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Chair:  @ David Pyke

Scribe: @Suzanne Gonzales-Webb


(ATTENDEES TABLE moved to after Agenda)

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
Minutes Approval

2019-08-27 CBCP Meeting Agenda/Minutes

VOTE: (motion) :  (Suzanne/Accept with corrections (spelling errors), remove items not discussed but moved forward/ JimK

Abstain: none / Opposed: none/  Approve: 15 2019-08-27 Meeting Minutes Approval

 Blue Button IG

CARIN - Ryan Howells / (Amol Vyas), Enterprise Architect (Cambia Health Solutions

  • (Presentation?)
  • Discussion

(PDF presentation given)

CARIN- Building a Volunteer Trust Framework to move data from a regulated to unregulated space

  • phase 1 - foundational; application developers self-attest to the principles in the CARIN Code of Conduct
  • phase 2 - questionnaire; application developers fill out a questionnaire and self-attest to how they will use, manage and security the consumers health information
  • phase 3 - validation; multiple, independent certifiers validate the self-attested questions and the applications' systems, processes, clinical guidelines, clinical decision support, etc.

On Consent - As of right now, (spoke to Josh Mandel, Grahame, other smart folks) while not perfect, using the SMART approach/logic  is a primary means of gathering information—its the best option we have right now.  We believe that's the best approach.  there is another group within CARIN that is looking into digital identity and how to look at not only gathering identity but also (32.33)

MOTION: CBCP willingness to co-sponsor of the CARIN Blue Button IG (no further discussion) "non-binding" as it is

Abstain: 3  (Mike, KenS, Serafina); Oppose: none; Approve:12

Discussion: Collaboration on what we want this to look like.  PSS would need to be brought forth to us for approval.  Need to confirm where it is in the approval process

 42CFR4 Part 2

Jim Kretz/Ken Salyards overview

(Ken) The latest attempt is trying to make it easier to share part 2 data;

  • from that perspective - its a mute point, ie. if part of a Methadone it's not like you're going to take a 30-day dosage–you have to go daily. In regard to the current changes---not sure how its gong to improve–help.
    • What they're finding is that the more screws they put to drug prescriptions,  they are finding alternate sources–meth cut with fentanyl.
  • if you have a specific questions, that would be easier to direct responses to.

(Jim): There are a lot objectional but not a fault of standards, concern is that seems to be a misunderstanding on what DS4P is about (see pg 21 ) of proposed regulations this suggest that somehow that DS4P software has to be on the recipient side, but was designed to be on the part 2 side.  

Second big problem they refer to consent2share which is not an ANSI standards.  Was consent 2 share subject to a temporary provisional standard for provisional use... (no) it never even got a PSS

There are a number of provisions in the proposed regulations that call... presume additional information floating around–so for example... there are claims that data could be sent to a research organization–ot a HIPAA entity or subject to the common rule, but maybe covered by FDA regulations.  there is no provisions how those constrinas be realized.

(hoepuflly some of the issues will be brought forwad to PAC)

these are some of my big objetions - the simplimcations .. one could simply by saying that part 2 information parther could isclose by whomever the patient wanted, rather than only certain kinds of porgnaziaotns ---i'm unsure of all the separate constraints..

(kathleen will send

anything that goes under FDA separate form of consent;

 Meeting recording:  

Share with Protections - Mike Davis

(no update) Meeting set-up TBD (Mike not on) Mike is starting the PSS for this project

"Share with Protections"

  • PSS update
  •  (document update)

 eLTSS FHIR IG Project - Becky, Johnathan

Completing comments; reviewing for duplicates

  •  working on final updates to the IG
  • weekly prep calls - Tuesday, 2PM ET;  

--reconciliation is uploaded on the website

policy for approval has been changed.  FHIR IG must be officially be mature (at least one Connectathon to be approved); 

  • new policy was posted in FHIR Chat, also in minutes

link to IG:

 eLTSS Use Case - Craig (15-20 min)

Discussion:  Next steps for Connectathon track

  • Craig from Altarum and a group from TCI are meeting weekly are working toward the Atlanta Connectathon supporting eLTSS IG, pulling in pieces from care track.
  • eLTSS is included in September 2019 connectathon
    • we are not making changes to IG example sets, but corrections (for Connectathon), wherein all connections are constrained

