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  1. FHIR Specification Feedback
  2. FHIR-26798

Better use case detailing why the consumer needs the data.

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Highest Highest
    • US CARIN Blue Button (FHIR)
    • 0.1 [deprecated]
    • Financial Mgmt
    • (NA)
    • onsumer-Directed Payer Data Exchange
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      Providing member educational materials is outside the scope of this IG and according to the CMS rule the responsibility of each payer. CMS reviewed a document related to ‘personas’ associated with the HIPAA consent and authorization process within a health plan and stated that it is their preference that “no discussion around consent processes, which are internal payer business processes, be attributed to the final rule. The consent issues discussed in the first half of this document are specific to existing federal and state law, and thus beyond the scope of the final rule beyond noting that the rule does not alter any obligation under such existing laws, and as such are beyond the scope of any one IG.”

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      Providing member educational materials is outside the scope of this IG and according to the CMS rule the responsibility of each payer. CMS reviewed a document related to ‘personas’ associated with the HIPAA consent and authorization process within a health plan and stated that it is their preference that “no discussion around consent processes, which are internal payer business processes, be attributed to the final rule. The consent issues discussed in the first half of this document are specific to existing federal and state law, and thus beyond the scope of the final rule beyond noting that the rule does not alter any obligation under such existing laws, and as such are beyond the scope of any one IG.”
    • Mark Roberts/ Pat Taylor: 17-0-0

    Description

      H.Resources (Use Case). To determine what kind of data should be included, the use case should provide a reason why the patient/patient rep. is downloading the data. The way you have worded the use case, it sounds like their primary intent is to invoke their right to the data. As a consumer, I don't think that people would typically download the data just for the sake of it. We might download data because our insurance company has questioned something or requires documentation. In that case the data that we want is really for the insurance company with their arcane codes. We might download data because we , as patient or consumer, might want to review the date for our own purposes. In that case, we might want something besides financial codes.

      Existing Wording:

      Consumer authorizes the application to access their digital claims data (thereby invoking their Individual Right of Access under HIPAA) via the SMART on FHIR authorization flow

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            rberge Ruth Berge
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            Dates

              Created:
              Updated:
              Resolved: