2020-07-07 Meeting notes

Mobile Application Assurance Registry

@Tom Jones

• Proposed Kantara work item

  • Based on ONC final rule mandate

  • Some level of app certification is required

  • Kantara hosted API to show what apps or developers meet the requirements

  • Supports due diligence

  • Jeff: Will there be testing of assertions? (not at the moment)

    • Rule only states app must be made by certified app developer, so the app needs a cert mark for the user to know if it used a certified developer

    • Self-assertion is US centric, outside third party assertion is normally required, can evolve to a third party process (precedents: CCHIT.org, DEA/NIST rules forbidding electronically prescribing controlled substances, Surescripts); Pete: CCHIT provided test suites

  • Healthcare record providers key grant beneficiary

    • ONC allows (in the commentary, not the rule) EHR to insist that the app used to access and transfer records is developed by a certified developer; Catherine will look at the rule 

    • Sites are being sued for damages for releasing consumers private information. Expect CIOs to enforce requirement certified developer.

    • EHR creates “tethered patient portals” which are hard for patients or their proxies to access. Creates a conflict of interest.

  • Patient matching (@Former user (Deleted) )

    • Not identity, just aligning identifier string (like Covid contact tracing)

    • Looking at Nordic electronic identifier

      • Economy is using mobile device as identifier assertion with any app (banks, police, etc)

      • Strong reliant parties, standards/same rules

      • Flexible pricing, features, functionality

      • Low fraud rate

    • Part of the smartphone device itself, not just app

    • Identity verification like FaceID/facial biometric, Photo of physical ID, and others contribute to strong identity assurance when used with strong apps. Binds identity to the app.

  • Concern for App Developers

    • Fraud is a big issue, making sure the patient is insured, will get the payment in

    • Tax supported payors like Medicaid may have some difficulty, while they also have a huge need for combating fraud

  • Two processes

    • Proofing: Assure this person is who they say they are, outcome IAL1 or IAL2

    • Mobile phone app authentication

  • Phone containers segregate the code, digitally signed, virtual machine only allows the program to run in that container.

  • Ease of use, number of users that can apply this

    • Looks simple to use device as authenticator 

    • Can be combined with second factor (facial or PiN)

    • Fast, simple UX, low friction

  • Branded app (insurance company, provider)

    • Confidence: trusted provider

  • Catherine is demoing Thursday at HIWJ, Jim will send invitation to this group