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Chair: @Kathleen Connor

Scribe: @Suzanne Gonzales-Webb 

Weekly calls Tuesdays 3PM ET

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Meeting ID: 895 5988 3576

Passcode: 258923

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Agenda Topics

Agenda Overview

  • Minutes
  • FHIR Security
  • Harmonization - UTG Voting Process presentation by Jeff Hellman
  • Privacy and Security Logical Data Model update
  • FHIR DS4P IG - Ballot Reconciliation
  • Cross Paradigm US Security Labeling IG
  • Security Labeling 202101 Connectathon Track
  • Share with Protections White Paper Project
  • Infrastructure SD - Reaffirmation of Access Control Catalog
  • Ballot Management
  • ONC Announcements
  • Chat notes

 Minutes Approval

Approve Meeting Minutes:

2020-11-24 Security WG Agenda/Minutes

Motion to Approve Meeting minutes as written

Moved/Second: Suzanne / Mike

Vote - Approve/Abstain/Oppose :  1 abstain; opposed: none; 3

FHIR Security

2020-11-30 FHIR-Security Meeting Agenda

Discussion on the topic of use of Digital Signature across the tags to enable accountability trace to classifier actors.

John - accountability would be far more effective and efficient using Provenance without adding the overhead of Signatures. The Provenance record would be needed even if a digital signature was used to carry the Who, What, Where, When, and Why of the changes. Recommend defining a specific pattern for Provenance record when the change is for data classification. This pattern would be distinguishable from other Provenance use-cases. Thus mandatory carrying of these Provenance in an external communication would be easy.

Is it possible to have a Digital Signature ( that just covers the – YES. It would require a new canonicalization algorithm that identifies when that canonicalization is used that ONLY the element is signed. (see

Is it possible to have a Digital Signature that just covers some of the values in – possibly with FHIR specific encoding of canonicalization beyond that typical in  XML or JSON signatures. Might leverage FHIR-Path expressions.

Note that Digital Signatures are expensive. The overhead to maintain them, to maintain the certificate authority, the certificate expiration, the certificate purpose, etc. And a digital signature just tells you if the object has or has-not changed.

Trust-Frameworks are more important than the technology. It is far more effective to include in the Trust-Framework requirements around accessibility, upon need, to audit logs. Where the need can be identified as specific events, not general surveillance, for example.

Audit Logs and Provenance are both just as important. Provenance focuses on create/update with a pointed efficient way to prove to a recipient that they should trust the data. Audit Logs prove to data holders that their data are being used appropriately. Yes Audit Logs can carry the functionality of Provenance, but would likely have different accessibility rules and different retention rules. They both are distinct and needed for Trust-Frameworks.

No meetings in December.  Planning for FHIR Security session in week between Connectathon and WGM for track report outs for

2021-01 Consent Management and Enforcement Services Track

2021-01-Security Labeling

SMART V2 (Focus: Granular Controls, Token Introspection)




Thursday, November 26, 2020

12:08 PM

  1. FHIR Specification Feedback
  2. FHIR-27944

More detail on how to assign security labels to convey applicable policies, and value of consensus labels.



  • Type:

Change Request



Please elaborate more on how to select a proposed consensus security label for a privacy, privacy consent, security, provenance or trust policy. Please include more information about the means and value of establishing a consensus security label for a policy.


From <>


MOTION: to accept as presented (Suzanne / Beth)

VOTE: opposed: none; abstain: none; Approve: 4


PSAF Provenance Errata

Update: Waiting on a Response from CTO.  Kathleen re-sent request last week.

Review and approve Errata Letter for CTO Consideration

QA of final ANSI publication submittal missed that Volume 3 Provenance DAM did not include the Contributor Table.

We are requesting an errata version.  May not be possible because ANSI has already approved it.

Mike's alternative: wants to claim an author name on HL7 formal letterhead (not to add as an ANSI change)



Jeff and Kathleen added as UTG Reviewers.  We still don't know how the approval process works.

Jeff Helman to present on UTG voting process so that we can vote on proposed security labeling codes.

