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When Julie is 16, she begins to experience sex and also begins using alcohol socially. Julie thinks her mother might not approve, but Julie does share this information with her pediatrician in confidence during her annual visit.  Her pediatrician discusses these details with her during the annual visit and makes notes in her record.  Her pediatrician provides relevant educational information and discusses safe behavior, as part of her overall evaluation for multiple potential risks of adolescents in transition. During their discussion, Julie and her PCP agree she should be using an oral contraceptive and it is prescribed.  Julie is also tested for STI, which comes back positive.  Julie is prescribed Zithromax to clear the infection.

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"Policy" covers many different elements, (think about bolts) from data privacy and security requirements to the legal landscape the defines how health systems must operate. For example, who is liable to protect health data. Often the implmentation implementation of policy excludes the most important person - the patient who is the subject of the information 

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5. UMA application to use-case (steady state) *needs a diagram

6. UMA/HEART support for sensitive data

8. Conclusion

There is more to consider in step with the technology capability of UMA, groups needs to consider all the BOLTS when designing solutions and not 'leave it to the reader' to sort out themselves

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Julie Story - NL will continue to edit

Suggestion

1. Done - Convert this to a user story
2. Done -Make it simpler
3. Done - Start with an overview of PP2PI and share that other groups are addressing policy issues
   1. Insert their diagram
4. Add 2 paragraphs on the fact that there are tensions in the HC community around certain issues. Those need to be addressed and resolved by the Policy WGs.  We will make these assumptions.
5. Discuss patient policy trumping organizational policy
6. Outline simpler story for illustration
   1. Done - Start with Julie as a child and her mother controls access to her record
      1. Demonstrate a simple use case of her mother sharing records with another physician on her behalf (straight UMA)
         1. Note to Eve:  For the first section, when our use case describes basic UMA, I think this will be a good place to explain what UMA has over oAuth and highlight the increased security.  If we can nail that part of the message it may help in all healthcare UMA implementations.
   2. Done - Julie turns 13
      1. She is educated on how to use her portal and has exclusive right to manage who has access.
      2. (For now – skip the issue of multi-subject data in one record. We will assume this is not the case in our user story.)
   3. Done - When Julie is 16, she begins to experience with Sex and also begins using alcohol socially. Julie knows her mother would not approve but does share it with her pediatrician in confidence.  Her pediatrician discusses these details with her during annual visit and makes notes in her record.  Her pediatrician provides relevant educational information, discusses safe behavior, as part of her overall evaluation for multiple potential risks of adolescents in transition.
      1. 1. Add the specifics per the PP2PI user story
      2. Add some policy to the stack - ex default policy sexual status not shared with her mother.  Julies decides either sticking with that or overriding and sharing with her mother
      3. Done - Continue story with her sharing her data, removing sexually and behave health sensitive data
      4. Discuss how UMA/HEART manages the transition from the consent to the protocol
      5. Discuss what gets redacted
      6. Describe the FHIR scope call
      7. Describe what is exchanged.
   4. Will skip this as already have a transition - At the end – transition again to Julie as an adult

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