Data Segmentation of Sensitive Information

Printer Friendly, PDF & Email
Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Implementation Specification
Final
Production
Rating 1
Yes
Free
Yes
Standard
Final
Production
Rating 5
Yes
Free
No
Emerging Implementation Specification
In Development
Pilot
Feedback Requested
No
No
Emerging Implementation Specification
Final
Pilot
Rating 1
No
Free
No
Limitations, Dependencies, and Preconditions for Consideration
Applicable Security Patterns for Consideration
  • 2015 Edition Health IT Certification Criterion for DS4P (§ 170.315(b)(7) and § 170.315(b)(8)), requires the use of the cda Privacy Segmented Document template for certification.
  • HL7 v3 Implementation Guide for DS4P provides CDA templates to enable privacy and segmentation markings at the document, section and entry (data element) levels:
    • cda Privacy Markings Section- specifies how a document, section, or entry may be constrained to specify privacy and security markings.
    • cda Privacy Segmented Section-may apply to any section of a C-CDA document if that section metadata (sensitivity, confidentiality) is different than the
      document's overall
    • Privacy Metadata Templates-support the exchange of protected information by annotating specific entries with several observations, policies and constraints.  Examples include:
      • cda Privacy Annotation-a set of security observations that allow for specific privacy metadata for an entry that overrides that of a document or section
      • cda Protected Problem-combines a mandatory provenance and privacy annotations with the default constraints applied to a ProblemObservation
      • cda Security Observation-a class of abstract templates to indicate a security classification, control, category, or integrity criterion
        • Subclasses include Obligation, Confidentiality, Refrain Policy, and Purpose of Use Security Observations
  • Consent2Share FHIR Consent Profile specifies how Substance Abuse and Mental Health Services Administration's (SAMHSA) Consent2Share application and associated access control solution uses FHIR resources to represent and persist patient consent for treatment, research, or disclosure (e.g. 42 CFR Part 2, Title 38)
  • For C-CDA transmission, document level DS4P is required in the C-CDA General Header.  Therefore, adoption levels may be higher for document level tagging (vs. section level).
  • See CDA and DS4P in the Interoperability Proving Ground.
  • Feedback requested

Comment

Is Federally required accurate?

Federally required, MU2015 this was an optional certification criteria at the document level for DS4P, is Federally required accurate if optional or does that apply to use of this IG?

CDA DS4P segmentation applied to section level. CDA Privacy Segmented Section-may apply to any section of a C-CDA document if that section metadata (sensitivity, confidentiality) is different than the document's overall

This IG needs further development.  The concept that a section is more private then the document is pointless. The Document privacy should be inherited from the most private section. Esp. when the MU2015 optional certification was limited to document level privacy. 

Pharmacy HIT Collaborative's Comments on ONC's Proposed 2018 ISA

The Pharmacy HIT Collaborative supports the use of Consolidated HL7 Implementation Guide: Data Segmentation for Privacy (DS4P), Release 1; HL7 Clinical Document Architecture (CDA), Release 2.0, Final Edition and IHE IT Infrastructure Technical Framework Volume 4 – National Extensions – Section 3.1 Data Segmentation for Privacy (DS4P). The Collaborative also supports Consent2Share FHIR Consent Profile Design, which is in development.