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INFORMATIONAL
Network Working Group                                        G. MarshallRequest for Comments: 3881                                       SiemensCategory: Informational                                   September 2004Security Audit and Access Accountability MessageXML Data Definitions for Healthcare ApplicationsStatus of this Memo   This memo provides information for the Internet community.  It does   not specify an Internet standard of any kind.  Distribution of this   memo is unlimited.Copyright Notice   Copyright (C) The Internet Society (2004).IESG Note   This RFC is not a candidate for any level of Internet Standard.  The   IETF disclaims any knowledge of the fitness of this RFC for any   purpose, and notes that it has not had IETF review.  The RFC Editor   has chosen to publish this document at its discretion.Abstract   This document defines the format of data to be collected and minimum   set of attributes that need to be captured for security auditing in   healthcare application systems.  The format is defined as an XML   schema, which is intended as a reference for healthcare standards   developers and application designers.  It consolidates several   previous documents on security auditing of healthcare data.Marshall                     Informational                      [Page 1]

RFC 3881         Security Audit & Access Accountability   September 2004Table of Contents1. Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . .22. Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42.1.  Data Collection . . . . . . . . . . . . . . . . . . . . .42.2.  Anticipated Data End-uses . . . . . . . . . . . . . . . .52.3.  Conformance . . . . . . . . . . . . . . . . . . . . . . .63. Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63.1.  Effective Data Gathering. . . . . . . . . . . . . . . . .63.2.  Efficiency. . . . . . . . . . . . . . . . . . . . . . . .74. Trigger Events. . . . . . . . . . . . . . . . . . . . . . . . .84.1.  Security Administration . . . . . . . . . . . . . . . . .84.2.  Audit Administration and Data Access. . . . . . . . . . .94.3.  User Access . . . . . . . . . . . . . . . . . . . . . . .105. Data Definitions. . . . . . . . . . . . . . . . . . . . . . . .135.1.  Event Identification. . . . . . . . . . . . . . . . . . .135.2.  Active Participant Identification . . . . . . . . . . . .175.3.  Network Access Point Identification . . . . . . . . . . .205.4.  Audit Source Identification . . . . . . . . . . . . . . .225.5.  Participant Object Identification . . . . . . . . . . . .246. XML Schema. . . . . . . . . . . . . . . . . . . . . . . . . . .316.1.  XML Schema Definition . . . . . . . . . . . . . . . . . .316.2.  XML Schema Localization . . . . . . . . . . . . . . . . .437. Security Considerations . . . . . . . . . . . . . . . . . . . .448. References. . . . . . . . . . . . . . . . . . . . . . . . . . .448.1.  Normative References. . . . . . . . . . . . . . . . . . .448.2.  Informative References. . . . . . . . . . . . . . . . . .45   Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . .45   Author's Address . . . . . . . . . . . . . . . . . . . . . . . . .46   Full Copyright Statement . . . . . . . . . . . . . . . . . . . . .471.  Purpose   To help assure healthcare privacy and security in automated systems,   usage data needs to be collected.  This data will be reviewed by   administrative staff to verify that healthcare data is being used in   accordance with the healthcare provider's data security requirements   and to establish accountability for data use.  This data collection   and review process is called security auditing.   This document defines the format of the data to be collected and   minimum set of attributes that need to be captured by healthcare   application systems for subsequent use by an automation-assisted   review application.  The data includes records of who accessed   healthcare data, when, for what action, from where, and whichMarshall                     Informational                      [Page 2]

RFC 3881         Security Audit & Access Accountability   September 2004   patients' records were involved.  The data definition is an XML   schema to be used as a reference by healthcare standards developers   and application designers.   This document consolidates previously disjointed viewpoints of   security auditing from Health Level 7 (HL7) [HL7SASIG], Digital   Imaging and Communications in Medicine (DICOM) Working Group 14,   Integrating the Healthcare Enterprise (IHE) [IHETF-3], the ASTM   International Healthcare Informatics Technical Committee (ASTM E31)   [E2147], and the Joint NEMA/COCIR/JIRA Security and Privacy Committee   [NEMASPC].  It is intended as a reference for these groups and other   healthcare standards developers.   The purposes the document fulfills are to:   1) Define data to be communicated for evidence of compliance with, or      violations of, a healthcare enterprise's security and privacy      policies and objectives.      This document defines the audit message format and content for      healthcare application systems.  The focus of auditing is to      retrospectively detect and report security/privacy breaches.  This      includes capturing data that supports individual accountability      for patient record creation, access, updates, and deletions.      This document does not define healthcare security and privacy      policies or objectives.  It also does not include real-time access      alarm actions since there is a perception in the healthcare      community that security measures that inhibit access may also      inhibit effective patient care, under some circumstances.   2) Depict the data that would potentially reside in a common audit      engine or database.      Privacy and security audit data is to be collected on each      hardware system, and there are likely to be separate local data      stores for system-level and application-level audits.  Collating      these records and providing a common view - transcending hardware      system boundaries - is seen as necessary for cost-effective      security and privacy policy administration.      The data definitions in this document support such a collation,      but the technical implementation alternatives are not covered in      this document.Marshall                     Informational                      [Page 3]

RFC 3881         Security Audit & Access Accountability   September 2004   3) Depict data that allows useful queries against audited events.      Audit data, in its raw form, reflects a sequential view of system      activity.  Useful inquiries for security and privacy      administration need workflow, business process, organizational,      role, and person-oriented views.  Data definitions in this      document anticipate and support creating those views and queries,      but do not define them.   4) Provide a common reference standard for healthcare IT standards      development organizations.      By specifying an XML schema, this document anticipates extensions      to the base schema to meet requirements of healthcare standards      bodies and application developers.2.  Scope2.1.  Data Collection   This document specifies audit data to be collected and communicated   from automated systems.  It does not include non-automated processes.   Data for events in the above categories may be selectively collected,   based on healthcare organization policy.  This document does not   specify any baseline or minimal policies.   For each audited event, this document specifies the minimal data   requirements plus optional data for the following event categories:   1) Security administrative events - establishing and maintaining      security policy definitions, secured object definitions, role      definitions, user definitions, and the relationships among them.      In general, these events are specific to the administrative      applications.   2) Audit access events - reflecting special protections implemented      for the audit trail itself.   3) Security-mediated events - recording entity identification and      authentication, data access, function access, nonrepudiation,      cryptographic operations, and data import/export for messages and      reports.  In general, these events are generic to all protected      resources, without regard to the application data content.Marshall                     Informational                      [Page 4]

RFC 3881         Security Audit & Access Accountability   September 2004   4) Patient care data events - documenting what was done, by whom,      using which resources, from what access points, and to whose      medical data.  In general, these audits are application-specific      since they require knowledge of the application data content.   Security subsystems found in most system infrastructures include a   capability to capture system-level security relevant events like   log-on and security object accesses.  This document does not preclude   such functions being enabled to record and supply the data defined in   this document, but transformation of the collected data to the common   XML schema definition may be necessary to support requirements   consolidated auditing views.   Application-level events, such as patient record access, are not   captured by system-level security audits.  The defined data support   applications' record access auditing for healthcare institutional   security and privacy assurance plus related policy administration   functions.   System-local data definitions for collection and storage of audit   data, prior to transformation to a common schema and transmission to   a common repository, are not included in this document.2.2.  Anticipated Data End-uses   This document anticipates, but does not define, end-uses for the data   collected.   The typical healthcare IT environment contains many systems from   various vendors and developers who have not implemented common or   interoperable security administrative functions.  This document   anticipates a requirement to transmit data from several unrelated   systems to a common repository.  It also anticipates the aggregated   data which may then be queried and viewed in a variety of ways.   There are distinctions of detail granularity, specificity, and   frequency between audit data required for surveillance versus   forensic purposes.  While some surveillance data may be useful for   forensics, the scope of this document is limited to surveillance.   This document does not address access real-time policy violation   alarm actions.  There is a perception in the healthcare community   that security measures which inhibit access may also inhibit   effective patient care, under some circumstances.Marshall                     Informational                      [Page 5]