?  Nothing needed from WG at this time

 Provenance DAM - Mike Davis

Content due 8/4 (Sunday) , Normative ballot

PSAF Package, including Final Provenance Content submitted to HL7 office on Saturday 8/3 (PDF and word versions)

Out for ballot - this version is significantly improved from first version.  encourage everyone to look at it and provide comment.  this doc is intended to put the scientific viewpoint on Provenance.  its not an implementation but based on work that is out there. its inteted to give structure to other HL7 work in this area


  • Consensus pool for September ballot is out, please sign up to review and vote
  • working on completing sections of the document

 DS4P FHIR IG - Kathleen Connor

Waiting to hear back... waiting to kick-off the project, on agend for today's Security WG meeting.

Update: Approved, start date is in January for September balloting.  Low hanging fruit to start, staring with security labels to describe how to do data segmentation in FHIR

  • add topic for joint session (Security/CBCP)

Update (question) Approval from FMG and will go to e-vote from TSC - completed

PSS Approved 6/4/2019: FHIR Data Segmentation for Privacy (DS4P) Implementation Guide PSS (by Steering Division)

 September 2019 WGM

Suzanne, Kathleen to collaborate on MON Q3/Q4 and other Security/CBCP joint sessions at a future date

No additional agenda items added to 2019 September WGM at this time.

  • Low hanging fruit to start, staring with security labels to describe how to do data segmentation in FHIR

    • add topic for joint session (Security/CBCP)

Additional Agenda Items

If you are interested in becoming a FHIR IG Author - Dave will send you the link to attend (SEND HIM AN e-mail!)

  • Cost to attend?  It's FREE (ONC Sponsored)
  • Course is a day and a half (Wednesday/Thursday)
  • Curriculum is still being put together

Background intent is to have a pool of people to write FHIR IGs

LINK: Please e-mail David Pyke if you would like to register for this course (


Announcement : interoper   (ISA)

Deadline for comment is September 23, 2019 1150 ET ISA Comments

  • let them know DS4P FHIR IG project is underway
    • is on Security Agenda; so that we can bring input to PAC comments

Carin has published BlueButton FHIR IG 'self-attestation' to privacy and security requirements

 Carin has published a blue button IG; 

  • noted that they have federation project on their 
    • recommend invite author to CBCP/Security - discuss their privacy/security considerations 
    • Author:  Amol Vyas (Cambia Health)

Suggest that Security and CBCP WGs monitor Carin BlueButton FHIR IG "self-attestation" to privacy and security requirements, and seek collaboration on attestation criteria.
Note that "Consent Federation" is a project on their roadmap. Suggest that we invite Amol Vyas, Cambria Health, to Security/CBCP call.

Amol Vyas

FHIR Consent

Next Thursday at 2PM ET is next attempt for comment resolution 

  • some open topics; new examples uploaded
  • met with patient care to talk about the use case for FHIR consent

have revised all the examples to fit the model

other changes to the documentation with minor changes; need to vet the changes before bringing forward to the WG

 Additional agenda Items?None brought forward 
AdjournmentMeeting adjourned at 1001 Arizona Time (Suzanne )

Temporary Meeting Recording:






Johnathan Coleman Co-Chair audio

xVA (Book Zurman)

David Pyke  Co-Chair

Ready Computing
x@Jim Kretz SAMHSA 

John Davis  aka Mike Davis

xKathleen ConnorVA (Book Zurman)

Georgia Tech
xChris ShawnVA

@David Staggs

SSA (Aegis)

@Laura Bright 


@Forrest White forrest.white@altarum.orgAltarum

Greg WhiteSRS

@Pele Yu Children's Hospital



@Hannah Galvin


@Amber PatelSRS
xJamie Parker   Carradora
x@Victor (unknown last name)Medside


@Joseph Parker
xRyan Howells   Leavitt Partners
 xSerafina Versaggi  
xKenneth Salyards  

Supporting Documents

Outline Reference

Supporting Document

Minute Approval

Action items Suzanne Gonzales-Webb