https://s3.amazonaws.com/IGG/
When the individuals involved are a licensed professional and a patient, the Logical Model (p62) makes almost no sense at all.
The EHR could be compiled from source and patient owned as long as:
(1) the licensed professional's claims can be verified by the patient against their issuers
(2) the licensed professional can put a digital signature on a detailed log entry created by the EHR
(3) the timestamped hash of the log entry can be put on a distributed public ledger
(4) the licensed professional may keep a copy of their log entry and the timestamp proof in case of dispute where the patient "loses" their copy.
An effective individual-centric solution depends on substitutability and therefore standards. There are standards being worked on for many of these steps:
(1) W3C Verifiable Claims https://www.w3.org/2017/vc/charter
(2) Rebooting Web of Trust Decentralized Identifier (DID) is being implemented by 4 separate groups
(3) Chainpoint http://www.chainpoint.org/ and Open Timestamps are being combined in Rebooting Web of Trust
(4) is just a personal data store like Dropbox
The HIE of One Use Case and reference implementation http://hieofone.org/ is in the process of implementing this whole stack.
(a) The patient-controlled EHR is done.
(b) The patient-controlled controller of the EHR and other resources is a personal UMA AS and is done.
(c) The physician's DID and secure signature are initially demonstrated using uPort and being upgraded and integrated.
(d) Verifiable Claims is not yet implemented. The Use Case paper won an ONC Blockchain Health prize.
(e) Timestamps of the physician's interaction with the EHR are not yet implemented.
I believe this shows a licensed individual writing a prescription or curating a patient-centered longitudinal health record in the absence of any particular federation or trust framework.
Adrian