RFC 3881         Security Audit & Access Accountability   September 2004   This document does not define any data for patient care consents or   patients' permissions for data disclosure.  It is conceivable that   the proposed audit data could be input to such applications, however,   assuming strict access controls for audit data have been established.   This document does not define system-specific or application-specific   data that may be collected and reported in addition to the defined   elements.  For example, it is conceivable that audit mechanisms may   be useful for tracking financial or payroll transactions.  At the   same time, this document does not preclude extending the XML schema   to incorporate additional data.   There is a potential requirement for a set of administrative messages   to be sent from a central source to each participating system to   uniformly specify, control, enable, or disable audit data collection.   Such messages are not included in this document.2.3.  Conformance   This document does not include any definitions of conformance   practices.  Instead, it anticipates that standards development   organizations that reference this document may specify their own   conformance requirements.3.  Goals3.1.  Effective Data Gathering   The process of assuring that security policies are implemented   correctly is essential to information security administration.  It is   a set of interrelated tasks all aimed at maintaining an acceptable   level of confidence that security protections are, in fact, working   as intended.  These tasks are assisted by data from automated   instrumentation of system and application functions.   Data gathered from a secured environment is used to accumulate   evidence that security systems are working as intended and to detect   incidents and patterns of misuse for further actions.  Once messages   have been collected, various reports may be created in support of   security assurance and administration information requirements.   When a site runs multiple heterogeneous applications, each   application system may have its own security mechanisms - user log-   on, roles, access right permissions and restrictions, etc.  Each   application system also has its own security log file that records   security relevant events, e.g., log-in, data access, and updates to   the security policy databases.  A system administrator or security   auditor must examine each of these log files to find securityMarshall                     Informational                      [Page 6]

RFC 3881         Security Audit & Access Accountability   September 2004   relevant incidents.  Not only is it difficult to examine each of   these files separately, the format and contents of each file may be   confusingly different.   Resolving these issues requires a framework to:   -  Maximize interoperability and the meaningfulness of data across      applications and sites   -  Minimize ambiguity among heterogeneous systems   -  Simplify and limit the costs of administrative audit tasks.3.2.  Efficiency   One of the leading concerns about auditing is the potential volume of   data gathering and its impact on application system performance.   Although this document does not prescribe specific implementations or   strategies, the following are meant as informative guidance for   development.   1) Audits should be created for transactions or record-level data      access, not for individual attribute-level changes to data.   2) This document does not discourage locally optimized gathering of      audit data on each application system.  Instead, it anticipates      implementation-defined periodic gathering and transmission of data      to a common repository.  This common repository would be optimized      for after-the-fact audit queries and reporting, thus unburdening      each application system of those responsibilities.  It is also      important to keep the message size compact so that audit data will      not penalize normal network operation.   3) On each application system, a variety of policy-based methods      could be employed to optimize data gathering and storage, e.g.,      selective auditing of only events defined as important plus      workload buffering and balancing.  Data gathering itself should be      stateless to avoid the overhead of transactional semantics.  In      addition, prior to transmission, some filtering, aggregation, and      summarization of repeated events would reduce the number of      messages.  Audit data storage and integrity on each application      system need only be scaled for relatively low-volume and short-      duration requirements, yet be consistent with implementation-      defined minimums for holding the data for subsequent collection.   4) Leveraging existing data collection should be considered.  For      example, most commercial security subsystems record events in a      local common log file, so the log file data can be extracted for      communication to a common repository.  Also, it is common in some      systems' designs to have a transaction log for data reconstructionMarshall                     Informational                      [Page 7]

RFC 3881         Security Audit & Access Accountability   September 2004      in event of database loss, so collecting data-update audit data      within this subsystem could reduce impact on application system      performance.   5) A security audit repository would gather all audit message data      from the different applications in one database with one standard      structure.  This would allow easier evaluation and querying.  Once      a suspicious pattern has been found in the audit log repository,      investigation might proceed with more detail in the application      specific audit log.  The presence of a common repository also      simplifies and streamlines the implementation of policies for      audit data storage, integrity, retention, and destruction.4.  Trigger Events   The following identifies representative trigger events for generating   audit messages.  This is not a complete list of trigger events.   For those events arising in the security infrastructure the "minimal"   and "basic" level of auditing as outlined in the Common Criteria   [ISO15408-2] should be used as a reference standard.4.1.  Security Administration   This group includes all actions that create, maintain, query, and   display definitions for securing data, functions, and the associated   access policies.  For each trigger type, the creation, update or   amendment, deletion, and activation or deactivation are auditable.4.1.1.  Data Definition   This includes creation, modification, deletion, query, and display of   security attributes for data sets, data groups, or classes plus their   atomic data elements or attributes.4.1.2.  Function Definition   This includes, for example, creation, modification, deletion, query,   or display of security attributes and auditable events for the   application functions used for patient management, clinical   processes, registry of business objects and methods, program creation   and maintenance, etc.4.1.3.  Domain Definition   This includes all activities to create, modify, delete, query, or   display security domains according to various organizational   categories such as entity-wide, institutional, departmental, etc.Marshall                     Informational                      [Page 8]

RFC 3881         Security Audit & Access Accountability   September 20044.1.4.  Classification Definition   This includes all activities that create, modify, delete, query or   display security categories or groupings for functions and data such   as patient management, nursing, clinical, etc.4.1.5.  Permission Definition   This includes all activities that create, modify, delete, query or   display the allowable access permissions associated with functions   and data, such as create, read, update, delete, and execution of   specific functional units or object access or manipulation methods.4.1.6.  Role Definition   This includes all activities that create, modify, delete, query or   display security roles according to various task-grouping categories   such as security administration, admissions desk, nurses, physicians,   clinical specialists, etc.  It also includes the association of   permissions with roles for role-based access control.4.1.7.  User Definition   This includes all activities that create, modify, delete, query, or   display user accounts.  It includes password or other authentication   data.  It also includes the association of roles with users for   role-based access control, or permissions with users for user-based   access control.4.2.  Audit Administration and Data Access   This category includes all actions that determine the collection and   availability of audit data.4.2.1.  Auditable Event Enable or Disable   This reflects a basic policy decision that an event should or should   not be audited.  Some, but not necessarily all, triggers or use cases   must create an audit record.  The selection of what to audit depends   on administrative policy decisions.  Note that, for integrity, this   event should always be audited.Marshall                     Informational                      [Page 9]

RFC 3881         Security Audit & Access Accountability   September 20044.2.2.  Audit Data Access   This includes instances where audit data is viewed or reported for   any purpose.  Since the audit data itself may include data protected   by institutional privacy policies and expose the implementation of   those policies, access to the data is highly sensitive.  This event   should therefore always be audited.4.2.3.  Audit Data Modify or Delete   This includes instances where audit data is modified or deleted.   While such operations are sometimes permitted by systems policies,   modification or destruction of audit data may well be the result of   unauthorized hostile systems access.  Therefore, this type of event   should always be audited.4.3.  User Access   This category includes events of access to secured data and functions   for which audit data might be collected.4.3.1.  Sign-On   This includes successful and unsuccessful attempts from human users   and automated system.  It also includes re-authentication actions and   re-issuing time-sensitive credentials such as Kerberos tickets.4.3.2.  Sign-Off   This includes explicit sign-off events and session abandonment   timeouts from human users and automated systems.4.3.3.  Function Access   This includes user invocation of application or system functions that   have permission definitions associated with them.  Note that in a   Discretionary Access Control environment not all functions require   permissions, especially if their impact is benign in relation to   security policies.   The following are examples of trigger events relevant to healthcare   privacy.  The actual triggers for institutional data access, policies   for non-care functions, and support regulatory requirements need to   be identified by application-domain standards developers and system   implementers.Marshall                     Informational                     [Page 10]

