By accessing subject / role and relationship based rights (These concepts are mutually exclusive, one and only one is required for a valid confidentiality coding.)

Used to enumerate the typical confidentiality constraints placed upon a clinical document.

Normal confidentiality rules (according to good health care practice) apply, that is, only authorized individuals with a legitimate medical or business need may access this item.

Restricted access, e.g. only to providers having a current care relationship to the patient.

Very restricted access as declared by the Privacy Officer of the record holder.

Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. However, no patient related information may ever be of this confidentiality level.

Only clinicians may see this item, billing and administration persons can not access this item without special permission.

Access only to individual persons who are mentioned explicitly as actors of this service and whose actor type warrants that access (cf. to actor type code).

No patient record item can be of low confidentiality. However, some service objects are not patient related and therefore may have low confidentiality.

Normal confidentiality rules (according to good health care practice) apply, that is, only authorized individuals with a legitimate medical or business need may access this item.

Restricted access, e.g. only to providers having a current care relationship to the patient.

Very restricted access as declared by the Privacy Officer of the record holder.

By information type, only for service catalog entries (multiples allowed). Not to be used with actual patient data!

Alcohol/drug-abuse related item

HIV and AIDS related item

Psychiatry related item

Sexual assault / domestic violence related item

Modifiers of role based access rights (multiple allowed)

Celebrities are people of public interest (VIP) including employees, whose information require special protection.

Information for which the patient seeks heightened confidentiality. Sensitive information is not to be shared with family members. Information reported by the patient about family members is sensitive by default. Flag can be set or cleared on patient's request.

Information not to be disclosed or discussed with patient except through physician assigned to patient in this case. This is usually a temporary constraint only, example use is a new fatal diagnosis or finding, such as malignancy or HIV.