Contract Example: pcd-example-notThis

ConsentDirective Example

Narrative

The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for.

specific to use-case 2. Withhold or withdraw consent for disclosure of a specific record (e.g. Lab Order/Result)

Patient "P. van de Heuvel" Primary Care Provider, Dr. Philip Primary, has ordered a set of lab test which Adam wishes to keep as private as possible. At the sample collection facility, he indicates that he would like withhold consent to disclose the order and all results associated with that specific order from all other providers

Example XML

<?xml version="1.0" encoding="UTF-8"?>
<Contract xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
  xsi:schemaLocation="http://hl7.org/fhir ../../schema/contract.xsd">
  <id value="pcd-example-notThis"/>

  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing
      jurisdictional policy and are realized in existing systems in Canada. The default policy is
      one of implied consent for the provision of care, so these scenarios all deal with withdrawal
      or withholding consent for that purpose. In other jurisdictions, where an express consent
      model is used (Opt-In), these would examples would contain the phrase "consent to" rather than
      "withhold" or "withdraw" consent for. <p> specific to use-case 2. Withhold or withdraw consent
        for disclosure of a specific record (e.g. Lab Order/Result) </p><p> Patient "P. van de
        Heuvel" Primary Care Provider, Dr. Philip Primary, has ordered a set of lab test which Adam
        wishes to keep as private as possible. At the sample collection facility, he indicates that
        he would like withhold consent to disclose the order and all results associated with that
        specific order from all other providers </p>
    </div>
  </text>

  <issued value="2015-11-18"/>
  <!-- not bound by a timeframe - Contract.applies -->

  <subject>
    <reference value="Patient/f001"/>
    <display value="P. van de Heuvel"/>
  </subject>

  <authority>
    <reference value="Organization/3"/>
    <display value="Michigan Health"/>
  </authority>

  <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
  <domain>
    <reference value="Location/ukp"/>
    <display value="UK Pharmacies"/>
  </domain>

  <type>
    <coding>
      <system value="http://loinc.org"/>
      <code value="57016-8"/>
    </coding>
  </type>

  <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
  <subType>
    <coding>
      <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
      <code value="Opt-In"/>
      <display value="Default Authorization with exceptions."/>
    </coding>
  </subType>

  <!-- I can easily say to exclude a type of FHIR Resource, but lab-orders is not a direct Resource type. Might we put in FHIR based query parameters? -->
  <term>
    <identifier>
      <system value="http://example.org/fhir/term-items"/>
      <value value="3347689"/>
    </identifier>
    <issued value="2015-11-01"/>
    <applies>
      <start value="2015-11-18"/>
    </applies>
    <type>
      <coding>
        <!-- made up code system -->
        <system value="http://example.org/fhir/consent-term-type-codes"/>
        <code value="withhold-identified-object-and-related"/>
        <display
          value="Withhold the identified object and any other resources that are related to this object."
        />
      </coding>
    </type>
    <offer>
      <topic>
        <reference value="ServiceRequest/lipid"/>
      </topic>
      <!-- by not specifying term.actor I assume this means everyone? -->
      <text value="Withhold this order and any results or related objects from any provider."/>
    </offer>
  </term>

  <!-- the terms of the consent in friendly consumer speak -->
  <friendly>
    <contentAttachment>
      <title value="The terms of the consent in friendly consumer speak."/>
      <!-- likely use url pointer to common text -->
    </contentAttachment>
  </friendly>

  <!-- the legal terms of the consent in lawyer speak -->
  <legal>
    <contentAttachment>
      <title value="The terms of the consent in lawyer speak."/>
      <!-- likely use url pointer to common text -->
      <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
    </contentAttachment>
  </legal>
</Contract>