RFC 3881         Security Audit & Access Accountability   September 20044.3.3.1.  Subject of Care Record Access   This includes all functions which manipulate basic patient data:   -  Create, e.g., demographics or patient profile   -  Assign identifier, e.g., medical record number   -  Update, amend   -  Merge/unmerge, e.g., combine multiple medical records for one      patient   -  Import/export of data from/to an external source, including      printing and creation of portable media copies.   -  Delete, e.g., invalid creation of care record4.3.3.2.  Encounter or Visit   This includes all functions which associate a subject of care with an   instance of care:   -  Create, e.g., demographics or patient profile   -  Assign encounter identifier   -  Per-admit   -  Admit   -  Update, amend   -  Delete, e.g., invalid creation of encounter record, breakdown of      equipment, patient did not arrive as expected4.3.3.3.  Care Protocols   This includes all functions which associate care plans or similar   protocols with an instance or subject of care:   -  Schedule, initiate   -  Update, amend   -  Complete   -  Cancel4.3.3.4.  Episodes or Problems   This includes specific clinical episodes within an instance of care.   Initiate:   -  Update, amend   -  Resolve, complete   -  CancelMarshall                     Informational                     [Page 11]

RFC 3881         Security Audit & Access Accountability   September 20044.3.3.5.  Orders and Order Sets   This includes clinical or supplies orders within an instance or   episode of care:   -  Initiate   -  Update, amend   -  Check for contraindications   -  Verify   -  Deliver/complete - including instructions   -  Cancel4.3.3.6.  Health Service Event or Act   This includes various health services scheduled and performed within   an instance or episode of care:   -  Schedule, initiate   -  Update, amend   -  Check for contraindications   -  Verify   -  Perform/complete - including instructions   -  Cancel4.3.3.7.  Medications   This includes all medication orders and administration within an   instance or episode of care:   -  Order   -  Check   -  Check for interactions   -  Verify   -  Dispense/deliver - including administration instructions   -  Administer   -  Cancel4.3.3.8.  Staff/Participant Assignment   This includes staffing or participant assignment actions relevant to   an instance or episode of care:   -  Assignment of healthcare professionals, caregivers attending      physician, residents, medical students, consultants, etc.   -  Change in assigned role or authorization, e.g., relative to      healthcare status change.   -  De-assignmentMarshall                     Informational                     [Page 12]

RFC 3881         Security Audit & Access Accountability   September 20045.  Data Definitions   This section defines and describes the data in the XML schema.  The   actual XML schema definition is insection 6.   The proposed data elements are grouped into these categories:   1) Event Identification - what was done   2) Active Participant Identification - by whom   3) Network Access Point Identification - initiated from where   4) Audit Source Identification - using which server   5) Participant Object Identification - to what record5.1.  Event Identification   The following data identifies the name, action type, time, and   disposition of the audited event.  There is only one set of event   identification data per audited event.5.1.1.  Event ID   Description      Identifier for a specific audited event, e.g., a menu item,      program, rule, policy, function code, application name, or URL.      It identifies the performed function.   Optionality: Required   Format / Values      Coded value, either defined by the system implementers or as a      reference to a standard vocabulary.  The "code" attribute must be      unambiguous and unique, at least within Audit Source ID (seesection 5.4).  Examples of Event IDs are program name, method      name, or function name.      For implementation defined coded values or references to      standards, the XML schema defines these optional attributes:         Attribute      Value         -------------- --------------------------------------------         CodeSystem     OID reference         CodeSystemName Name of the coding system; strongly recommended                        to be valued for locally-defined code-sets.         DisplayName    The value to be used in displays and reports         OriginalText   Input value that was translated to the codeMarshall                     Informational                     [Page 13]

RFC 3881         Security Audit & Access Accountability   September 2004      To support the requirement for unambiguous event identification,      multiple values may not be specified.   Rationale      This identifies the audited function.  For "Execute" Event Action      Code audit records, this identifies the application function      performed.5.1.2.  Event Action Code   Description      Indicator for type of action performed during the event that      generated the audit.   Optionality: Optional   Format / Values      Enumeration:         Value Meaning               Examples         ----- --------------------- ----------------------------------           C   Create                Create a new database object, such                                     as Placing an Order.           R   Read/View/Print/Query Display or print data, such as a                                     Doctor Census           U   Update                Update data, such as Revise                                     Patient Information           D   Delete                Delete items, such as a doctor                                     master file record           E   Execute               Perform a system or application                                     function such as log-on, program                                     execution, or use of an object's                                     method   Rationale      This broadly indicates what kind of action was done on the      Participant Object.Marshall                     Informational                     [Page 14]

RFC 3881         Security Audit & Access Accountability   September 2004   Notes      Actions that are not enumerated above are considered an Execute of      a specific function or object interface method or treated two or      more distinct events.  An application action, such as an      authorization, is a function Execute, and the Event ID would      identify the function.      For some applications, such as radiological imaging, a Query      action may only determine the presence of data but not access the      data itself.  Auditing need not make as fine a distinction.      Compound actions, such as "Move," would be audited by creating      audit data for each operation - read, create, delete - or as an      Execute of a function or method.5.1.3.  Event Date/Time   Description      Universal coordinated time (UTC), i.e., a date/time specification      that is unambiguous as to local time zones.   Optionality: Required   Format / Values      A date/time representation that is unambiguous in conveying      universal coordinated time (UTC), formatted according to the ISO      8601 standard [ISO8601]   Rationale      This ties an event to a specific date and time.  Security audits      typically require a consistent time base, e.g., UTC, to eliminate      time-zone issues arising from geographical distribution.   Notes      In a distributed system, some sort of common time base, e.g., an      NTP [RFC1305] server, is a good implementation tactic.5.1.4.  Event Outcome Indicator   Description      Indicates whether the event succeeded or failed.Marshall                     Informational                     [Page 15]

RFC 3881         Security Audit & Access Accountability   September 2004   Optionality: Required   Format / Values      Enumeration:      Value Meaning       ---- ----------------------------------------------------        0   Success        4   Minor failure; action restarted, e.g., invalid password            with first retry        8   Serious failure; action terminated, e.g., invalid            password with excess retries       12   Major failure; action made unavailable, e.g., user            account disabled due to excessive invalid log-on attempts   Rationale      Some audit events may be qualified by success or failure      indicator.  For example, a Log-on might have this flag set to a      non-zero value to indicate why a log-on attempt failed.   Notes      In some cases a "success" may be partial, for example, an      incomplete or interrupted transfer of a radiological study.  For      the purpose of establishing accountability, these distinctions are      not relevant.5.1.5.  Event Type Code   Description      Identifier for the category of event.   Optionality: Optional   Format / Values      Coded value enumeration, either defined by the system implementers      or as a reference to a standard vocabulary.  For implementation      defined codes or references to standards, the XML schema defines      these optional attributes:Marshall                     Informational                     [Page 16]

