V3-Confidentiality.cs.xml

A set of codes specifying the security classification of acts and roles in accordance with the definition for concept domain "Confidentiality".

<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="v3-Confidentiality"/> 
  <meta> 
    <lastUpdated value="2019-07-31T00:00:00.000+10:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p> Release Date: 2019-07-31</p> 

      <table class="grid">
 
        <tr> 
          <td> 
            <b> Level</b> 
          </td> 
          <td> 
            <b> Code</b> 
          </td> 
          <td> 
            <b> Display</b> 
          </td> 
          <td> 
            <b> Definition</b> 
          </td> 
        </tr> 
 
        <tr> 
          <td> 1</td> 
          <td> _Confidentiality
            <a name="v3-Confidentiality-_Confidentiality"> </a> 
          </td> 
          <td> Confidentiality</td> 
          <td> 
                        A specializable code and its leaf codes used in Confidentiality
               value sets to value the Act.Confidentiality and Role.Confidentiality attribute in accordance
               with the definition for concept domain &quot;Confidentiality&quot;.
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   L
            <a name="v3-Confidentiality-L"> </a> 
          </td> 
          <td> low</td> 
          <td> 
                        Privacy metadata indicating that a low level of protection is
               required to safeguard personal and healthcare information, which has been altered in such
               a way as to minimize the need for confidentiality protections with some residual risks
               associated with re-linking. The risk of harm to an individual's reputation and sense of
               privacy if disclosed without authorization is considered negligible, and mitigations are
               in place to address reidentification risk.
            <br/>  

                        
                           Usage Note: 
                        
            <br/>  
The level of protection afforded anonymized and pseudonymized, and non-personally identifiable
               information (e.g., a limited data set) is dictated by privacy policies and data use agreements
               intended to engender trust that health information can be used and disclosed with little
               or no risk of re-identification.
                           Example: Personal and healthcare information, which excludes
               16 designated categories of direct identifiers in a HIPAA Limited Data Set. This information
               may be disclosed by HIPAA Covered Entities without patient authorization for a research,
               public health, and operations purposes if conditions are met, which includes obtaining
               a signed data use agreement from the recipient. See 45 CFR Section 164.514.
            <br/>  

                        This metadata indicates that the receiver may have an obligation
               to comply with a data use agreement with the discloser. The discloser may have obligations
               to comply with policies dictating the methods for de-identification.
            <br/>  

                        Confidentiality code total order hierarchy: Low (L) is less protective
               than V, R, N, and M, and subsumes U.
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   M
            <a name="v3-Confidentiality-M"> </a> 
          </td> 
          <td> moderate</td> 
          <td> 
                        Privacy metadata indicating the level of protection required to
               safeguard personal and healthcare information, which if disclosed without authorization,
               would present a moderate risk of harm to an individual's reputation and sense of privacy.
            <br/>  

                        
                           Usage Note: The level of protection afforded moderately confidential
               information is dictated by privacy policies intended to engender trust in a service provider.
               May include publicly available information in jurisdictions that restrict uses of that
               information without the consent of the data subject.
            <br/>  

                        Privacy policies mandating moderate levels of protection, which
               preempt less protective privacy policies. &quot;Moderate&quot; confidentiality policies
               differ from and would be preempted by the prevailing privacy policies mandating the normative
               level of protection for information used in the delivery and management of healthcare.
            <br/>  

                        Confidentiality code total order hierarchy: Moderate (M) is less
               protective than V, R, and N, and subsumes all other protection levels (i.e., L and U).
            <br/>  

                        
                           Examples: Includes personal and health information that an
               individual authorizes to be collected, accessed, used or disclosed to a bank for a health
               credit card or savings account; to health oversight authorities; to a hospital patient
               directory; to worker compensation, disability, property and casualty or life insurers;
               and to personal health record systems, consumer-controlled devices, social media accounts
               and online Apps; or for marketing purposes
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   N
            <a name="v3-Confidentiality-N"> </a> 
          </td> 
          <td> normal</td> 
          <td> 
                        Privacy metadata indicating the level of protection required to
               safeguard personal and healthcare information, which if disclosed without authorization,
               would present a considerable risk of harm to an individual's reputation and sense of privacy.
            <br/>  

