In May 2024, the FAST Focus webinar, "Secure Health Data Exchange," brought together experts from across the healthcare industry to delve into the intricacies of the HL7 Unified Data Access Profiles (UDAP) Security for Scalable Registration, Authentication, and Authorization Implementation Guide, commonly referred to as the FAST Security IG. This session featured insights on key components and practical implementations of the FAST Security IG.
Introduction to the FAST Security IG
The session began with an explanation of the role of FAST in addressing healthcare interoperability challenges. The FAST Security IG aims to create a scalable, secure framework for health data exchange across national networks like TEFCA, Carequality, and CommonWell.
The Journey to Trustworthy Information Exchange
A historical perspective on the FAST Security IG highlighted its roots back to 2017. The goal was to leverage existing standards like public key infrastructure (PKI), OpenID Connect, and OAuth 2.0 to ensure a scalable, secure data exchange solution. The FAST Security IG integrates these standards into a cohesive framework, emphasizing the importance of trust in health data transactions.
Key Components of the FAST Security IG
The core elements of the FAST Security IG include:
- JWT-Based Authentication and Authorization: Utilizing JSON Web Tokens for secure assertions of claims from trusted third parties.
- Dynamic Client Registration: Automating client registration using digital certificates to eliminate the need for shared secrets.
- Tiered OAuth: Facilitating patient-facing workflows by directing patients to trusted identity providers for authentication.
This approach ensures that both clients and servers can be securely identified and authenticated, streamlining the registration process, and enhancing trust across the network.
Real-World Implementations and Insights
The panel discussion featured firsthand experiences from implementers of the FAST Security IG. The discussion emphasized the collaborative effort in refining the FAST Security IG and the importance of ongoing participation in workgroups to further enhance the specification.
Open-source solutions to facilitate implementation were highlighted, including a .NET reference implementation and a diagnostic tool called UDAP Ed. These resources help developers visualize and test their implementations, accelerating the adoption of the FAST Security IG.
The importance of identity assurance was underscored, advocating for a centralized, trusted entity to manage high-security registrations. The FAST Security IG's reliance on well-established standards makes it a robust and scalable solution for the healthcare industry.
Scalability and Security in Action
The dual focus on scalability and security was discussed, noting how the FAST Security IG's dynamic client registration and PKI-based approach address these critical needs. The ability to revoke certificates quickly enhances the security posture, ensuring that only trusted entities can access sensitive health data.
Challenges of scaling HL7 FHIR® (Fast Healthcare Interoperability Resources) were addressed, and the FAST Security IG was presented as a viable solution. The community-driven approach allows for customization and further constraint within specific networks, ensuring that the implementation aligns with regulatory requirements and real-world use cases.
The Road Ahead
The importance of a scalable, secure framework for national health data exchange was emphasized, highlighting the broader implications of the FAST Security IG, including its integration into other FAST initiatives such as consent management, directory services, and identity verification.
In closing, the necessity of continued collaboration and community participation to refine and expand the FAST Security IG was agreed upon. The future of secure health data exchange depends on the collective effort of stakeholders across the healthcare ecosystem.
For those who missed the live webinar, you a encouraged to watch the full recording and to check out the PDF of the slides. This resource, along with additional materials and slides, can be accessed on the FAST Confluence space.
