacy law or disclosure authorization..
  U	unrestricted	Definition: Privacy metadata indicating that the information is not classified as sensitive. Examples: Includes publicly available information, e.g. business name, phone, email or physical address. Usage Note: This metadata indicates that the receiver has no obligation to consider additional policies when making access control decisions. Note that in some jurisdictions, personally identifiable information must be protected as confidential, so it would not be appropriate to assign a confidentiality code of "unrestricted" to that information even if it is publicly available.
  V	very restricted	. Privacy metadata indicating that the information is extremely sensitive and likely stigmatizing health information that presents a very high risk if disclosed without authorization. This information must be kept in the highest confidence. 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 “legal lock� or attorney-client privilege Map: This metadata indicates that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject. Usage Note: This metadata indicates that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.

• Include these codes as defined in http://hl7.org/fhir/v3/ActUSPrivacyLaw version 1.0.2

  Code	Display	Definition
  _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	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	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	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	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	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	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.

• Include these codes as defined in http://hl7.org/fhir/v3/ActCode version 1.0.2

  Code	Display	Definition
  ETH	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	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	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.
  PSY	psychiatry information sensitivity	Policy for handling psychiatry information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to psychiatry 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.
  SCA	sickle cell anemia	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	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. 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	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.
  STD	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	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.
  SICKLE	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.
  DEMO	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	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	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	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	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.
  RACE	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	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.
  B	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	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	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	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	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	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	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	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	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	patient default sensitivity	Policy for handling information reported by the patient about another person, e.g. a family member, which will be afforded heightened confidentiality. Sensitive information reported by the patient about another person, e.g. family members may be deemed sensitive by default. The flag may be set or cleared on patient's request. Usage Note: For sensitive information relayed 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.) 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.
  PRS	patient requested sensitivity	For sensitive information relayed 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.) 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. Usage Note: For use within an enterprise that provides heightened confidentiality to certain types of information designated by a patient 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.
  HRCOMPT	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.
  RESCOMPT	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	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.
  COMPT	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."
  ANONY	anonymize	Custodian system must remove any information that could result in identifying the information subject.
  AOD	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	audit	Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.
  AUDTR	audit trail	Custodian system must monitor and maintain retrievable log for each user and operation on information.
  CPLYCC	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.
  CPLYCD	comply with consent directive	Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives.
  CPLYJPP	comply with jurisdictional privacy policy	Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information.
  CPLYOPP	comply with organizational privacy policy	Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information.
  CPLYOSP	comply with organizational security policy	Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information.
  CPLYPOL	comply with policy	Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information.
  DEID	deidentify	Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
  DELAU	delete after use	Custodian system must remove target information from access after use.
  ENCRYPTR	encrypt at rest	Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage.
  ENCRYPTT	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	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.
  ENCRYPT	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.)
  HUAPRV	human approval	Custodian system must require human review and approval for permission requested.
  MASK	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	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.
  PRIVMARK	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."
  PSEUD	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	redact	Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users.
  ObligationPolicy	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.
  NOAUTH	no disclosure without subject authorization	Prohibition on disclosure without information subject's authorization.
  NOCOLLECT	no collection	Prohibition on collection or storage of the information.
  NODSCLCD	no disclosure without consent directive	Prohibition on disclosure without organizational approved patient restriction.
  NODSCLCDS	no disclosure without information subject's consent directive	Prohibition on disclosure without a consent directive from the information subject.
  NOINTEGRATE	no integration	Prohibition on Integration into other records.
  NOLIST	no unlisted entity disclosure	Prohibition on disclosure except to entities on specific access list.
  NOMOU	no disclosure without MOU	Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU).
  NOORGPOL	no disclosure without organizational authorization	Prohibition on disclosure without organizational authorization.
  NOPAT	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	no collection beyond purpose of use	Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.
  NORDSCLCD	no redisclosure without consent directive	Prohibition on redisclosure without patient consent directive.
  NORDSCLCDS	no redisclosure without information subject's consent directive	Prohibition on redisclosure without a consent directive from the information subject.
  NORDSCLW	no disclosure without jurisdictional authorization	Prohibition on disclosure without authorization under jurisdictional law.
  NORELINK	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	no reuse beyond purpose of use	Prohibition on use of the information beyond the purpose of use initially authorized.
  NOVIP	no unauthorized VIP disclosure	Prohibition on disclosure except to principals with access permission to specific VIP information.
  ORCON	no disclosure without originator authorization	Prohibition on disclosure except as permitted by the information originator.
  RefrainPolicy	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.
  SecurityPolicy	security policy	Types of security policies that further specify the ActClassPolicy value set. Examples: obligation to encrypt refrain from redisclosure without consent

