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  1. FHIR Specification Feedback
  2. FHIR-9167

AuditEvent needs to make more obvious how to record a break-glass event

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • DSTU2
    • Security
    • AuditEvent
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      Persuasive with Mod.

      1. add the example AuditEvent below.

      2. update "Event codes for Common Scenarios" table with pointer to this example

      3. Update dragon text on security-labels page regarding break-the-glass as now having an audit event

      4. Update dragon text with note of example OperationOutcome for break-glass (from security.html page)

      5. Update security.html break-glass mention to only reference Break the Glass Protocol (not operationOutcome example)

      --------------------example AuditEvent for break-glass ------------

      <AuditEvent xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/auditevent.xsd">

      <id value="example-breakglass-start"/>

      <text>

      <status value="generated"/>

      <div xmlns="http://www.w3.org/1999/xhtml">Authorized Break-Glass period has been declared to enable immediate emergent treatment condition. This AuditEvent indicates the start of the Break-Glass event. Another would indicate the stop of that Break-Glass period, providd there is a session or state that can detect the end of the break-glass event.</div>

      </text>

      <type>

      <system value="http://dicom.nema.org/resources/ontology/DCM"/>

      <code value="110113"/>

      <display value="Security Alert"/>

      </type>

      <subtype>

      <system value="http://dicom.nema.org/resources/ontology/DCM"/>

      <code value="110127"/>

      <display value="Emergency Override Started"/>

      </subtype>

      <action value="R"/>

      <!-- when was the break-glass started -->

      <recorded value="2013-09-22T00:08:00Z"/>

      <outcome value="0"/>

      <outcomeDesc value="Successful Start of Break-Glass"/>

      <purposeOfEvent>

      <!-- why was the break-glass declared -->

      <coding>

      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>

      <code value="ETREAT"/>

      <display value="Emergency Treatment"/>

      </coding>

      </purposeOfEvent>

      <agent>

      <!-- who declared the break-glass -->

      <who>

      <reference>

      <value value="Practitioner-example-f001-evdb"/>

      </reference>

      </who>

      <requestor value="true"/>

      <!-- where was the break-glass emergency declared -->

      <location>

      <reference value="Location/1"/>

      </location>

      <network>

      <address value="custodian.net"/>

      <type value="1"/>

      </network>

      </agent>

      <source>

      <!-- what system detected this break-glass -->

      <site value="Watcher"/>

      <observer>

      <display value="Watchers Accounting of Disclosures Application"/>

      </observer>

      <type>

      <system value="http://terminology.hl7.org/CodeSystem/security-source-type"/>

      <code value="4"/>

      <display value="Application Server"/>

      </type>

      </source>

      <entity>

      <!-- patient whos data is being accessed -->

      <what>

      <reference value="Patient/example"/>

      </what>

      <type>

      <system value="http://terminology.hl7.org/CodeSystem/audit-entity-type"/>

      <code value="1"/>

      <display value="Person"/>

      </type>

      <role>

      <system value="http://terminology.hl7.org/CodeSystem/object-role"/>

      <code value="1"/>

      <display value="Patient"/>

      </role>

      </entity>

      </AuditEvent>

      Show
      Persuasive with Mod. 1. add the example AuditEvent below. 2. update "Event codes for Common Scenarios" table with pointer to this example 3. Update dragon text on security-labels page regarding break-the-glass as now having an audit event 4. Update dragon text with note of example OperationOutcome for break-glass (from security.html page) 5. Update security.html break-glass mention to only reference Break the Glass Protocol (not operationOutcome example) --------------------example AuditEvent for break-glass ------------ <AuditEvent xmlns=" http://hl7.org/fhir " xmlns:xsi=" http://www.w3.org/2001/XMLSchema-instance " xsi:schemaLocation=" http://hl7.org/fhir ../../schema/auditevent.xsd"> <id value="example-breakglass-start"/> <text> <status value="generated"/> <div xmlns=" http://www.w3.org/1999/xhtml ">Authorized Break-Glass period has been declared to enable immediate emergent treatment condition. This AuditEvent indicates the start of the Break-Glass event. Another would indicate the stop of that Break-Glass period, providd there is a session or state that can detect the end of the break-glass event.</div> </text> <type> <system value=" http://dicom.nema.org/resources/ontology/DCM "/> <code value="110113"/> <display value="Security Alert"/> </type> <subtype> <system value=" http://dicom.nema.org/resources/ontology/DCM "/> <code value="110127"/> <display value="Emergency Override Started"/> </subtype> <action value="R"/> <!-- when was the break-glass started --> <recorded value="2013-09-22T00:08:00Z"/> <outcome value="0"/> <outcomeDesc value="Successful Start of Break-Glass"/> <purposeOfEvent> <!-- why was the break-glass declared --> <coding> <system value=" http://terminology.hl7.org/CodeSystem/v3-ActReason "/> <code value="ETREAT"/> <display value="Emergency Treatment"/> </coding> </purposeOfEvent> <agent> <!-- who declared the break-glass --> <who> <reference> <value value="Practitioner-example-f001-evdb"/> </reference> </who> <requestor value="true"/> <!-- where was the break-glass emergency declared --> <location> <reference value="Location/1"/> </location> <network> <address value="custodian.net"/> <type value="1"/> </network> </agent> <source> <!-- what system detected this break-glass --> <site value="Watcher"/> <observer> <display value="Watchers Accounting of Disclosures Application"/> </observer> <type> <system value=" http://terminology.hl7.org/CodeSystem/security-source-type "/> <code value="4"/> <display value="Application Server"/> </type> </source> <entity> <!-- patient whos data is being accessed --> <what> <reference value="Patient/example"/> </what> <type> <system value=" http://terminology.hl7.org/CodeSystem/audit-entity-type "/> <code value="1"/> <display value="Person"/> </type> <role> <system value=" http://terminology.hl7.org/CodeSystem/object-role "/> <code value="1"/> <display value="Patient"/> </role> </entity> </AuditEvent>
    • Luis Maas/Kathleen Connor: 9-0-0
    • Enhancement
    • Non-substantive
    • R5

    Description

      In AuditEvent, there is already a defined way to indicate that Break-Glass has been used. One event would record the declaration of break-glass including who, what, where, when, and why. A later event could indicate that the break-glass has ended (provided there is a session or state that can detect the end)

      AuditEvent.type ---110113, Security Alert

      AuditEvent.subtype — 110127, Emergency Override Started

      AuditEvent.recorded — When

      AuditEvent.agent — Who

      AuditEvent.agent.location — Where

      AuditEvent.purposeOfEvent — Why if coded

      AuditEvent.outcomeDesc – Why if freeformed text

      followed later, hopefully, by 110138, Emergency Override Stopped

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            john_moehrke John Moehrke
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              Updated:
              Resolved: