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1. Review Agenda
   • Care Team Provisioning for LHS (presented by Kathleen Connors)

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   • Care Team and specially Authorized Access - can have different types of configurations. If organized differently can affect the type of consent used. 
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   • Obligations related to HIPAA may need added security and encryptions
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   • How do the dimentions relate to each other 
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   • Need to know is really important for security
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   • (Russ) Care Team DAM have not specifically separated out the roles in the model. Have discussed the need for team members that may never be face-to-face with the patient (e.g. radiologists, pathologists) but will be included in context of a Learning Health System as part of the feedback loop. We are looking at a future where radiologist or pathologists may need to have more access to the patient record to do a more informed interpretations.
     • This will have implications for patient consent to share the data. 
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   • With Covid, Public health is very much a part of the care team. 
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   • Interdependent - where everyone is aware of what is happening with the patient. 
   • (Claude) CT DAM does not have an atribute that explicitly captures Unidisciplinary, Intradisciplinary. 
   • In order to have a consent set up will need to be explicit - will need to know ahead of time for the consent. 
   • (Claude) question is where to put it in the model. 
   • (Russ) in the model, the team is everyone who has touched the patient. Unidisciplinary team would be a team member on the patient's care team. 
   • (Claude) we don't have anything in the model specifically addressing "Unidisciplinary " or "Intradisciplinary"
   • (Emma) wouldn't roles attribute to this?
   • (Russ) the Role would encount for the individuals filling the roles
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   • Role base access can have a laundry list of characteristics. 
   • (Russ) If plan on automating care coordination and the idea of coverage - will need to delegate the consent to the role rather than the individuals. 
   • SAMHSA - security labeling system uses a  - code system in VSAC - Sensitive Condition Valueset - to be able to tag specific elements as sensitive
   • (Russ) - care team member who provide a service as part of care planning - e.g. a PT who provides prescribes a prescribes series of services but have a limited reason for providing the patient's list of meds. May need a less granular level and something that is implementatble implementable in the model. Like creating a Service Delivery Sphere. 
     • This is the team-ness. will need something like the spreadsheet. 
     • Need both the weeds (lower level) and the higher level. 
   • Structural Role - practitioner
   • Care Team Compartment - this is the configuration. Like classification role
   • CareTeam category/workflow type - what part of the workflow they are involved in
   • Communications and information sharing should align with the care team compartment
   • Permission Object/Operations - Read means access. Can use the CRUD . The permissions can be given to the role. Permission gets into the functional role. 
   • Confidentiality - this has levels - Normal for US is HIPAA. Most use is restricted and Normal (Gravity level providers are not covered by HIPAA so they would be restricted)
   • Role will have both permission and Confidentiality
   • Sensitivity - general information is not sensitive (Substance Use Disorder is sensitive)
   • Security WG is currently working on a Permission resource. 
2. Next discussion about this is the joint quarter at the WGM. ACTION: Meet next week and create a detail agenda for the WGM Joint quarter.