                        
                           Usage Note: The level of protection afforded normatively confidential
               information is dictated by the prevailing normative privacy policies, which are intended
               to engender patient trust in their healthcare providers.
            <br/>  

                        Privacy policies mandating normative levels of protection, which
               preempt less protective privacy policies when the information is used in the delivery
               and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public
               health reporting or emergency treatment).
            <br/>  

                        Confidentiality code total order hierarchy: Normal (N) is less
               protective than V and R, and subsumes all other protection levels (i.e., M, L, and U).
            <br/>  

                        
                           Map:Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical
               Care when purpose of use is treatment: 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. 
            <br/>  

                        
                           Examples: 
                        
            <br/>  
n the US, this includes what HIPAA identifies as protected health information (PHI) under
               45 CFR Section 160.103.
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   R
            <a name="v3-Confidentiality-R"> </a> 
          </td> 
          <td> restricted</td> 
          <td> 
                        Privacy metadata indicating the level of protection required to
               safeguard potentially stigmatizing information, which if disclosed without authorization,
               would present a high risk of harm to an individual's reputation and sense of privacy.
            <br/>  

                        
                           Usage Note: The level of protection afforded restricted confidential
               information is dictated by specially protective organizational or jurisdictional privacy
               policies, including at an authorized individual’s request, intended to engender patient
               trust in providers of sensitive services.
            <br/>  

                        Privacy policies mandating additional levels of protection by
               restricting information access preempt less protective privacy policies when the information
               is used in the delivery and management of healthcare. May be pre-empted by jurisdictional
               law (e.g., for public health reporting or emergency treatment).
            <br/>  

                        Confidentiality code total order hierarchy: Restricted (R) is
               less protective than V, and subsumes all other protection levels (i.e., N, M, L, and U).
            <br/>  

                        
                           Examples: 
                        
            <br/>  
Includes information that is additionally protected such as sensitive conditions mental
               health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive
               health; or sensitive demographic information such as a patient’s standing as an employee
               or a celebrity. May be used to indicate proprietary or classified information that is
               not related to an individual (e.g., secret ingredients in a therapeutic substance; or
               the name of a manufacturer).
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   U
            <a name="v3-Confidentiality-U"> </a> 
          </td> 
          <td> unrestricted</td> 
          <td> 
                        Privacy metadata indicating that no level of protection is required
               to safeguard personal and healthcare information that has been disclosed by an authorized
               individual without restrictions on its use.
            <br/>  

                        
                           Examples: Includes publicly available information e.g., business
               name, phone, email and physical address.
            <br/>  

                        
                           Usage Note: The authorization to collect, access, use, and
               disclose this information may be stipulated in a contract of adhesion by a data user (e.g.,
               via terms of service or data user privacy policies) in exchange for the data subject's
               use of a service.
            <br/>  

                        This metadata indicates that the receiver has no obligation to
               consider privacy policies other than its own when making access control decisions.
            <br/>  

                        This metadata indicates that the receiver has no obligation to
               consider privacy policies other than its own when making access control decisions.
            <br/>  

                        Confidentiality code total order hierarchy: Unrestricted (U) is
               less protective than V, R, N, M, and L, and is the lowest protection levels.
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr> 
          <td> 2</td> 
          <td>   V
            <a name="v3-Confidentiality-V"> </a> 
          </td> 
          <td> very restricted</td> 
          <td> 
                        Privacy metadata indicating the level of protection required under
               atypical cicumstances to safeguard potentially damaging or harmful information, which
               if disclosed without authorization, would (1) present an extremely high risk of harm to
               an individual's reputation, sense of privacy, and possibly safety; or (2) impact an individual's
               or organization's legal matters.
            <br/>  

                        
                           Usage Note: The level of protection afforded very restricted
               confidential information is dictated by specially protective privacy or legal policies
               intended to ensure that under atypical circumstances additional protections limit access
               to only those with a high 'need to know' and the information is kept in highest confidence..
            <br/>  

                        Privacy and legal policies mandating the highest level of protection
               by stringently restricting information access, preempt less protective privacy policies
               when the information is used in the delivery and management of healthcare including legal
               proceedings related to healthcare. May be pre-empted by jurisdictional law (e.g., for
               public health reporting or emergency treatment but only under limited circumstances).
            <br/>  

                        Confidentiality code total order hierarchy: Very Restricted (V)
               is the highest protection level and subsumes all other protection levels s (i.e., R, N,
               M, L, and UI).
            <br/>  

                        
                           Examples: 
                        
            <br/>  
Includes information about a victim of abuse, patient requested information sensitivity,
               and taboo subjects relating to health status that must be discussed with the patient by
               an attending provider before sharing with the patient. May also include information held
               under a legal hold or attorney-client privilege.
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 1</td> 
          <td> 
            <span style="color: grey">
              <i> (_ConfidentialityByAccessKind)</i> 
            </span>  
            <b> 
              <i> Abstract</i> 
            </b>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> 
            <a name="v3-Confidentiality-_ConfidentialityByAccessKind"> </a> 
          </td> 
          <td> 
                        
                           Description: By accessing subject / role and relationship based
                rights  (These concepts are mutually exclusive, one and only one is required for a valid
               confidentiality coding.)
            <br/>  

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   B
            <a name="v3-Confidentiality-B"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> business</td> 
          <td> 
                        
                           Description: Since the service class can represent knowledge
               structures that may be considered a trade or business secret, there is sometimes (though
               rarely) the need to flag those items as of business level confidentiality.  However, no
               patient related information may ever be of this confidentiality level.
            <br/>  

                        
                           Deprecation Comment: Replced by ActCode.B
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   D
            <a name="v3-Confidentiality-D"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> clinician</td> 
          <td> 
                        
                           Description: Only clinicians may see this item, billing and
               administration persons can not access this item without special permission.
            <br/>  

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   I
            <a name="v3-Confidentiality-I"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> individual</td> 
          <td> 
                        
                           Description: Access only to individual persons who are mentioned
               explicitly as actors of this service and whose actor type warrants that access (cf. to
               actor type code).
            <br/>  

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 1</td> 
          <td> 
            <span style="color: grey">
              <i> (_ConfidentialityByInfoType)</i> 
            </span>  
            <b> 
              <i> Abstract</i> 
            </b>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> 
            <a name="v3-Confidentiality-_ConfidentialityByInfoType"> </a> 
          </td> 
          <td> 
                        
                           Description: By information type, only for service catalog
               entries (multiples allowed). Not to be used with actual patient data!
            <br/>  

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   ETH
            <a name="v3-Confidentiality-ETH"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> substance abuse related</td> 
          <td> 
                        
                           Description: Alcohol/drug-abuse related item
            <br/>  

                        
                           Deprecation Comment:Replced by ActCode.ETH
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   HIV
            <a name="v3-Confidentiality-HIV"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> HIV related</td> 
          <td> 
                        
                           Description: HIV and AIDS related item
            <br/>  

                        
                           Deprecation Comment:Replced by ActCode.HIV
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   PSY
            <a name="v3-Confidentiality-PSY"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> psychiatry relate</td> 
          <td> 
                        
                           Description: Psychiatry related item
            <br/>  

                        
                           Deprecation Comment:Replced by ActCode.PSY
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   SDV
            <a name="v3-Confidentiality-SDV"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> sexual and domestic violence related</td> 
          <td> 
                        
                           Description: Sexual assault / domestic violence related item
            <br/>  

                        
                           Deprecation Comment:Replced by ActCode.SDV
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 1</td> 
          <td> 
            <span style="color: grey">
              <i> (_ConfidentialityModifiers)</i> 
            </span>  
            <b> 
              <i> Abstract</i> 
            </b>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> 
            <a name="v3-Confidentiality-_ConfidentialityModifiers"> </a> 
          </td> 
          <td> 
                        
                           Description: Modifiers of role based access rights  (multiple
               allowed)
            <br/>  

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   C
            <a name="v3-Confidentiality-C"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> celebrity</td> 
          <td> 
                        
                           Description: Celebrities are people of public interest (VIP)
               including employees, whose information require special protection.
            <br/>  

                        
                           Deprecation Comment:Replced by ActCode.CEL
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   S
            <a name="v3-Confidentiality-S"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> sensitive</td> 
          <td> 
                        
                           Description: 
                        
            <br/>  
Information for which the patient seeks heightened confidentiality. Sensitive information
               is not to be shared with family members.  Information reported by the patient about family
               members is sensitive by default. Flag can be set or cleared on patient's request.
                           Deprecation Comment:Deprecated due to updated confidentiality
               codes under ActCode
            <br/>  

                     
          </td> 
        </tr> 
 
        <tr style="background: #EFEFEF">
          <td> 2</td> 
          <td>   T
            <a name="v3-Confidentiality-T"> </a>  
            <b> 
              <i> Deprecated</i> 
            </b> 
          </td> 
          <td> taboo</td> 
          <td> 
                        
                           Description: Information not to be disclosed or discussed with
               patient except through physician assigned to patient in this case.  This is usually a
               temporary constraint only, example use is a new fatal diagnosis or finding, such as malignancy
               or HIV.
            <br/>  

                        
                           Deprecation Note:Replced by ActCode.TBOO
            <br/>  

                     
          </td> 
        </tr> 

      </table> 

    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="external"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="0"/> 
  </extension> 
  <url value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.5.25"/> 
  </identifier> 
  <version value="2019-07-31"/> 
  <name value="v3.Confidentiality"/> 
  <title value="v3 Code System Confidentiality"/> 
  <status value="active"/> 
  <experimental value="false"/> 
  <date value="2019-07-31T00:00:00+10:00"/> 
  <publisher value="HL7, Inc"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org"/> 
    </telecom> 
  </contact> 
  <description value=" A set of codes specifying the security classification of acts and roles in accordance
     with the definition for concept domain &quot;Confidentiality&quot;."/> 
  <caseSensitive value="true"/> 
  <valueSet value="http://terminology.hl7.org/ValueSet/v3-Confidentiality"/> 
  <hierarchyMeaning value="is-a"/> 
  <content value="complete"/> 
  <property> 
    <code value="notSelectable"/> 
    <uri value="http://hl7.org/fhir/concept-properties#notSelectable"/> 
    <description value="Indicates that the code is abstract - only intended to be used as a selector for other
       concepts"/> 
    <type value="boolean"/> 
  </property> 
  <property> 
    <code value="status"/> 
    <uri value="http://hl7.org/fhir/concept-properties#status"/> 
    <description value="A property that indicates the status of the concept. One of active, experimental, deprecated,
       retired"/> 
    <type value="code"/> 
  </property> 
  <property> 
    <code value="deprecationDate"/> 
    <uri value="http://hl7.org/fhir/concept-properties#deprecationDate"/> 
    <description value="The date at which a concept was deprecated. Concepts that are deprecated but not inactive
       can still be used, but their use is discouraged"/> 
    <type value="dateTime"/> 
  </property> 
  <concept> 
    <code value="_Confidentiality"/> 
    <display value="Confidentiality"/> 
    <definition value="A specializable code and its leaf codes used in Confidentiality value sets to value the
       Act.Confidentiality and Role.Confidentiality attribute in accordance with the definition
       for concept domain &quot;Confidentiality&quot;."/> 
    <concept> 
      <code value="L"/> 
      <display value="low"/> 
      <definition value="Privacy metadata indicating that a low level of protection is required to safeguard personal
         and healthcare information, which has been altered in such a way as to minimize the need
         for confidentiality protections with some residual risks associated with re-linking. The
         risk of harm to an individual's reputation and sense of privacy if disclosed without authorization
         is considered negligible, and mitigations are in place to address reidentification risk.

