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Medical Use Cases Based on. HL7 Clinical Document Architecture (an ANSII standard) based on XML Medical considerations Legislation and Executive Branch rules regarding privacy (HIPAA). HL7 CDA Form. Header – administrative information Body – clinical record. Ms AXS & her abusive ex.

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Medical use cases based on
Medical Use Cases Based on

  • HL7 Clinical Document Architecture (an ANSII standard) based on XML

  • Medical considerations

  • Legislation and Executive Branch rules regarding privacy (HIPAA)


Hl7 cda form
HL7 CDA Form

  • Header – administrative information

  • Body – clinical record


Ms axs her abusive ex
Ms AXS & her abusive ex

  • Don’t let him know my contact info

    a) She gets help with tendonitis from a physical therapist

    • Therapist gets record; the restrictions follow

      b) Billing info goes to outside payer

    • Restrictions are transmitted with info (even when the info leaves the originator, the restrictions persist)


Patient grants only primary care physician access to psych notes
Patient grants only primary care physician access to psych notes

  • Primary care physician grants overall record access to a covering doctor or practice, but blocks access to the psych notes.


Patient restricts access to hiv test results
Patient restricts access to HIV test results notes

  • The patient arrives at the emergency room with a severe trauma. The restrictions are overridden to provide the best treatment.


Patient is a care giver in a medical system
Patient is a care giver in a medical system notes

  • For the whole record, the patient grants access only to the primary care giver.

  • If billing is done in house, the billing staff is granted access to the record of services and charges.


Summary of requirements
Summary of Requirements notes

  • ACLs + selectors yielding fine grained access control

  • Persistence of access semantics over organizational boundaries

  • Override mechanism(s) such as “super user”

  • Ability to change access over time and context


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