Shared Health Record (EN)

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Confidentiality

SHR Encounters supports many levels of Confidentiality. An Encounter Confidentiality is also influenced by the confidentiality of the patient.

Encounters marked as confidential will have restricted access. Only and SHR system admin or the patient himself will be able to access this information.

SHR Encounter Confidentiality can be defined in an FHIR Composition resource of an Encounter.

<Composition xmlns="http://hl7.org/fhir">
        ...
    <confidentiality value="N"/>
        ...
</Composition>

The confidentiality values are available for composition can be seen here.

Encounters with confidentiality level above N are considered confidential in SHR.

The encounters confidentiality is also directly dependent on the Patient. The patient confidentiality levels can be seen here. The patient confidentiality is of higher priority than an encounter confidentiality.

If a patient is marked as confidential, all his encounters are also marked as confidential irrespective of the confidentiality level defined in the encounters.

If a patient is not marked as confidential, the encounter confidentiality level is considered.

Some examples :-

  • Consider a patient P1 and some encounters for the patient P1E1 and P1E2.
    P1 -> Confidential.
    P1E1 → Confidentiality level N.
    P1E2 → Confidentiality level R.
    P1E1 and P1E2 → Confidential (as P1 is marked as confidential.)
    Hence the encounter information cannot be accessed by normal users and need special permission
  • Consider a patient P2 and some encounters for the patient P2E1 and P2E2.
    P2 → Confidential.
    P2E1 → Confidentiality level N.
    P2E2 → Confidentiality level R.
    P2E1 → Not confidential
    P2E2 → Confidential
    Hence the encounter P2E2 information cannot be accessed by normal users and need special permission whereas P2E1 can be accessed by people easily.

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