RFC 3881         Security Audit & Access Accountability   September 2004         Attribute      Value         -------------- --------------------------------------------         CodeSystem     OID reference         CodeSystemName Name of the coding system; strongly recommended                        to be valued for locally-defined code-sets.         DisplayName    The value to be used in displays and reports         OriginalText   Input value that was translated to the code      Since events may be categorized in more than one way, there may be      multiple values specified.   Rationale      This field enables queries of messages by implementation-defined      event categories.5.2.  Active Participant Identification   The following data identify a user for the purpose of documenting   accountability for the audited event.  A user may be a person, or a   hardware device or software process for events that are not initiated   by a person.   Optionally, the user's network access location may be specified.   There may be more than one user per event, for example, in cases of   actions initiated by one user for other users, or in events that   involve more than one user, hardware device, or system process.   However, only one user may be the initiator/requestor for the event.5.2.1.  User ID   Description      Unique identifier for the user actively participating in the event   Optionality: Required   Format / Values      User identifier text string from the authentication system.  It is      a unique value within the Audit Source ID (seesection 5.4).   Rationale      This field ties an audit event to a specific user.Marshall                     Informational                     [Page 17]

RFC 3881         Security Audit & Access Accountability   September 2004   Notes      For cross-system audits, especially with long retention, this user      identifier will permanently tie an audit event to a specific user      via a perpetually unique key.      For node-based authentication -- where only the system hardware or      process, but not a human user, is identified -- User ID would be      the node name.5.2.2.  Alternative User ID   Description      Alternative unique identifier for the user   Optionality: Optional   Format / Values      User identifier text string from authentication system.  This      identifier would be one known to a common authentication system      (e.g., single sign-on), if available.   Rationale   In some situations a user may authenticate with one identity but, to   access a specific application system, may use a synonymous identify.   For example, some "single sign on" implementations will do this.  The   alternative identifier would then be the original identify used for   authentication, and the User ID is the one known to and used by the   application.5.2.3.  User Name   Description      The human-meaningful name for the user   Optionality: Optional   Format / Values      Text stringMarshall                     Informational                     [Page 18]

RFC 3881         Security Audit & Access Accountability   September 2004   Rationale      The User ID and Alternative User ID may be internal or otherwise      obscure values.  This field assists the auditor in identifying the      actual user.5.2.4.  User Is Requestor   Description      Indicator that the user is or is not the requestor, or initiator,      for the event being audited.   Optionality: Optional   Format / Values      Boolean, default/assumed value is "true"   Rationale      This value is used to distinguish between requestor-users and      recipient-users.  For example, one person may initiate a report-      output to be sent to a another user.5.2.5.  Role ID Code   Description      Specification of the role(s) the user plays when performing the      event, as assigned in role-based access control security.   Optionality: Optional; multi-valued   Format / Values      Coded value, with attribute "code" valued with the role code or      text from authorization system.  More than one value may be      specified.      The codes may be implementation-defined or reference a standard      vocabulary enumeration.  For implementation defined codes or      references to standards, the XML schema defines these optional      attributes:Marshall                     Informational                     [Page 19]

RFC 3881         Security Audit & Access Accountability   September 2004         Attribute      Value description         -------------- --------------------------------------------         CodeSystem     OID reference         CodeSystemName Name of the coding system; strongly recommended                        to be valued for locally-defined code-sets.         Display Name   The value to be used in displays and reports         OriginalText   Input value that was translated to the code   Rationale      This value ties an audited event to a user's role(s).  It is an      optional value that might be used to group events for analysis by      user functional role categories.   Notes      Many security systems are unable to produce this data, hence it is      optional.      For the common message, this identifier would be the one known to      a common authorization system, if available.  Otherwise, it is a      unique value within the Audit Source ID (seesection 5.4).      Consider using a globally unique identifier associated with the      role to avoid ambiguity in auditing data collected from multiple      systems.      Role ID is not a substitute for personal accountability.      Ambiguities arise from composite roles and users with multiple      roles, i.e., which role within a composite is being used or what      privilege was a user employing?5.3.  Network Access Point Identification   The network access point identifies the logical network location for   application activity.  These data are paired 1:1 with the Active   Participant Identification data.5.3.1.  Network Access Point Type Code   Description      An identifier for the type of network access point that originated      the audit event.   Optionality: Optional   Format / ValuesMarshall                     Informational                     [Page 20]

RFC 3881         Security Audit & Access Accountability   September 2004      Enumeration:         Value Meaning         ----- --------------------------------           1   Machine Name, including DNS name           2   IP Address           3   Telephone Number   Rationale      This datum identifies the type of network access point identifier      of the user device for the audit event.  It is an optional value      that may be used to group events recorded on separate servers for      analysis of access according to a network access point's type.5.3.2.  Network Access Point ID   Description      An identifier for the network access point of the user device for      the audit event.  This could be a device id, IP address, or some      other identifier associated with a device.   Optionality: Optional   Format / Values      Text may be constrained to only valid values for the given Network      Access Point Type, if specified.  Recommendation is to be as      specific as possible where multiple options are available.   Rationale      This datum identifies the user's network access point, which may      be distinct from the server that performed the action.  It is an      optional value that may be used to group events recorded on      separate servers for analysis of a specific network access point's      data access across all servers.   Note      Network Access Point ID is not a substitute for personal      accountability.  Internet IP addresses, in particular, are highly      volatile and may be assigned to more than one person in a short      time period.Marshall                     Informational                     [Page 21]

RFC 3881         Security Audit & Access Accountability   September 2004   Examples      Network Access Point ID: SMH4WC02      Network Access Point Type: 1 = Machine Name      Network Access Point ID: 192.0.2.2      Network Access Point Type: 2 = IP address      Network Access Point ID: 610-555-1212      Network Access Point Type: 3   = Phone Number5.4.  Audit Source Identification   The following data are required primarily for application systems and   processes.  Since multi-tier, distributed, or composite applications   make source identification ambiguous, this collection of fields may   repeat for each application or process actively involved in the   event.  For example, multiple value-sets can identify participating   web servers, application processes, and database server threads in an   n-tier distributed application.  Passive event participants, e.g.,   low-level network transports, need not be identified.   Depending on implementation strategies, it is possible that the   components in a multi-tier, distributed, or composite applications   may generate more than one audit message for a single application   event.  Various data in the audit message may be used to identify   such cases, supporting subsequent data reduction.  This document   anticipates that the repository and reporting mechanisms will perform   data reduction when required, but does not specify those mechanism.5.4.1.  Audit Enterprise Site ID   Description      Logical source location within the healthcare enterprise network,      e.g., a hospital or other provider location within a multi-entity      provider group.   Optionality: Optional   Format / Values      Unique identifier text string within the healthcare enterprise.      May be unvalued when the audit-generating application is uniquely      identified by Audit Source ID.Marshall                     Informational                     [Page 22]

RFC 3881         Security Audit & Access Accountability   September 2004   Rationale      This value differentiates among the sites in a multi-site      enterprise health information system.   Notes      This is defined by the application that generates the audit      record.  It contains a unique code that identifies a business      organization (owner of data) that is known to the enterprise.  The      value further qualifies and disambiguates the Audit Source ID.      Values may vary depending on type of business.  There may be      levels of differentiation within the organization.5.4.2.  Audit Source ID   Description      Identifier of the source where the event originated.   Optionality: Required   Format / Values      Unique identifier text string, at least within the Audit      Enterprise Site ID   Rationale      This field ties the event to a specific source system.  It may be      used to group events for analysis according to where the event      occurred.   Notes      In some configurations, a load-balancing function distributes work      among two or more duplicate servers.  The values defined for this      field thus may be considered as an source identifier for a group      of servers rather than a specific source system.5.4.3.  Audit Source Type Code   Description      Code specifying the type of source where event originated.   Optionality: OptionalMarshall                     Informational                     [Page 23]

