Privacy Considerations
A Digital Health Privacy Toolkit is under development and it will be a companion guide for the CA:FeX Interoperability Specifications. This Toolkit will be available and referenced here as part of the CA:FeX v1 Trial Implementation release.
Security Considerations
Fast Healthcare Interoperability Resources (FHIR) is not a security protocol, nor does it define any security related functionality. However, FHIR does define exchange protocols and content models that need to be used with various security protocols defined elsewhere.
FHIR transactions defined as part of the CA:FeX implementation pattern often make use of patient-specific information which could be exploited by malicious actors resulting in exposure of patient data. For this reason, all FHIR transactions must be secured appropriately with access to limited authorized individuals, data protected in transit, and appropriate audit measures taken.
Implementers SHOULD be aware of security considerations associated with FHIR transactions (http://hl7.org/fhir/R4/security.html), particularly those related to:
- Communications
- Authentication
- Authorization/Access Control
- Audit Logging
- Digital Signatures
- Security Labels
- Narrative
Additionally, many FHIR transactions using HTTP REST will include query parameters that would be identifiers, quasi-identifiers, or sensitive health topics. For example, it is common for patient identifier to be a query parameter. With this URL pattern, the query parameters are typically visible in the server audit log or browser history. The risk from this visibility should be mitigated in system or operational design, by protecting the logs as sensitive data, or by designing other measures into the system to prevent inappropriate exposure.