• Include these codes as defined in http://hl7.org/fhir/v3/ObservationValue version 1.0.2

  Code	Display	Definition
  ABSTRED	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	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	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	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	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	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	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	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	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	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	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.
  CRYTOHASH	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	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.
  HRELIABLE	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	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	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	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.
  CLINAST	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	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	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	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	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	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	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	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.
  CLINRPT	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	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	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	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	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	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	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	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.

• Include these codes as defined in http://hl7.org/fhir/v3/ActReason version 1.0.2

  Code	Display	Definition
  HMARKT	healthcare marketing	To perform one or more operations on information for marketing services and products related to health care.
  DONAT	donation	To perform one or more operations on information used for cadaveric organ, eye or tissue donation.
  FRAUD	fraud	To perform one or more operations on information used for fraud detection and prevention processes.
  GOV	government	To perform one or more operations on information used within government processes.
  HACCRED	health accreditation	To perform one or more operations on information for conducting activities related to meeting accreditation criteria.
  HCOMPL	health compliance	To perform one or more operations on information used for conducting activities required to meet a mandate.
  HDECD	decedent	To perform one or more operations on information used for handling deceased patient matters.
  HDIRECT	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
  HLEGAL	legal	To perform one or more operations on information for conducting activities required by legal proceeding.
  HOUTCOMS	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	health program reporting	To perform one or more operations on information used for conducting activities to meet program accounting requirements.
  HQUALIMP	health quality improvement	To perform one or more operations on information used for conducting administrative activities to improve health care quality.
  HSYSADMIN	health system administration	To perform one or more operations on information to administer the electronic systems used for the delivery of health care.
  MEMADMIN	member administration	To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.
  PATADMIN	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	patient safety	To perform one or more operations on information in processes related to ensuring the safety of health care.
  PERFMSR	performance measure	To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.
  RECORDMGT	records management	To perform one or more operations on information used within the health records management process.
  TRAIN	training	To perform one or more operations on information used in training and education.
  HOPERAT	healthcare operations	To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.
  CLMATTCH	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	coverage authorization	To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
  ELIGDTRM	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	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	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.
  COVERAGE	coverage under policy or program	To perform one or more operations on information for conducting activities related to coverage under a program or policy.
  REMITADV	remittance advice	To perform one or more operations on information about the amount remitted for a health care claim.
  HPAYMT	healthcare payment	To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.
  CLINTRCH	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.
  HRESCH	healthcare research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge.
  FAMRQT	family requested	To perform one or more operations on information in response to a request by a family member authorized by the patient.
  PWATRNY	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	support network	To perform one or more operations on information in response to a request by a person authorized by the patient.
  PATRQT	patient requested	To perform one or more operations on information in response to a patient's request.
  DISASTER	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	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.
  PUBHLTH	public health	To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
  CAREMGT	Care Management	To perform one or more operations on information for provision of health care coordination.
  CLINTRL	clinical trial	To perform health care as part of the clinical trial protocol.
  ETREAT	Emergency Treatment	To perform one or more operations on information for provision of immediately needed health care for an emergent condition.
  POPHLTH	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.
  TREAT	treatment	To perform one or more operations on information for provision of health care.
  PurposeOfUse	purpose of use	Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives. Usage Notes: The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.

This value set expansion contains 174 concepts.