                        
                           Usage Note: 
                        
The level of protection afforded anonymized and pseudonymized, and non-personally identifiable
         information (e.g., a limited data set) is dictated by privacy policies and data use agreements
         intended to engender trust that health information can be used and disclosed with little
         or no risk of re-identification.
                           Example: Personal and healthcare information, which excludes
         16 designated categories of direct identifiers in a HIPAA Limited Data Set. This information
         may be disclosed by HIPAA Covered Entities without patient authorization for a research,
         public health, and operations purposes if conditions are met, which includes obtaining
         a signed data use agreement from the recipient. See 45 CFR Section 164.514.

                        This metadata indicates that the receiver may have an obligation
         to comply with a data use agreement with the discloser. The discloser may have obligations
         to comply with policies dictating the methods for de-identification.

                        Confidentiality code total order hierarchy: Low (L) is less protective
         than V, R, N, and M, and subsumes U."/> 
    </concept> 
    <concept> 
      <code value="M"/> 
      <display value="moderate"/> 
      <definition value="Privacy metadata indicating the level of protection required to safeguard personal and
         healthcare information, which if disclosed without authorization, would present a moderate
         risk of harm to an individual's reputation and sense of privacy.

                        
                           Usage Note: The level of protection afforded moderately confidential
         information is dictated by privacy policies intended to engender trust in a service provider.
         May include publicly available information in jurisdictions that restrict uses of that
         information without the consent of the data subject.

                        Privacy policies mandating moderate levels of protection, which
         preempt less protective privacy policies. &quot;Moderate&quot; confidentiality policies
         differ from and would be preempted by the prevailing privacy policies mandating the normative
         level of protection for information used in the delivery and management of healthcare.

                        Confidentiality code total order hierarchy: Moderate (M) is less
         protective than V, R, and N, and subsumes all other protection levels (i.e., L and U).

                        
                           Examples: Includes personal and health information that an
         individual authorizes to be collected, accessed, used or disclosed to a bank for a health
         credit card or savings account; to health oversight authorities; to a hospital patient
         directory; to worker compensation, disability, property and casualty or life insurers;
         and to personal health record systems, consumer-controlled devices, social media accounts
         and online Apps; or for marketing purposes"/> 
    </concept> 
    <concept> 
      <code value="N"/> 
      <display value="normal"/> 
      <definition value="Privacy metadata indicating the level of protection required to safeguard personal and
         healthcare information, which if disclosed without authorization, would present a considerable
         risk of harm to an individual's reputation and sense of privacy.

                        
                           Usage Note: The level of protection afforded normatively confidential
         information is dictated by the prevailing normative privacy policies, which are intended
         to engender patient trust in their healthcare providers.

                        Privacy policies mandating normative levels of protection, which
         preempt less protective privacy policies when the information is used in the delivery
         and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public
         health reporting or emergency treatment).

                        Confidentiality code total order hierarchy: Normal (N) is less
         protective than V and R, and subsumes all other protection levels (i.e., M, L, and U).

                        
                           Map:Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical
         Care when purpose of use is treatment: 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. 

                        
                           Examples: 
                        
n the US, this includes what HIPAA identifies as protected health information (PHI) under
         45 CFR Section 160.103."/> 
    </concept> 
    <concept> 
      <code value="R"/> 
      <display value="restricted"/> 
      <definition value="Privacy metadata indicating the level of protection required to safeguard potentially
         stigmatizing information, which if disclosed without authorization, would present a high
         risk of harm to an individual's reputation and sense of privacy.

                        
                           Usage Note: The level of protection afforded restricted confidential
         information is dictated by specially protective organizational or jurisdictional privacy
         policies, including at an authorized individual’s request, intended to engender patient
         trust in providers of sensitive services.

