1. ATNA Repositories Federation Brief Profile Proposal for 2014/15 presented to the IT Infrastructure Planning Committee Mauro Zanardini (consorzio Arsenàl.IT) October9th 2013OakBrook October 9th 2013, Oak Brook

2. IT Infrastructure Planning Committee The need… allowingthe patient to consult the audit of data accessEuropean Digital Agenda dedicates its Action 75 to increase patients empowerment giving them online access to their medical information. In this sense great attention is played on allowing the patient to consult the audit of data access, as demonstrated by its inclusion among the online services assessed by the Sustains Project, the EU initiative directly inspired by Action 75. CIP (Competitiveness Innovation Program ): – –7M (from 1-jan-2012 to 31-dec-2014) – – 19 partners, 9 countries – –11 pilots (in 7 countries ) Spain Sweden Italy Greece Denmark Finland Slovenia

3. IT Infrastructure Planning Committee The need…. The patient SHALL have electronic access to those information anytimeDecreto FSE, Articolo 14 comma 3 (Ministerial Order): “Each access to clinical information stored in the regional PHR must be tracked in a specific section of patient’s web portal. The patient SHALL have electronic access to those information anytime…” Sharing Infrastructure PHR AUDIT Infrastructure Query for Clinical Data Query for Audit Data

4. IT Infrastructure Planning Committee Use-case How it should/could work: All the audit messages are structured in accordance to ATNA profile and can be consumed by the web application. The system of federated ARR can collect all the Audit messages of interest starting from the Registry and ending to each Repository that stores Document consulted by clinicians (in an efficient way). How it works: All the audit messages are structured in accordance to ATNA profile, but it is not profiled how to have access to that information (no query standardized etc.). If it should be possible to query the ARR systems, it is quite impossible to span all the ARR Repositories in order to collect all the Audit messages of interest.

5. IT Infrastructure Planning Committee Which are the Problems…? Audit Infrastructure: Each enterprise manages and collects audit messages created by systems that belong to it: THEY DO NOT WANT TO EXPORT THIS DATA FROM THEIR ENTERPRISE. In addition central Audit Record Repository would involve unsustainable data traffic. Standardized sotred Queries for ATNA Repository Federation of many ARR Repositories to have simple acces to Autdit Messages stored in many places Standardized Query: Each Repository stores data in accordance to ATNA structure for audit messages BUT the access to this information is legacy.

6. IT Infrastructure Planning Committee Requirements Efficiency is the most important feature to take in consideration drafting the profile. Only a stored query approach could grant low cost of integration The focus should be on Document Access traceability (no other relevant use cases).

7. IT Infrastructure Planning Committee Proposed Standards & Systems IHE ATNAIHE ATNA RFC3881RFC3881 HL7 PASSHL7 PASS HL7 FHIR (resource SecurityEvent)HL7 FHIR (resource SecurityEvent) (???)(???)

8. IT Infrastructure Planning Committee Effort Estimation The Effort for this work item is evaluated:The Effort for this work item is evaluated: –Medium work effort. Is there someone who is willing to act as profile editor?Is there someone who is willing to act as profile editor? –Mauro Zanardini (Arsenàl.IT), Arianna Cocchiglia (Arsenàl.IT), …