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The eHealth Infrastructure has two Authorization Services (AS) configurations providing authentication and authorization for client systems and internal use. |
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Authorization Service Configurations
The Authorization Service configurations support the following user types of the eHealth Infrastructure:
citizen
clinical and administrative employee
service, support & logistics (SSL) supplier employee
system users
system administrator users
The AS configurations consist of:
One KeyCloak with
realm ehealth - for clinical and administrative employee login
realm nemlogin - for citizen login
One SSL KeyCloak with
realm SSL - SSL supplier employee login
System users and system administrator users exist in all realms.
Authentication and Authorization Flow
The login protocol between the client systems and the login component will follow the standard is the OpenID Authentication Code Flow of OpenID Connect 1.0. Authentication should be done by completing an OpenID Connect "code flow"
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Further details on the client’s initiation are described in Client Application use of eHealth Infrastructure authentification server (AS). As a reaction, the Authorization Service initiates a federation of authentication and possibly authorization depending on the realm:
realm nemlogin is federated to Nemlogin
realm eHealth is federated to SEB (in Danish: Sundhedsvæsenets Elektroniske Brugerstyring shortened SEB) which is a common platform for user administration of the solutions provided by the National Health Data Authority
realm SSL is/can be federated to SSL suppliers' IdPs
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In non-production environments, login without this federation actually taking place can be simulated through use of the so-called mocked users. Mocked users are authenticated (and authorized depending on variant) in the eHealth Authentication Services. |
After successful authentication, three tokens are issued for separate purposes:
an ID token – information for the client system about the authenticated user.
an Access Token (AT) – a token with a relatively short period of validity (a few minutes), which the client systems must include in all service requests.
a Refresh Token (RT) – a token with
along validity, which can be used to renew the AT, thereby extending or resuming the session without the user having to authenticate again.
NOTE: AT and RT are tokens that may be in JWT format, but the user systems must not assume this. The format of these may change without notice, and may for example be so-called "opaque tokens", which basically are just an ID string that does not in itself carry any information.
The AT is sent as an HTTP header in all service requests in this form (where "<access token>" is replaced by a specific AT) - see https://jwt.io/introduction/ for further introduction:
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Authorization: Bearer <access token> |
The details on how to use these tokens will vary, depending on whether the client system is for citizens or employees, as well as specific security requirements for the called service. There will be services that do not return personal data and therefore require less protection, while other services will require both authentication, context information and more detailed authorization. The login flow is described on the Login page. The data that lays the basis for authorization and authentication is found in the final SAML Assertion that is passed to the AS.
Authentication for citizen clients
Client systems for citizens will in their (initial) login be met by NemID, which is presented via a federated login service from NemLogin. If the client system is running on a platform that supports it, it will be possible to store the RT and apply this later to resume an authenticated session, based on either pin code or biometric data. Details of this is can be read on Key Service overview, but in essence it involves selecting a PIN, registering a user / device / PIN via the Key Service, and resuming the session based on stored data and calling the Key Service.
The aim of this is to make an alternative - but simpler - "authentication" available to citizens in a secure manner.
Authentication for clinical clients
Client systems for clinical users will make a login which delegates to SEB. If there is already a session in SEB from the same browser, then a single-signon experience can be realized. Through SEB, a number of information about the user is handed over to AS, including clinical user's roles / rights. These roles and rights are embedded in the SAML Assertion using the OIO BPP 1.1 structure, model 3, described in the following section.
Authorization, SAML requirements and OIO BPP
Citizen SAML attributes
Citizen access to the eHealth Infrastructure goes through NemLogin. NemLogin provides a set of SAML attributes in a SAML assertion which is used to identify the citizen. Other attributes are also part of the SAML attribute; they are however not currently used. The table below lists the current attributes that are delivered by NemLogin:
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Based on the above mentioned SAML attributes the citizen is able to read data
Clinical SAML attributes
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OIO BPP in the eHealth Infrastructure
The structure of the OIO BPP is capable of expressing multiple careteam- and organization affiliations.
In the case where the user is part of multiple careteams (stated in the OIO BPP as part of the SAML AuthResponse), the user needs to set the wanted careteam in context (see context description). If the user is only part of a single careteam, it is automatically set in context. Once a careteam is set into context (see context switching), the set of roles changes in the returned access token and provides the user with a different set of accessibility to the data within the eHealth Infrastructure. The set of items that can be set into context are: Organization, Patient, CareTeam, EpisodeOfCare (see context switching). As such, the eHealth Infrastructure governs the access to data using both RBAC (stated roles from login) and ABAC (asserting data attributes on the actual content).
Clinical client systems avoid the complexity associated with user registration and resumption of sessions based on pin code or biometric data. It should not be supported for clinical users.
On the other hand, there is a need for strict management in relation to the context in which the user works, so that there is no potential for the systems to mix data together that relate to different patients / citizens. Therefore, it will be require exchanging AT or RT to a new AT that is context-specific and where the user's rights in the specific context have been evaluated.
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The set of services and service operations that the client is authorized to use privileges is conveyed through the Access Token. The set depends on user type and/or federated authentication. The eHealth services perform access control based on the Access Token, often constrained by additional contexts that must be set in the Access Token.
Authorization Based on User Type and Contexts set in the Access Token
The eHealth infrastructure defines the following contexts:
Organization Context
Careteam Context
Patient Context
Episode of Care Context
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The following is an informative overview of user types must present what contexts. The normative mapping is described in Access Control in eHealth Services. |
Citizen User Type and Contexts
A citizen user type is authorized to see almost all data about the citizen.
This user type will have the Patient Context set.
In general, modifying data requires the Episode of Care Context to be set.
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Citizens that logs into the infrastructure using NemID are looked up as FHIR Patient resources with the social security number found in the SAML assertion. If a match is found, the FHIR Patient resource ID will be present in the Refresh Token handed back to the client. If no match to a FHIR Patient resource is found, no FHIR Patient resource ID will be present in the Refresh Token. This means that citizens that are not part of any treatment in the infrastructure will be allowed to login, but won't have any rights to read or write any data. |
Clinical and/or Administrative Employee User Type and Contexts
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Whenever clinicians passes a successful loginflow the data from the SAML assertion is parsed and converted to the matching FHIR resources Practitioner, PractitionerRole and CareTeam which are updated in the infrastructure. This means that clinicians (FHIR Practitioners) will be present after login. This also means that clinicians that haven't logged in, won't be present as FHIR resources. Besides the creation and update of the FHIR resources, the loginflow also results in short lived session within the AS (Keycloak). The lifetime of the Keycloak session follows the lifetime of the Refresh Token. |