Health Care High Assurance Access by Patient to their records

Patient Proofed at Primary Care Provider(PCP)

  1. There is at least one well-known health care trust registry where users can get trust information about HIPAA compliant web sites and apps.
  2. Patient visits their PCP and does in-person proofing of their identity and payment mechanisms (insurance, bank card, Medicare).
  3. PCP creates or updates its own (or a federated) Electronic HealthCare Record (EHR) for the patient.
  4. Patient asks for access to EHR from their mobile phone for viewing and for download.
  5. Patient gives PCP their mobile smart phone number, which they have on their person.
  6. PCP creates a bearer token for access to the patient records and sends it to patient phone as a QR code.
  7. At home patient loads a pre-approved app for access to their personal health care records.
  8. They go to a pre-approved authentication site that accepts the app and authenticate themselves using the QR code and the PCP web site.
  9. A late binding feature of the smart phone app binds the authentication site to the smart phone for this or later accesses by the patient using a cryptographic key generated by the Late Binding Token and validated by the site.
  10. The patient is able to access their EHR, not only on the originating PCP site, but now on any registered site of medical records that is recognized by the authentication site.
  11. This authentication meets NIST 800-63-3 IAL2 and AAL2 criteria as specified by the CARIN alliance criteria.
  12. The patient has their records on their phone and the ability to release records to any site that can prove that they are HIPAA compliant by membership in the trust repository.

Health Care Trust Registry with free access for Patients

  1. The patient will expect some definitive information about the trustworthiness of any of the web sites that they visit. This registry is desined to provide that information and so must be free and easy for the patient to use in their decisions about where to allow their data to be used.

Create Patient Credentials based on recent PCP Office Visit

  1. At in-person office vist patent asks for access to their Electronic Health Records (EHR).
  2. Patient recieves an access token, for examaple a printed QR code on one of the papers that they take away with them.
  3. At home the patient uses an approprite computing device with a suitble input sensor, for example a camera.
  4. Patient needs to acquire a CARIN compliant app for that computing device.
  5. There will be a simple on-boarding URL for the patient to acquire whatever one support tool is needed to kick off the process. That URL will contain a list of all of the options, but will be structured so that a patient with limited computer experience will be able to succeed. A collection of appropriate languages and accessibility options will be available.
  6. n.b. In-person proofing is not required for NIST IAL2, but is the solution for this use case. A future use will cover remote proofing.

Some limited functionality will be available to the user that cannot download apps. To download the patient EHR the device will need to support the following:

  1. The ability to download trusted apps for the particular make and model of computing device will be needed - hereinafter assumed to be for a smart phone.
  2. All approved apps can be accessed directly from this site, but will mostly be downloaded from the app store of the particular operating system for the phone.

Health Care Mobile Device App for Patients' Private Data

  1. This will be the best user experience case and will be used to showcase the other solutions.

Late Binding Tokens for Protecting Patients' Private Keys

  1. The private keys that form the basis for the patient authentication will be hidden away in some protected space.
  2. While it is possible to protect the data in the Healthcare app the software alone, there is no way to make that secure, so it would only be for demo purposes.
  3. Better protection would include harware protection, either in the phone's trused execuation environment or in a portable token.
  4. The best use case is for hardware protection of both user data and user billing authorization.

Patient Medical Record Locator Service

  1. Patients will usually have a good ideas about accessing the current PCP, but may not know any way to access their other medical records.
  2. Both care providers and patients have a need to access records to provide good care and good outcomes.
  3. Others are thinking about helping providers to find records, but the patient should be empowered as well.

Authentication and cloud storage controlled for Patients by Trusted Third Party

  1. This solution is optional but gives the most visual feedback for the patient.
  2. For example we are planning a demo of a patient entering emergency contact information.
  3. This could also be used as a demo of acquiring blue button data.

Solutions on this web site may be covered by one or more US patents.