This value set includes codes based on the following rules:

• Include these codes as defined in http://hl7.org/fhir/v3/ActCode version 2016-11-11

  Code	Display	Definition
  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.
  DECLASSIFYLABEL	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	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.
  DOWNGRDLABEL	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	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.
  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.
  LABEL	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	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.
  PERSISTLABEL	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	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.
  UPGRDLABEL	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.
  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/ActReason version 2016-11-11

  Code	Display	Definition
  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.
  HMARKT	healthcare marketing	To perform one or more operations on information for marketing services and products related to health care.
  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.
  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.
  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.
  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.
  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.
  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.
  REMITADV	remittance advice	To perform one or more operations on information about the amount remitted for a health care claim.
  HRESCH	healthcare research	To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge.
  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.
  PATRQT	patient requested	To perform one or more operations on information in response to a patient's request.
  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.
  PUBHLTH	public health	To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
  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.
  TREAT	treatment	To perform one or more operations on information for provision of health care.
  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.

This value set expansion contains 91 concepts.

                       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.)

                       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.

                       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.

                    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."

                       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.

                       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).

                       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.

                       Examples:
                    

                    
                       obligation to encrypt
                       refrain from redisclosure without consent

                       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.

                       Examples: 
                    

                    
                       facility
                       enterprise
                       payer
                       health information exchange patient directory