Generated Narrative: ValueSet R5-v3-SecurityControlObservationValue-for-R4B This value set expansion contains 347 concepts. Code System Display Definition 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. PROCESSINLINELABEL http://terminology.hl7.org/CodeSystem/v3-ActCode process inline security label Custodian security system must take note that the data object contains inline security labels and process them. 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-17-12ï‡? 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-17-12ï‡? 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) 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. LIVSIT http://terminology.hl7.org/CodeSystem/v3-ObservationValue living situation Code specifying observations related to living situation for a person in a private residence. 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. 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. 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. 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. 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 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. 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. Homozygote http://terminology.hl7.org/CodeSystem/v3-ObservationValue HOMO Description: An individual having different alleles at one or more loci regarding a specific character 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) 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). 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.) _ObservationPopulationInclusion http://terminology.hl7.org/CodeSystem/v3-ObservationValue ObservationPopulationInclusion Observation values used to assert various populations that a subject falls into. 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 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. 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. 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. 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. 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. 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. 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 “hardâ€? 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.] 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.] 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.] 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] 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] 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] 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] 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. 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. 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. 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. SUP http://terminology.hl7.org/CodeSystem/v3-ObservationValue supine 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. 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.
Cross-version VS for R5.SecurityControlObservationValue for use in FHIR R4B
This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-SecurityControlObservationValue|2.0.0 for use in FHIR R4B. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4B.
comply with controlled unclassified information policy
comply with jurisdictional privacy policy
comply with jurisdictional security policy
comply with organizational privacy policy
comply with organizational security policy
no disclosure without subject authorization
no disclosure without information subject's consent directive
no disclosure without organizational authorization
no disclosure to patient, family or caregivers without attending provider's authorization
no redisclosure without consent directive
no redisclosure without information subject's consent directive
no disclosure without jurisdictional authorization
no disclosure without originator authorization
clinical trial research without patient care
clinical trial research with patient care
population origins or ancestry healthcare research
patient reported outcome performance measure
medium authentication level of assurance
low authentication process level of assurance
basic authentication process level of assurance
medium authentication process level of assurance
high authentication process level of assurance
low token and credential management level of assurance
basic token and credential management level of assurance
medium token and credential management level of assurance
high token and credential management level of assurance
low identity proofing level of assurance
basic identity proofing level of assurance
medium identity proofing level of assurance
high identity proofing level of assurance
basic non-repudiation level of assurance
medium non-repudiation level of assurance