Additional Codes For Security Label Vocabulary approved 10/26 have been uploaded into UTG

Security WG members who want to vote on these UTG proposals need to sign up to vote.  See: Vocabulary Maintenance at HL7

UTG Consensus Review

Anyone wishing to participate in the Consensus Review of proposals in flight is welcome to participate. No tooling is required to participate - if you want to be a reviewer/voter on vocabulary change proposals and you are not one already, click this link below: 

Request Reviewer Permissions

Documentation and Education Materials 

Unified Terminology Governance Project (UTG) Page

Curator Processing of Proposals

UTG Tooling and Proposal Documentation

Implementation of Consensus Review Voting

11/10 Mohammad already rebased this, and pushed new commit to Bitbucket repo. Should be a timely way to do this - needs to be reviewed and approved by harmonization process so that we don't have to continually redo.  Also, Security members who have asked to be reviewers have not been responded to.  We will ask that someone from UTG join Security to help us progress our proposals.

11/24 Jeff and Kathleen added as UTG Reviewers.  We still don't know how the approval process works.

Privacy & Security  Logical Data  Model

No comments received–all submitted comments prior to today have been incorporated into latest document.

(Security WG to review and approve on 12/2/2020 call,  Plan is to be submit finalized material on December 13th )

No plan to change current diagrams at this point.  Ioana updated some figures (Mike is reviewing to make sure they fit into current document version)


Final walk-through of Logical Data Model during tomorrow's call.

2020-12-02 Privacy and Security Logical Data Model

Plan on voting to recommend that the Security WG approve for submission to 202101 Ballot during 2020-12-8 call.

Dec 13: Final content deadline

Review and approve P&S Logical Model draft NIB submitted without suffix "Cross-Paradigm" after TSC review.

2020-11-11 Privacy and Security Logical Data Model meeting did not meet quorum.

Please review and send Mike comments on V3 Logical Model Draft 1116.docx

  • models have updated per comments, including ABAC (new material)
  • working on one more model- showing relationship between class model and 
  • The majority of the changes are in the ABAC section.
  • Mike will walk though the changes at tomorrow's meeting

Meeting scheduled for document and model review

HL7 Privacy and Security Information Model PSS

Information model update: The new information model will consolidate and harmonize security models across HL7 standards (Access Control, Audit, TF4FA etc.) and (incomplete) updates from FHIM (Consolidated unresolved models). Also included are direct mappings to Access Control, Audit and Authentication (e.g. Class models)  mapped to Access Control services.

ISD PPS approved 7/7

TSC PSS approval before August 23, 2020


IG QA report - remaining errors are due to UTG issues that have not yet been resolved.  However, per Grahame, we can go ahead to prepare to submit for ballot

From: Grahame Grieve []
Sent: Monday, November 30, 2020 9:07 PM
To: Kathleen Connor
Cc: Mohammad Jafari; Suzanne Webb; Melva Peters; Ted Klein; Jessica Bota; Shawn, Christopher A.
Subject: Re: DS4P FHIR IG for January Ballot

FMG may grant a waiver if there's a clear note to balloters. I will certainly support that in the FMG call


KC Most of the vocab errors are because approved codes didn’t make it into FHIR/UTG from V3

From: Grahame Grieve []
Sent: Monday, November 30, 2020 7:36 PM
To: Kathleen Connor
Cc: Mohammad Jafari; Suzanne Webb; Melva Peters; Ted Klein; Jessica Bota; Shawn, Christopher A.
Subject: Re: DS4P FHIR IG for January Ballot

You don't  need to delay a ballot because of QA issues that do not indicate problems in the IG itself. FMG will grant waivers if you can show that the QA issues are problems in the infrastructure. I'm not sure, on the other hand, whether UTG proposals yet to be made will count as grounds for waiver. You might be able to clearly indicate which parts of the ballot are subject to ongoing proposals, and argue to FMG that the ballot should still go ahead that way. But time is very tight - it's late for a discussion like that. Looking at the QA: it's just a set of codes that are not yet approved? If Mohammad sorts out the Jira issue which is purely procedural, then I would support going ahead with ballot with a clear note to balloters explaining what is happening, so they can comment directly or keep it in mind.

Moving comments from spreadsheet into JIRA Tickets - View comments at this link.

Previously approved NIB

Postponed early January ballot until regular January ballot cycle.

Review and approve FHIR DS4P IG Out-of-cycle ballot request for 10/20 opening date.

Carmela A. Couderc block - continue review

Review Reconciliation Spreadsheets and JIRA Ballot Recon

Missed approval of Reconciliation prior to July 5th Sept NIB due date Security WG Admin

Ballot results:

Quorum met - 107 voters, FHIR DS4P IG Ballot Passed

  • Affirmative - 26
  • Negative - 13
  • Abstain - 35

Negatives - missing definitions, which is the result of tooling errors we need to fix, and a general misunderstanding that the FHIR DS4P IG is the basis for profiles for policy specific security label IGs much like the CDA DS4P IG is.  Only the profiles are implementable.

 Spreadsheet Spreadsheet Spreadsheet


Upcoming deadlines:

  • FHIR IG must be substantively complete - ???, 2020
  • FHIR IG must be complete and handed over to sponsoring WG for QA review - ???
  • QA review cycle - ???
  • Content QA Change application - ???
  • Final content to Lynn for inclusion in Oct Out-of-cycle ballot ???
  • Submit Ballot Readiness Checklist - before ???

If you have any questions about these dates or the process, you can check out the FHIR IG Process Flow on Confluence


Finished Ballot Reconciliation on 2020-11-20 Security WG FHIR DS4P IG Ballot Reconciliation Call

Final ballotcomments_FHIR_IG_DS4P_R1_D1_2020MAY.xls Uploaded to Ballot Desktop.

DS4P Use Cases - work in progress.  Being incorporated in the FHIR DS4P IG.

Request approval to submit to 202101 Ballot

Moved/Seconded (Mohammad / Mike) 

Vote: abstain: none; opposed: none Motion carries : 4

Kathleen will work with Mohammad to get waiver request before FMG

Cross-Paradigm US Regulatory Security Labeling IG

Postponed early January ballot until regular January ballot cycle.

Previously approved NIB already submitted.

JIRA tickets filed for acceptance of new UTG values/data; motion next week when we bring information forward on the value sets.

New CUI Notice 2020-06 RE CUI Marking Waivers with e.g., splash screens, seems to be limited to internal CUI use.

FHIR US Regulatory Security Labels Continuous Build - No update in the build

GitHub repo for the source material: 

John and Mohammad are committers.

US Regulatory Security Label Example Sandbox

Security Labeling Parking Lot

US Regulatory Security Label examples were included in the FHIR DS4P IG.  These will be the starter set for the FHIR US Regulatory Security Label IG

Still on hold.

KC to do - CARES Part 2 Security Label update for CBCP

Security Labeling Connectathon Track

Security Labeling 202101 Connectathon Track - update

need to send sub-resource label for another person to pick up

Can we link  a use case to 2021-01 Consent Management and Enforcement Services Track?

Connectathon in place (bare-bones, but in on time!);

Share with Protections White Paper Project

will need to find time during the January 18 week need time for FHIR (two 2-hour blocks to wrap up ballot reconciliation); recommend two separate days

Worked on ballot recon with Beth for KP comments.  Ready for review.

amalgamated_ballotcomments_HL7_WP_SWP_R1_I1_2020SEP neg sort 360 post BP.xls

Share with Protections White Paper Release 1 202009 Ballot v2 KC 360 post BP.docx

Discussed meetings for SwP ballot dispositions: 12/9, 12/16 and wrap up in longer session on January 20, WEDNESDAY starting at 9AM Pacific, 12N-4PM Eastern

Need to set up FHIR Security and International Session during week of 1/18 - 22

Infrastructure SD

Progress on ISD approval of Project for Reaffirmation of Normative Healthcare (Security and Privacy) Access Control Catalog, Release 3

Kathleen moved for Security.  Need a second, 3 days of discussion, and then the vote.