RFC 3881         Security Audit & Access Accountability   September 2004   Format / Values      Coded-value enumeration, optionally defined by system implementers      or a as a reference to a standard vocabulary.  Unless defined or      referenced, the default values for the "code" attribute are:         Value  Meaning         -----  ------------------------------------------------------           1    End-user interface           2    Data acquisition device or instrument           3    Web server process tier in a multi-tier system           4    Application server process tier in a multi-tier system           5    Database server process tier in a multi-tier system           6    Security server, e.g., a domain controller           7    ISO level 1-3 network component           8    ISO level 4-6 operating software           9    External source, other or unknown type      For implementation defined codes or references to standards, the      XML schema defines these optional attributes:         Attribute      Value         -------------- --------------------------------------------         CodeSystem     OID reference         CodeSystemName Name of the coding system; strongly recommended                        to be valued for locally-defined code-sets.         DisplayName    The value to be used in displays and reports         OriginalText   Input value that was translated to the code      Since audit sources may be categorized in more than one way, there      may be multiple values specified.   Rationale      This field indicates which type of source is identified by the      Audit Source ID.  It is an optional value that may be used to      group events for analysis according to the type of source where      the event occurred.5.5.  Participant Object Identification   The following data assist the auditing process by indicating specific   instances of data or objects that have been accessed.   These data are required unless the values for Event Identification,   Active Participant Identification, and Audit Source Identification   are sufficient to document the entire auditable event.  Production ofMarshall                     Informational                     [Page 24]

RFC 3881         Security Audit & Access Accountability   September 2004   audit records containing these data may be enabled or suppressed, as   determined by healthcare organization policy and regulatory   requirements.   Because events may have more than one participant object, this group   can be a repeating set of values.  For example, depending on   institutional policies and implementation choices:   -  Two participant object value-sets can be used to identify access      to patient data by medical record number plus the specific health      care encounter or episode for the patient.   -  A patient participant and his authorized representative may be      identified concurrently.   -  An attending physician and consulting referrals may be identified      concurrently.   -  All patients identified on a worklist may be identified.   -  For radiological studies, a set of related participant objects      identified by accession number or study number, may be identified.   Note, though, that each audit message documents only a single usage   instance of such participant object relationships and does not serve   to document all relationships that may be present or possible.5.5.1.  Participant Object Type Code   Description      Code for the participant object type being audited.  This value is      distinct from the user's role or any user relationship to the      participant object.   Optionality: Optional   Format / Values      Enumeration:         Value Meaning         ----- -------------           1   Person           2   System Object           3   Organization           4   OtherMarshall                     Informational                     [Page 25]

RFC 3881         Security Audit & Access Accountability   September 2004   Rationale      To describe the object being acted upon.  In addition to queries      on the subject of the action in an auditable event, it is also      important to be able to query on the object type for the action.5.5.2.  Participant Object Type Code Role   Description      Code representing the functional application role of Participant      Object being audited   Optionality: Optional   Format / Values      Enumeration, specific to Participant Object Type Code:         Value Meaning              Participant Object Type Codes         ----- -------------------- ----------------------------------           1   Patient              1 - Person           2   Location             3 - Organization           3   Report               2 - System Object           4   Resource             1 - Person                                    3 - Organization           5   Master file          2 - System Object           6   User                 1 - Person                                    2 - System Object (non-human user)           7   List                 2 - System Object           8   Doctor               1 - Person           9   Subscriber           3 - Organization          10   Guarantor            1 - Person                                    3 - Organization          11   Security User Entity 1 - Person                                    2 - System Object          12   Security User Group  2 - System Object          13   Security Resource    2 - System Object          14   Security Granularity 2 - System Object               Definition          15   Provider             1 - Person                                    3 - Organization          16   Data Destination     2 - System Object          17   Data Repository      2 - System Object          18   Schedule             2 - System Object          19   Customer             3 - Organization          20   Job                  2 - System Object          21   Job Stream           2 - System ObjectMarshall                     Informational                     [Page 26]

RFC 3881         Security Audit & Access Accountability   September 2004          22   Table                2 - System Object          23   Routing Criteria     2 - System Object          24   Query                2 - System Object      A "Security Resource" is an abstract securable object, e.g., a      screen, interface, document, program, etc. -- or even an audit      data set or repository.   Rationale      For some detailed audit analysis it may be necessary to indicate a      more granular type of participant, based on the application role      it serves.5.5.3.  Participant Object Data Life Cycle   Description      Identifier for the data life-cycle stage for the participant      object.  This can be used to provide an audit trail for data, over      time, as it passes through the system.   Optionality: Optional   Format/Values      Enumeration:         Value Meaning         ----- --------------------------------------           1   Origination / Creation           2   Import / Copy from original           3   Amendment           4   Verification           5   Translation           6   Access / Use           7   De-identification           8   Aggregation, summarization, derivation           9   Report          10   Export / Copy to target          11   Disclosure          12   Receipt of disclosure          13   Archiving          14   Logical deletion          15   Permanent erasure / Physical destructionMarshall                     Informational                     [Page 27]

RFC 3881         Security Audit & Access Accountability   September 2004   Rationale      Institutional policies for privacy and security may optionally      fall under different accountability rules based on data life      cycle.  This provides a differentiating value for those cases.5.5.4.  Participant Object ID Type Code   Description      Describes the identifier that is contained in Participant Object      ID.   Optionality: Required   Format / Values      Coded-value enumeration, specific to Participant Object Type Code,      using attribute-name "code".  The codes below are the default set.         Value Meaning                Participant Object Type Codes         ----- ---------------------- -----------------------------           1   Medical Record Number  1 - Person           2   Patient Number         1 - Person           3   Encounter Number       1 - Person           4   Enrollee Number        1 - Person           5   Social Security Number 1 - Person           6   Account Number         1 - Person                                      3 - Organization           7   Guarantor Number       1 - Person                                      3 - Organization           8   Report Name            2 - System Object           9   Report Number          2 - System Object           10  Search Criteria        2 - System Object           11  User Identifier        1 - Person                                      2 - System Object           12  URI                    2 - System Object      User Identifier and URI [RFC2396] text strings are intended to be      used for security administration trigger events to identify the      objects being acted-upon.      The codes may be the default set stated above, implementation-      defined, or reference a standard vocabulary enumeration, such as      HL7 version 2.4 table 207 or DICOM defined media types.  For      implementation defined codes or references to standards, the XML      schema defines these optional attributes:Marshall                     Informational                     [Page 28]

RFC 3881         Security Audit & Access Accountability   September 2004         Attribute      Value         -------------- --------------------------------------------         CodeSystem     OID reference         CodeSystemName Name of the coding system; strongly recommended                        to be valued for locally-defined code-sets.         DisplayName    The value to be used in displays and reports         OriginalText   Input value that was translated to the code   Rationale      Required to distinguish among various identifiers that may      synonymously identify a participant object.5.5.5.  Participant Object Sensitivity   Description      Denotes policy-defined sensitivity for the Participant Object ID      such as VIP, HIV status, mental health status, or similar topics.   Optionality: Optional   Format / Values      Values are institution- and implementation-defined text strings.5.5.6.  Participant Object ID   Description      Identifies a specific instance of the participant object.   Optionality: Required   Format / Values      Text string.  Value format depends on Participant Object Type Code      and the Participant Object ID Type Code.   Rationale      This field identifies a specific instance of an object, such as a      patient, to detect/track privacy and security issues.   Notes      Consider this to be the primary unique identifier key for the      object, so it may be a composite data field as implemented.Marshall                     Informational                     [Page 29]

