Publish-box (todo)
Security Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Patient, Practitioner, RelatedPerson |
Raw XML (canonical form + also see XML Format Specification)
Example of using Provenance as De-Identifiation linkage with security tag protection, enabling Re-Identification with authorization. (id = "example-anon0")
<?xml version="1.0" encoding="UTF-8"?> <Bundle xmlns="http://hl7.org/fhir"> <id value="example-anon0"/> <!-- a search bundle on anon0 patient by a HIGHLY Priviliaged User that is authorized to see linkage --> <meta> <lastUpdated value="2014-08-18T01:43:30Z"/> <security> <!-- Bundle confidentiality at high water mark of most sensitive --> <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> <code value="V"/> </security> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> <code value="PSEUDED"/> </security> </meta> <type value="searchset"/> <link> <relation value="self"/> <url value="https://example.com/fhir/Patient/anon0/$everything"/> </link> <entry> <fullUrl value="http://example.org/fhir/Provenance/anon0"/> <resource> <Provenance> <!-- This Provenance shows a link between real-world and anon for a given patient --> <id value="anon0"/> <meta> <security> <!-- Provenance is the link between real-world and anon, so is highest possible confidentiality --> <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> <code value="V"/> </security> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> <code value="PSEUDED"/> </security> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Provenance</b> <a name="anon0"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Provenance "anon0" </p> <p style="margin-bottom: 0px">Security Labels: <span title="{http://terminology.hl7.org/CodeSystem/v3-Confidentiality http://terminology.hl7.org/CodeSyst em/v3-Confidentiality}">http://terminology.hl7.org/CodeSystem/v3-Confidentiality</span> , <span title="{http://terminology.hl7.org/CodeSystem/v3-ObservationValue http://terminology.hl7.org/CodeSys tem/v3-ObservationValue}">http://terminology.hl7.org/CodeSystem/v3-ObservationValue</span> </p> </div> <p> <b> target</b> : <a href="broken-link.html">http://example.org/fhir/Patient/anon0</a> </p> <p> <b> recorded</b> : 27 June 2015, 8:39:24 am</p> <p> <b> policy</b> : <span title=" policy would indicate the rules used for De-Identification, and appropriate purposes of use of the data "><a href="http://example.org/policies/666">http://example.org/policies/666</a> </span> </p> <p> <b> activity</b> : De-Identify (Anononymize) Record Lifecycle Event <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-iso-21089-lifecycle.html">ISO 21089 2017 Health Record Lifecycle Events</a> #deidentify)</span> </p> <h3> Agents</h3> <table class="grid"><tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Who</b> </td> </tr> <tr> <td> *</td> <td> Assembler <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-provenance-participant-type.html">Provenance participant type</a> #assembler)</span> </td> <td> <span> : Device/software</span> </td> </tr> </table> <h3> Entities</h3> <table class="grid"><tr> <td> -</td> <td> <b> Role</b> </td> <td> <b> What</b> </td> </tr> <tr> <td> *</td> <td> source</td> <td> <a href="patient-example.html">Patient/example</a> "Peter CHALMERS"</td> </tr> </table> </div> </text> <target> <reference value="http://example.org/fhir/Patient/anon0"/> </target> <recorded value="2015-06-27T08:39:24+10:00"/> <!-- policy would indicate the rules used for De-Identification, and appropriate purposes of use of the data --> <policy value="http://example.org/policies/666"/> <activity> <coding> <system value="http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle"/> <code value="deidentify"/> </coding> </activity> <!-- not identified in original patient compartment as should not show up there (confidentiatlt yCode V protected too) --> <agent> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/> <code value="assembler"/> </coding> </type> <who> <display value="Device/software"/> </who> </agent> <entity> <role value="source"/> <what> <reference value="Patient/example"/> </what> </entity> </Provenance> </resource> <search> <mode value="match"/> </search> </entry> <entry> <fullUrl value="http://example.org/fhir/Patient/anon0"/> <resource> <Patient> <id value="anon0"/> <!-- De-Identifed equivilant, removing all direct identifiers, and keeping only minimally necessary indirect identifiers --> <meta> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> <code value="L"/> </security> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> <code value="PSEUDED"/> </security> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b> First-0 Anon-0 </b> male, DoB: 1974-12-01</p> <hr/> </div> </text> <name> <!-- some made up name --> <family value="Anon-0"/> <given value="First-0"/> </name> <!-- male/female gender is needed, and group is big enough. --> <gender value="male"/> <!-- birthdate is generalized to 1st of month of the birth year --> <birthDate value="1974-12-01"/> </Patient> </resource> <search> <mode value="match"/> </search> </entry> <entry> <fullUrl value="http://example.org/fhir/Condition/anon0"/> <resource> <Condition> <id value="anon0"/> <!-- De-Identified data, change reference to Patient, eliminate free-text, and fuzz dates --> <meta> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> <code value="L"/> </security> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-ObservationValue"/> <code value="PSEUDED"/> </security> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Condition</b> <a name="anon0"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Condition "anon0" </p> <p style="margin-bottom: 0px">Security Labels: <span title="{http://terminology.hl7.org/CodeSystem/v3-Confidentiality http://terminology.hl7.org/CodeSyst em/v3-Confidentiality}">http://terminology.hl7.org/CodeSystem/v3-Confidentiality</span> , <span title="{http://terminology.hl7.org/CodeSystem/v3-ObservationValue http://terminology.hl7.org/CodeSys tem/v3-ObservationValue}">http://terminology.hl7.org/CodeSystem/v3-ObservationValue</span> </p> </div> <p> <b> clinicalStatus</b> : Active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a> #active)</span> </p> <p> <b> verificationStatus</b> : Confirmed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-ver-status.html">ConditionVerificationStatus</a> #confirmed)</span> </p> <p> <b> category</b> : Encounter Diagnosis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-condition-category.html">Condition Category Codes</a> #encounter-diagnosis; <a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #439401001 "Diagnosis")</span> </p> <p> <b> severity</b> : Severe <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #24484000)</span> </p> <p> <b> code</b> : Burn of ear <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #39065001)</span> </p> <p> <b> bodySite</b> : Left external ear structure <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #49521004)</span> </p> <p> <b> subject</b> : <a href="broken-link.html">Patient/anon0</a> </p> <p> <b> onset</b> : <span title=" dates aligned to first of month ">2012-05-01</span> </p> </div> </text> <clinicalStatus> <coding> <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"/> <code value="active"/> </coding> </clinicalStatus> <verificationStatus> <coding> <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/> <code value="confirmed"/> </coding> </verificationStatus> <category> <coding> <system value="http://terminology.hl7.org/CodeSystem/condition-category"/> <code value="encounter-diagnosis"/> <display value="Encounter Diagnosis"/> </coding> <!-- and also a SNOMED CT coding --> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="Diagnosis"/> </coding> </category> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="24484000"/> <display value="Severe"/> </coding> </severity> <code> <coding> <system value="http://snomed.info/sct"/> <code value="39065001"/> <display value="Burn of ear"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="49521004"/> <display value="Left external ear structure"/> </coding> </bodySite> <subject> <!-- patient as anon0 id --> <reference value="Patient/anon0"/> </subject> <!-- dates aligned to first of month --> <onsetDateTime value="2012-05-01"/> </Condition> </resource> <search> <mode value="match"/> </search> </entry> </Bundle>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
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