Reaffirm HL7 Version 3 Standard: Healthcare (Security and Privacy) Access Control Catalog, Release 3

ANSI Standards approaching expiration

3 WGs voted to affirm.  Checking with ISD chairs about what's needed to finalize.
Ballot Management

With the move of the WGM schedule dates to start virtually on January 25, the ballot cycle and content deadline dates have also changed.

Nov 8: Next Sunday is the Notification of Intent to Ballot (NIB) deadline – Now November 8th (Ballot minus 6 weeks)

Nov 17: FHIR Connectathon proposals due– (The Connectathon dates did NOT change)

Nov 29: Reconciliation deadline for ballot items having previously balloted – (Ballot -3 weeks)

Dec 13: Final content deadline

Dec 18: Ballot opens

Dec 27: Deadline for TSC approval of PSS for 2021MAY cycle

The on-line Notification of Intent to Ballot form (off of the TSC Utilities page) is available at:

All Calendars for this cycle are available on the new Confluence Calendars page at:


New Initiative Announced: Project US@

Today, ONC announced a new initiative, Project US@, to launch at the start of 2021. ONC has agreed to develop a unified specification for address in health care. This project will be a collaboration with Health Level 7 (HL7), the National Council for Prescription Drug Programs (NCPDP), and X12 (along with the other standards development organizations and members of the Health Standards Collaborative.) The goal of the project is to issue a unified, cross-SDO, health care industry-wide specification for representing address within the year.

Read the Blog Post →

Update on CBCP transitioning sponsorship to Security. (intent is to ballot as Normative in future)
Next steps:  STU extension request listing emerging use cases, and possible sponsors for preparing DPROV CDA IG for normative ballot

Need to create Confluence page to track DPROV CDA use cases, ballot history, and next steps. KC to do.

SOA Consent Management Service

This SOA project is co-sponsored by Security and CBCP. 

2021-01 Consent Management and Enforcement Services Track

Consent Management Service PSS

The project's model has progressed and is impressive.

See Consent Management Service Project

SOA invites Security to join 7 pm ET call Nov 5

Join Zoom Meeting

Phone Number: +1 770-657-9270
Participant Passcode: 071582

Nothing to report.
OCR News

Annual Report Workgroup Meeting

Thu, 11/19/2020, 3:00 PM

To learn more, visit our calendar

Annual Report Workgroup Meeting

Thu, 12/17/2020, 3:00 PM

To learn more, visit our calendar

Notes from CHAT

Sub-resource labeling

Useful Links

Confluence and JIRA Tutorials

Meeting Adjournment

No additional agenda items brought forward

Meeting adjourned at 1350 Arizona time

Meeting recording: 



@Adam Wong adam.wong@hhs.govHHS
HL7 Austria
Amol Vyas amol.vyas@cambiahealth.comCambia Health
Wave One
Celine Lefebvre AMA
Clara Y. Ren Electronic Health Records Modernization (FEHRM) Office

Chris Shawn, Co-Chair


Dave SilverElectrosoft
 Ready Computing
 @David Staggs drs@securityrs.comSRS 

@Heather McComas AMA 

Jim KamperAltarum
Federal Electronic Health Records Modernization (FEHRM) Office

John Davis (Mike)


John Moehrke Co-Chair

Julie Chan jchan@cwglobalconsult.comCWGlobal

Kathleen Connor  Co-Chair

VA (Book Zurman)
Laura Bright
Laura Hoffman laura.hoffman@ama-assn.orgAMA


EMR Direct

Matthew Reid matt.reid@ama-assn.orgAMA
VA (Book Zurman)
Patient Centric Solutions
 PJM Consulting
Trustworthy EHR 

@Ricky Sahu,  

1up Health

Rob McClure
Saul Kravitz saul@mitre.orgMITRE


Serafina Versaggi
Stephen MacVicar smacvicar@mitre.orgMITRE
VA (Book Zurman)

Tom Hicke
Flinders University
Vicki Giatzikis vig9034@nyp.orgNYP
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