RFC 3881         Security Audit & Access Accountability   September 20045.5.7.  Participant Object Name   Description      An instance-specific descriptor of the Participant Object ID      audited, such as a person's name.   Optionality: Optional   Format / Values      Text string   Rationale      This field may be used in a query/report to identify audit events      for a specific person, e.g., where multiple synonymous Participant      Object IDs (patient number, medical record number, encounter      number, etc.) have been used.5.5.8.  Participant Object Query      Description      The actual query for a query-type participant object.   Optionality: Optional   Format / Values      Base 64 encoded data   Rationale      For query events it may be necessary to capture the actual query      input to the query process in order to identify the specific      event.  Because of differences among query implementations and      data encoding for them, this is a base 64 encoded data blob.  It      may be subsequently decoded or interpreted by downstream audit      analysis processing.5.5.9.  Participant Object Detail   Description      Implementation-defined data about specific details of the object      accessed or used.Marshall                     Informational                     [Page 30]

RFC 3881         Security Audit & Access Accountability   September 2004   Optionality: Optional   Format      Type-value pair.  The "type" attribute is an implementation-      defined text string.  The "value" attribute is a base 64 encoded      data.   Rationale      Specific details or values from the object accessed may be desired      in specific auditing implementations.  The type-value pair enables      the use of implementation-defined and locally-extensible object      type identifiers and values.  For example, a clinical diagnostic      object may contain multiple test results, and this element could      document the type and number and type of results.      Many possible data encodings are possible for this elements, so      the value is a base 64 encoded data blob.  It may be subsequently      decoded or interpreted by downstream audit analysis processing.6.  XML Schema   This section contains the actual XML schema definition for the data   defined insection 5.  It also provides brief guidance for specifying   schema localizations for implementation purposes.   The XML schema specified insection 6.1 conforms with the W3C   Recommendations for XML Schema structure [W3CXML-1] and data types   [W3CXML-2].6.1.  XML Schema Definition<xs:schema xmlns:xs="http://www.w3.org/2001/XMLSchema" elementFormDefault="qualified" attributeFormDefault="unqualified"> <xs:element name="AuditMessage">  <xs:complexType>   <xs:sequence>    <xs:element name="EventIdentification"     type="EventIdentificationType"/>    <xs:element name="ActiveParticipant" maxOccurs="unbounded">     <xs:complexType>      <xs:complexContent>       <xs:extension base="ActiveParticipantType"/>      </xs:complexContent>     </xs:complexType>    </xs:element>    <xs:element name="AuditSourceIdentification"Marshall                     Informational                     [Page 31]

RFC 3881         Security Audit & Access Accountability   September 2004     type="AuditSourceIdentificationType" maxOccurs="unbounded"/>    <xs:element name="ParticipantObjectIdentification"     type="ParticipantObjectIdentificationType" minOccurs="0"     maxOccurs="unbounded"/>   </xs:sequence>  </xs:complexType> </xs:element> <xs:complexType name="EventIdentificationType">  <xs:sequence>   <xs:element name="EventID" type="CodedValueType"/>   <xs:element name="EventTypeCode" type="CodedValueType"    minOccurs="0" maxOccurs="unbounded"/>  </xs:sequence>  <xs:attribute name="EventActionCode" use="optional">   <xs:simpleType>    <xs:restriction base="xs:string">     <xs:enumeration value="C">      <xs:annotation>       <xs:appinfo>Create</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="R">      <xs:annotation>       <xs:appinfo>Read</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="U">      <xs:annotation>       <xs:appinfo>Update</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="D">      <xs:annotation>       <xs:appinfo>Delete</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="E">      <xs:annotation>       <xs:documentation>Execute</xs:documentation>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute>  <xs:attribute name="EventDateTime" type="xs:dateTime"   use="required"/>  <xs:attribute name="EventOutcomeIndicator" use="required">   <xs:simpleType>Marshall                     Informational                     [Page 32]

RFC 3881         Security Audit & Access Accountability   September 2004    <xs:restriction base="xs:integer">     <xs:enumeration value="0">      <xs:annotation>       <xs:appinfo>Success</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="4">      <xs:annotation>       <xs:appinfo>Minor failure</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="8">      <xs:annotation>       <xs:appinfo>Serious failure</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="12">      <xs:annotation>       <xs:appinfo>Major failure; action made unavailable          </xs:appinfo>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute> </xs:complexType> <xs:complexType name="AuditSourceIdentificationType">  <xs:sequence>   <xs:element name="AuditSourceTypeCode" minOccurs="0"    maxOccurs="unbounded">    <xs:complexType>     <xs:complexContent>      <xs:restriction base="CodedValueType">       <xs:attribute name="code" use="required">        <xs:simpleType>         <xs:restriction base="xs:string">          <xs:enumeration value="1">           <xs:annotation>            <xs:appinfo>End-user display device, diagnostic             display</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="2">           <xs:annotation>            <xs:appinfo>Data acquisition device or             instrument</xs:appinfo>           </xs:annotation>          </xs:enumeration>Marshall                     Informational                     [Page 33]

RFC 3881         Security Audit & Access Accountability   September 2004          <xs:enumeration value="3">           <xs:annotation>            <xs:appinfo>Web server process</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="4">           <xs:annotation>            <xs:appinfo>Application server process</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="5">           <xs:annotation>            <xs:appinfo>Database server process</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="6">           <xs:annotation>            <xs:appinfo>Security server, e.g., a domain             controller</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="7">           <xs:annotation>            <xs:documentation>ISO level 1-3 network             component</xs:documentation>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="8">           <xs:annotation>            <xs:appinfo>ISO level 4-6 operating software</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="9">           <xs:annotation>            <xs:appinfo>External source, other or unknown             type</xs:appinfo>           </xs:annotation>          </xs:enumeration>         </xs:restriction>        </xs:simpleType>       </xs:attribute>      </xs:restriction>     </xs:complexContent>    </xs:complexType>   </xs:element>  </xs:sequence>  <xs:attribute name="AuditEnterpriseSiteID" type="xs:string"   use="optional"/>Marshall                     Informational                     [Page 34]

RFC 3881         Security Audit & Access Accountability   September 2004  <xs:attribute name="AuditSourceID" type="xs:string"   use="required"/> </xs:complexType> <xs:complexType name="ActiveParticipantType">  <xs:sequence minOccurs="0">   <xs:element name="RoleIDCode" type="CodedValueType" minOccurs="0"    maxOccurs="unbounded"/>  </xs:sequence>  <xs:attribute name="UserID" type="xs:string" use="required"/>  <xs:attribute name="AlternativeUserID" type="xs:string"   use="optional"/>  <xs:attribute name="UserName" type="xs:string" use="optional"/>  <xs:attribute name="UserIsRequestor" type="xs:boolean"   use="optional" default="true"/>  <xs:attribute name="NetworkAccessPointID" type="xs:string"   use="optional"/>  <xs:attribute name="NetworkAccessPointTypeCode" use="optional">   <xs:simpleType>    <xs:restriction base="xs:unsignedByte">     <xs:enumeration value="1">      <xs:annotation>       <xs:appinfo>Machine Name, including DNS name</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="2">      <xs:annotation>       <xs:appinfo>IP Address</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="3">      <xs:annotation>       <xs:appinfo>Telephone Number</xs:appinfo>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute> </xs:complexType> <xs:complexType name="ParticipantObjectIdentificationType">  <xs:sequence>   <xs:element name="ParticipantObjectIDTypeCode">    <xs:complexType>     <xs:complexContent>      <xs:restriction base="CodedValueType">       <xs:attribute name="code" use="required">        <xs:simpleType>         <xs:restriction base="xs:string">          <xs:enumeration value="1">Marshall                     Informational                     [Page 35]

