Patient Engagement Profile (PEP) DRAFT

This is a profile which outlines fields for inclusion in health applications.
It is designed to address logistical issues surrounding access to health information. The goals of this profile are:

1. To communicate digital identity information in a consistent fashion.
2. To provide a consistent way represent identifiers, which often act as pointers to health information.
3. To provide a consistent way to model relationships among people and organizations.

The PEP profile outlines claims (i.e. fields) to be contained within the id_token.

Note: In the context of this identity-centric profile the word "claim" is referring to any given field in the id_token. For example a user;s first name is the claim given_name. Claims in his context should not be confused with insurance claims.

Fields / Claims

This section profiles the fields individually.

Goal 1: Digitial Identity ________________________-

• vot - To encode Identity Assurance Level (1,2, or 3) and Authenticator Assurance Level (1,2, or 3). This profile requires that a numerical value for P and C are set. (P0, P1, P2, P3, C1, C2, C3). All other vot data is optional.

• vtm - To reference the specific set of vector values as defined by NIST 800-63-3. The value of the vtm claim shall be https://github.com/TransparentHealth/800-63-3-trustmark/.

• verified_claims - To provide details on the id verification event, if needed. (e.g. Details on a driver's license may be stored here.)

Goal 2: Identifiers

---

• document - This profile extends the iGov OIDC doc claim for documents.https://openid.net/specs/openid-igov-openid-connect-1_0-ID1.html#ClaimsResponse and should help facilitate patient linking and matching. The extension allows additional metadata to be added to fields including codes for country, subdivision (e.g. state), url. The helps better codify state issued documents such as a driver's license. In addition, Patient identifiers in various systems may be stored. For example, a FHIR Patient ID along with the URL to the FHIR server to which it pertains may be stored within the doc claim.

Goal 3: Relationships

---

• agent_to_organization - This claim is for employment relationships. Example: Bob works for ACME Health/
• person_to_organization - This claim is for membership/client/patient relationships. Examples: Bob has insurance through ACME Health. Carol is a client of City Mission. Carlos is patient at Capitol Clinic.
• person_to_person - This claim is for family relationships. Examples: Carlos is the spouse of Carol. Frank wants Eve to have access to his records.
• agent_to_person - This claim is Patient/provider relationships. Examples: Alice, of ACME Health, is the care coordinator for Jamese. Charlie, of City Mission, is the care coordinator for Frank. etc.

Other Claims:

---

• middle_name - To encode a middle name for aiding with patient linking and matching when no unique identifier (e.g. social security number) is known. (national identity)

• sex - A field to indicate biological/birth sex. Values are male, female, and other. In state systems within the United States these generally map to the values M, F, or X.

Example Content

Tha sample content could be in the id_token for James Kirk or the JSON response to an API Important information about James Kirk is provided to the relying party. This includes the following:

• James' identity has been verified to IAL2.
• James' primary care giver is NPI 123456789.
• James' middle name is Tiberius.
• James' birth sex is male.
• James' birthdate is March 22, 2233.
• James' has an NC Mediciad plan (NC is used as an example here. Any state or territory may be substitutued.)
• James' NC Mediciad ID is 123456789.
• James has or is receiving services from ACME Health.
• James has given his spouse, Alice, read access to his medical records.
• James' care coordinator is Carol Capenter of ACME Health.

Payload of id_token:

{
"sub": "130468531371930",
"aud": "some-app@example.com",
"auth_time": 1573568084.385469,
"email": "james@example.com",
"exp": 1573571700.0725582,
"iat": 1573568100.07256,
"iss": "https://oidc.example.com",
"nonce": "xc1bl2q8nfHZvxqPBo9C7ThuPTCHw8lEI2CbDWM2kUISaPBYQX57ocJFEznLdX1X",
"birthdate": "2233-03-22",
"email_verified": false,
"family_name": "Kirk",
"given_name": "James",
"middle_name": "Tiberius",
"name": "James Kirk",
"nickname": "Captian",
"phone_number": "+15555555555",
"phone_verified": false,
"picture": "https://oidc.example.com/media/profile-picture/james-kirk.jpg",
"preferred_username": "james",
"sex": "male",
"vot": "A2.P2.C2",
"vtm": "https://github.com/TransparentHealth/800-63-3-trustmark/",
document": [{
    "type": "MEDICAID_ID",
    "num": "123456789",
    "issuer": "dhhs.nc.gov",
    "country": "US",
    "subdivision": "NC",
    "uri": "https://medicaid.ncdhhs.gov/medicaid"
}],
"address": [{
	"formatted": "811 9th St. Suite 120-309\nDurham, NC 27705",
	"street_address": "811 9th St. Suite 120-309",
	"locality": "Durham",
	"region": "NC",
	"postal_code": "27705",
	"country": ""
}],
"person_to_organization": [{
		"name": "NC Medicaid Direct",
		"slug": "nc-medicaid-direct",
		"relationship_type": "Primary Medical Insurance",
		"sub": "270687240429810",
		"picture": "https://oidc.example.com/media/org-picture/nc-mediciad.jpg",
		"website": "https://medicaid.ncdhhs.gov",
		"phone_number": "+15555559999",
		"scope": "profile user/*.*"
	},
	{
		"name": "ACME Health",
		"slug": "acme-health",
		"relationship_type": "Recipient of services form a community-based organization",
		"sub": "260687240429810",
		"picture": "https://oidc.example.com/media/org-picture/acme.jpg",
		"website": "http://acme.example.com",
		"phone_number": "+155555555555",
		"scope": "profile user/*.read"
	}
],
"person_to_person": [{
	"name": "Alice Alders",
	"sub": "160687240429810",
	"picture": "https://oidc.example.com/media/profile-picture/alice.jpg",
	"phone_number": "+155555551234",
	"relationship": "spouse",
	"scope": "profile user/*.read"
}],
"agent_to_person": [{
	"name": "Carol Capenter",
	"sub": "190688250429811",
	"picture": "https://oidc.example.com/media/profile-picture/alice.jpg",
	"phone_number": "+155555558894",
	"relationship": "Care coordinator",
	"scope": "profile user/*.*",
	"organization": {
		"name": "ACME Health",
		"slug": "acme-health",
		"sub": "260687240429810"
	}
}],
"verified_claims": [{
	"verification": {
		"trust_framework": "nist_800_63A_ial_2",
		"time": "2019-11-08 16:50:06.252483+00:00",
		"evidence": [{
			"type": "id_document",
			"method": "pipp",
			"document": {
				"type": "idcard",
				"issuer": {
					"name": "State of North Carolina",
					"country": "US",
					"region": "NC"
				},
				"number": "1234567",
				"date_of_issuance": "2019-11-07",
				"date_of_expiry": "2029-11-07"
			}
		}],
		"claims": {
			"given_name": "JAMES",
			"family_name": "KIRK",
			"birthdate": "1975-10-12"
		}
	}

}]
}