                        Privacy policies mandating additional levels of protection by
         restricting information access preempt less protective privacy policies when the information
         is used in the delivery and management of healthcare. May be pre-empted by jurisdictional
         law (e.g., for public health reporting or emergency treatment).

                        Confidentiality code total order hierarchy: Restricted (R) is
         less protective than V, and subsumes all other protection levels (i.e., N, M, L, and U).

                        
                           Examples: 
                        
Includes information that is additionally protected such as sensitive conditions mental
         health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive
         health; or sensitive demographic information such as a patient’s standing as an employee
         or a celebrity. May be used to indicate proprietary or classified information that is
         not related to an individual (e.g., secret ingredients in a therapeutic substance; or
         the name of a manufacturer)."/> 
    </concept> 
    <concept> 
      <code value="U"/> 
      <display value="unrestricted"/> 
      <definition value="Privacy metadata indicating that no level of protection is required to safeguard personal
         and healthcare information that has been disclosed by an authorized individual without
         restrictions on its use.

                        
                           Examples: Includes publicly available information e.g., business
         name, phone, email and physical address.

                        
                           Usage Note: The authorization to collect, access, use, and
         disclose this information may be stipulated in a contract of adhesion by a data user (e.g.,
         via terms of service or data user privacy policies) in exchange for the data subject's
         use of a service.

                        This metadata indicates that the receiver has no obligation to
         consider privacy policies other than its own when making access control decisions.

                        This metadata indicates that the receiver has no obligation to
         consider privacy policies other than its own when making access control decisions.

                        Confidentiality code total order hierarchy: Unrestricted (U) is
         less protective than V, R, N, M, and L, and is the lowest protection levels."/> 
    </concept> 
    <concept> 
      <code value="V"/> 
      <display value="very restricted"/> 
      <definition value="Privacy metadata indicating the level of protection required under atypical cicumstances
         to safeguard potentially damaging or harmful information, which if disclosed without authorization,
         would (1) present an extremely high risk of harm to an individual's reputation, sense
         of privacy, and possibly safety; or (2) impact an individual's or organization's legal
         matters.

                        
                           Usage Note: The level of protection afforded very restricted
         confidential information is dictated by specially protective privacy or legal policies
         intended to ensure that under atypical circumstances additional protections limit access
         to only those with a high 'need to know' and the information is kept in highest confidence..

                        Privacy and legal policies mandating the highest level of protection
         by stringently restricting information access, preempt less protective privacy policies
         when the information is used in the delivery and management of healthcare including legal
         proceedings related to healthcare. May be pre-empted by jurisdictional law (e.g., for
         public health reporting or emergency treatment but only under limited circumstances).

                        Confidentiality code total order hierarchy: Very Restricted (V)
         is the highest protection level and subsumes all other protection levels s (i.e., R, N,
         M, L, and UI).

                        
                           Examples: 
                        
Includes information about a victim of abuse, patient requested information sensitivity,
         and taboo subjects relating to health status that must be discussed with the patient by
         an attending provider before sharing with the patient. May also include information held
         under a legal hold or attorney-client privilege."/> 
    </concept> 
  </concept> 
  <concept> 
    <code value="_ConfidentialityByAccessKind"/> 
    <display value="ConfidentialityByAccessKind"/> 
    <definition value="Description: By accessing subject / role and relationship based  rights  (These concepts
       are mutually exclusive, one and only one is required for a valid confidentiality coding.)

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
       codes under ActCode"/> 
    <property> 
      <code value="notSelectable"/> 
      <valueBoolean value="true"/> 
    </property> 
    <property> 
      <code value="status"/> 
      <valueCode value="retired"/> 
    </property> 
    <property> 
      <code value="deprecationDate"/> 
      <valueDateTime value="2011-12-14"/> 
    </property> 
    <concept> 
      <code value="B"/> 
      <display value="business"/> 
      <definition value="Description: Since the service class can represent knowledge structures that may be considered
         a trade or business secret, there is sometimes (though rarely) the need to flag those
         items as of business level confidentiality.  However, no patient related information may
         ever be of this confidentiality level.