RFC 3881         Security Audit & Access Accountability   September 2004           <xs:annotation>            <xs:appinfo>Medical Record Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="2">           <xs:annotation>            <xs:appinfo>Patient Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="3">           <xs:annotation>            <xs:appinfo>Encounter Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="4">           <xs:annotation>            <xs:appinfo>Enrollee Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="5">           <xs:annotation>            <xs:appinfo>Social Security Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="6">           <xs:annotation>            <xs:appinfo>Account Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="7">           <xs:annotation>            <xs:appinfo>Guarantor Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="8">           <xs:annotation>            <xs:appinfo>Report Name</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="9">           <xs:annotation>            <xs:appinfo>Report Number</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="10">           <xs:annotation>            <xs:appinfo>Search Criteria</xs:appinfo>           </xs:annotation>Marshall                     Informational                     [Page 36]

RFC 3881         Security Audit & Access Accountability   September 2004          </xs:enumeration>          <xs:enumeration value="11">           <xs:annotation>            <xs:appinfo>User Identifier</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value="12">           <xs:annotation>            <xs:appinfo>URI</xs:appinfo>           </xs:annotation>          </xs:enumeration>          <xs:enumeration value=""/>         </xs:restriction>        </xs:simpleType>       </xs:attribute>      </xs:restriction>     </xs:complexContent>    </xs:complexType>   </xs:element>   <xs:choice minOccurs="0">    <xs:element name="ParticipantObjectName" type="xs:string"     minOccurs="0"/>    <xs:element name="ParticipantObjectQuery" type="xs:base64Binary"     minOccurs="0"/>   </xs:choice>   <xs:element name="ParticipantObjectDetail"    type="TypeValuePairType" minOccurs="0" maxOccurs="unbounded"/>  </xs:sequence>  <xs:attribute name="ParticipantObjectID" type="xs:string"   use="required"/>  <xs:attribute name="ParticipantObjectTypeCode" use="optional">   <xs:simpleType>    <xs:restriction base="xs:unsignedByte">     <xs:enumeration value="1">      <xs:annotation>       <xs:appinfo>Person</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="2">      <xs:annotation>       <xs:appinfo>System object</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="3">      <xs:annotation>       <xs:appinfo>Organization</xs:appinfo>      </xs:annotation>     </xs:enumeration>Marshall                     Informational                     [Page 37]

RFC 3881         Security Audit & Access Accountability   September 2004     <xs:enumeration value="4">      <xs:annotation>       <xs:appinfo>Other</xs:appinfo>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute>  <xs:attribute name="ParticipantObjectTypeCodeRole" use="optional">   <xs:simpleType>    <xs:restriction base="xs:unsignedByte">     <xs:enumeration value="1">      <xs:annotation>       <xs:appinfo>Patient</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="2">      <xs:annotation>       <xs:appinfo>Location</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="3">      <xs:annotation>       <xs:appinfo> Report</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="4">      <xs:annotation>       <xs:appinfo>Resource</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="5">      <xs:annotation>       <xs:appinfo>Master file</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="6">      <xs:annotation>       <xs:appinfo>User</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="7">      <xs:annotation>       <xs:appinfo>List</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="8">      <xs:annotation>Marshall                     Informational                     [Page 38]

RFC 3881         Security Audit & Access Accountability   September 2004       <xs:appinfo>Doctor</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="9">      <xs:annotation>       <xs:appinfo>Subscriber</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="10">      <xs:annotation>       <xs:appinfo>Guarantor</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="11">      <xs:annotation>       <xs:appinfo>Security User Entity</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="12">      <xs:annotation>       <xs:appinfo>Security User Group</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="13">      <xs:annotation>       <xs:appinfo>Security Resource</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="14">      <xs:annotation>       <xs:appinfo>Security Granualarity Definition</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="15">      <xs:annotation>       <xs:appinfo>Provider</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="16">      <xs:annotation>       <xs:appinfo>Report Destination</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="17">      <xs:annotation>       <xs:appinfo>Report Library</xs:appinfo>      </xs:annotation>     </xs:enumeration>Marshall                     Informational                     [Page 39]

RFC 3881         Security Audit & Access Accountability   September 2004     <xs:enumeration value="18">      <xs:annotation>       <xs:appinfo>Schedule</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="19">      <xs:annotation>       <xs:appinfo>Customer</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="20">      <xs:annotation>       <xs:appinfo>Job</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="21">      <xs:annotation>       <xs:appinfo>Job Stream</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="22">      <xs:annotation>       <xs:appinfo>Table</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="23">      <xs:annotation>       <xs:appinfo>Routing Criteria</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="24">      <xs:annotation>       <xs:appinfo>Query</xs:appinfo>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute>  <xs:attribute name="ParticipantObjectDataLifeCycle" use="optional">   <xs:simpleType>    <xs:restriction base="xs:unsignedByte">     <xs:enumeration value="1">      <xs:annotation>       <xs:appinfo>Origination / Creation</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="2">      <xs:annotation>Marshall                     Informational                     [Page 40]

RFC 3881         Security Audit & Access Accountability   September 2004       <xs:appinfo>Import / Copy from original </xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="3">      <xs:annotation>       <xs:appinfo>Amendment</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="4">      <xs:annotation>       <xs:appinfo>Verification</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="5">      <xs:annotation>       <xs:appinfo>Translation</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="6">      <xs:annotation>       <xs:appinfo>Access / Use</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="7">      <xs:annotation>       <xs:appinfo>De-identification</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="8">      <xs:annotation>       <xs:appinfo>Aggregation, summarization,        derivation</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="9">      <xs:annotation>       <xs:appinfo>Report</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="10">      <xs:annotation>       <xs:appinfo>Export / Copy to target</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="11">      <xs:annotation>       <xs:appinfo>Disclosure</xs:appinfo>      </xs:annotation>Marshall                     Informational                     [Page 41]

RFC 3881         Security Audit & Access Accountability   September 2004     </xs:enumeration>     <xs:enumeration value="12">      <xs:annotation>       <xs:appinfo>Receipt of disclosure</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="13">      <xs:annotation>       <xs:appinfo>Archiving</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="14">      <xs:annotation>       <xs:appinfo>Logical deletion</xs:appinfo>      </xs:annotation>     </xs:enumeration>     <xs:enumeration value="15">      <xs:annotation>       <xs:appinfo>Permanent erasure / Physical destruction       </xs:appinfo>      </xs:annotation>     </xs:enumeration>    </xs:restriction>   </xs:simpleType>  </xs:attribute>  <xs:attribute name="ParticipantObjectSensitivity" type="xs:string"   use="optional"/> </xs:complexType> <xs:complexType name="CodedValueType">  <xs:attribute name="code" type="xs:string" use="required"/>  <xs:attributeGroup ref="CodeSystem"/>  <xs:attribute name="displayName" type="xs:string" use="optional"/>  <xs:attribute name="originalText" type="xs:string" use="optional"/> </xs:complexType> <xs:complexType name="TypeValuePairType">  <xs:attribute name="type" type="xs:string" use="required"/>  <xs:attribute name="value" type="xs:base64Binary" use="required"/> </xs:complexType> <xs:attributeGroup name="CodeSystem">  <xs:attribute name="codeSystem" type="OID" use="optional"/>  <xs:attribute name="codeSystemName" type="xs:string"   use="optional"/> </xs:attributeGroup> <xs:simpleType name="OID">  <xs:restriction base="xs:string">   <xs:whiteSpace value="collapse"/>  </xs:restriction> </xs:simpleType>Marshall                     Informational                     [Page 42]

RFC 3881         Security Audit & Access Accountability   September 2004</xs:schema>6.2.  XML Schema Localization   The schema specified insection 6.1 may be extended and restricted to   meet local implementation-specific requirements.  W3C Recommendation   for XML Schema structure [W3CXML-1], section 4, is the governing   standard for accomplishing this.   As of the current version of this document, a public reference URI   for the base schema has not been established.   Local definitions reference the common audit message base schema.   For example, here is a schema with a local vocabulary restriction for   "Audit Enterprise Site ID" plus an extension adding a new "Audit   Source Asset Number" element.   The URI used to identify this schema (http://audit-message-uri) is a   syntactically valid example that does not represent an actual schema.   Schema validators might report an error when attempting to import a   schema using this URI.<xs:schema xmlns:audit="http://audit-message-URI" xmlns:xs="http://www.w3.org/2001/XMLSchema" elementFormDefault="qualified" attributeFormDefault="unqualified"> <xs:import schemaLocation="http://audit-message-URI"/> <xs:complexType name="LocaAuditSourceIdentificationType">  <xs:complexContent>   <xs:restriction base="AuditSourceIdentificationType">    <xs:attribute name="AuditEnterpriseSiteID" use="required">     <xs:simpleType>      <xs:restriction base="xs:string">       <xs:enumeration value="Main"/>       <xs:enumeration value="Clinic1"/>       <xs:enumeration value="Clinic2"/>       <xs:enumeration value="Radiology"/>       <xs:enumeration value="Lab"/>      </xs:restriction>     </xs:simpleType>    </xs:attribute>   </xs:restriction>  </xs:complexContent> </xs:complexType> <xs:element name="LocalAuditSourceIdentification">  <xs:complexType>   <xs:complexContent>    <xs:extension base="LocaAuditSourceIdentificationType">      <xs:attribute name="AuditSourceAssetNumber" type="xs:string"Marshall                     Informational                     [Page 43]

RFC 3881         Security Audit & Access Accountability   September 2004       use="required"/>    </xs:extension>   </xs:complexContent>  </xs:complexType> </xs:element></xs:schema>7.  Security Considerations   Audit data must be secured at least to the same extent as the   underlying data and activities being audited.  This includes access   controls as well as data integrity and recovery functions.  This   document acknowledges the need for, but does not specify, the   policies and technical methods to accomplish this.   It is conceivable that audit data might have unintended uses, e.g.,   tracking the frequency and nature of system use for productivity   measures.  ASTM standard E2147-01 [E2147] states, in paragraph   5.3.10, "Prohibit use for other reasons than to enforce security and   to detect security breaches in record health information systems, for   example, the audits are not to be used to explore activity profiles   or movement profiles of employees."   Some audit data arises from security-relevant processes other than   data access.  These are the trigger events listed insection 4.1 and   4.2 of this document.  Audit data, defined in this document, can   record the accountabilities for the results of these processes, as   part of a complete security implementation.  A discussion of the   associated authorities, reference standards, and implementation   technology choices for the processes is outside the scope of this   document.8.  References8.1.  Normative References   [E2147]      "E2147-01 Standard Specification for Audit and                Disclosure Logs for Use in Health Information Systems",                ASTM International, June 2002.   [ISO15408-2] "ISO/IEC 15408:1999 Common Criteria for Information                Technology Security Evaluation, Part 2: Security                Functional Requirements", ISO, August 1999.   [ISO8601]    "ISO 8601:2000 Data elements and interchange formats --                Information interchange -- Representation of dates and                times", ISO, December 2000.Marshall                     Informational                     [Page 44]

RFC 3881         Security Audit & Access Accountability   September 2004   [RFC1305]    Mills, D., "Network Time Protocol (Version 3)                Specification, Implementation",RFC 1305, March 1992.   [RFC2396]    Berners-Lee, T., Fielding, R. and L. Masinter, "Uniform                Resource Identifiers (URI): Generic Syntax",RFC 2396,                August 1998.   [W3CXML-1]   W3C Recommendation "XML Schema Part 1: Structures",                version 1.0, May 2001.   [W3CXML-2]   W3C Recommendation "XML Schema Part 2: Datatypes,"                version 1.0, May 2001.8.2.  Informative References   [HL7SASIG]   Marshall, G. and G. Dickinson, "Common Audit Message",                HL7 Security and Accountability Special Interest Group,                November 2001.   [IHETF-3]    "IHE Technical Framework", Volume III, HIMMS/RSNA, April                2002.   [NEMASPC]    "Security and Privacy Auditing in Health Care                Information Technology", Joint NEMA/COCIR/JIRA Security                and Privacy Committee, 26 June 2001.Acknowledgments   The author gratefully acknowledges the advice and assistance of the   following people during the preparation of this document:      Carmela Couderc, Siemens Medical Solutions      Michael Davis, SAIC      Gary Dickinson      Christoph Dickmann, Siemens Medical Solutions      Daniel Hannum, Siemens Medical Solutions      Robert Horn, Agfa      James McAvoy, Siemens Medical Solutions      John Moehrke, General Electric Medical Systems      Jennifer Puyenbroek, McKesson Information Solutions      Angela Ray, McKesson Information Solutions      Lawrence Tarbox, Siemens Corporate ResearchMarshall                     Informational                     [Page 45]

RFC 3881         Security Audit & Access Accountability   September 2004Author's Address   Glen Marshall   Siemens Medical Solutions Health Services   51 Valley Stream Parkway   Malvern, PA 19312   USA   Phone: (610) 219-3938   EMail: glen.f.marshall@siemens.comMarshall                     Informational                     [Page 46]

RFC 3881         Security Audit & Access Accountability   September 2004Full Copyright Statement   Copyright (C) The Internet Society (2004).   This document is subject to the rights, licenses and restrictions   contained inBCP 78, and at www.rfc-editor.org, and except as set   forth therein, the authors retain all their rights.   This document and the information contained herein are provided on an   "AS IS" basis and THE CONTRIBUTOR, THE ORGANIZATION HE/S HE   REPRESENTS OR IS SPONSORED BY (IF ANY), THE INTERNET SOCIETY AND THE   INTERNET ENGINEERING TASK FORCE DISCLAIM ALL WARRANTIES, EXPRESS OR   IMPLIED, INCLUDING BUT NOT LIMITED TO ANY WARRANTY THAT THE USE OF   THE INFORMATION HEREIN WILL NOT INFRINGE ANY RIGHTS OR ANY IMPLIED   WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.Intellectual Property   The IETF takes no position regarding the validity or scope of any   Intellectual Property Rights or other rights that might be claimed to   pertain to the implementation or use of the technology described in   this document or the extent to which any license under such rights   might or might not be available; nor does it represent that it has   made any independent effort to identify any such rights.  Information   on the ISOC's procedures with respect to rights in ISOC Documents can   be found inBCP 78 andBCP 79.   Copies of IPR disclosures made to the IETF Secretariat and any   assurances of licenses to be made available, or the result of an   attempt made to obtain a general license or permission for the use of   such proprietary rights by implementers or users of this   specification can be obtained from the IETF on-line IPR repository athttp://www.ietf.org/ipr.   The IETF invites any interested party to bring to its attention any   copyrights, patents or patent applications, or other proprietary   rights that may cover technology that may be required to implement   this standard.  Please address the information to the IETF at ietf-   ipr@ietf.org.Acknowledgement   Funding for the RFC Editor function is currently provided by the   Internet Society.Marshall                     Informational                     [Page 47]

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