                        
                           Deprecation Comment: Replced by ActCode.B"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="D"/> 
      <display value="clinician"/> 
      <definition value="Description: Only clinicians may see this item, billing and administration persons can
         not access this item without special permission.

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
         codes under ActCode"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="I"/> 
      <display value="individual"/> 
      <definition value="Description: Access only to individual persons who are mentioned explicitly as actors
         of this service and whose actor type warrants that access (cf. to actor type code).

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
         codes under ActCode"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
  </concept> 
  <concept> 
    <code value="_ConfidentialityByInfoType"/> 
    <display value="ConfidentialityByInfoType"/> 
    <definition value="Description: By information type, only for service catalog entries (multiples allowed).
       Not to be used with actual patient data!

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
       codes under ActCode"/> 
    <property> 
      <code value="notSelectable"/> 
      <valueBoolean value="true"/> 
    </property> 
    <property> 
      <code value="status"/> 
      <valueCode value="retired"/> 
    </property> 
    <property> 
      <code value="deprecationDate"/> 
      <valueDateTime value="2011-12-14"/> 
    </property> 
    <concept> 
      <code value="ETH"/> 
      <display value="substance abuse related"/> 
      <definition value="Description: Alcohol/drug-abuse related item

                        
                           Deprecation Comment:Replced by ActCode.ETH"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="HIV"/> 
      <display value="HIV related"/> 
      <definition value="Description: HIV and AIDS related item

                        
                           Deprecation Comment:Replced by ActCode.HIV"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="PSY"/> 
      <display value="psychiatry relate"/> 
      <definition value="Description: Psychiatry related item

                        
                           Deprecation Comment:Replced by ActCode.PSY"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="SDV"/> 
      <display value="sexual and domestic violence related"/> 
      <definition value="Description: Sexual assault / domestic violence related item

                        
                           Deprecation Comment:Replced by ActCode.SDV"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
  </concept> 
  <concept> 
    <code value="_ConfidentialityModifiers"/> 
    <display value="ConfidentialityModifiers"/> 
    <definition value="Description: Modifiers of role based access rights  (multiple allowed)

                        
                           Deprecation Comment:Deprecated due to updated confidentiality
       codes under ActCode"/> 
    <property> 
      <code value="notSelectable"/> 
      <valueBoolean value="true"/> 
    </property> 
    <property> 
      <code value="status"/> 
      <valueCode value="retired"/> 
    </property> 
    <property> 
      <code value="deprecationDate"/> 
      <valueDateTime value="2011-12-14"/> 
    </property> 
    <concept> 
      <code value="C"/> 
      <display value="celebrity"/> 
      <definition value="Description: Celebrities are people of public interest (VIP) including employees, whose
         information require special protection.

                        
                           Deprecation Comment:Replced by ActCode.CEL"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="S"/> 
      <display value="sensitive"/> 
      <definition value="Description: 
                        
Information for which the patient seeks heightened confidentiality. Sensitive information
         is not to be shared with family members.  Information reported by the patient about family
         members is sensitive by default. Flag can be set or cleared on patient's request.
                           Deprecation Comment:Deprecated due to updated confidentiality
         codes under ActCode"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
    <concept> 
      <code value="T"/> 
      <display value="taboo"/> 
      <definition value="Description: Information not to be disclosed or discussed with patient except through
         physician assigned to patient in this case.  This is usually a temporary constraint only,
         example use is a new fatal diagnosis or finding, such as malignancy or HIV.

                        
                           Deprecation Note:Replced by ActCode.TBOO"/> 
      <property> 
        <code value="status"/> 
        <valueCode value="retired"/> 
      </property> 
      <property> 
        <code value="deprecationDate"/> 
        <valueDateTime value="2011-12-14"/> 
      </property> 
    </concept> 
  </concept> 
</CodeSystem>