At 11:34 +1000 12/6/02, Thomas Beale wrote: >Li, Henry wrote: > >>This is the process >>A patient visits a care provider and presents his e-card as a proof of >>consent to treatment >> >>The health care provider loads up the health record into the browser and >>download the info into whatever system he is using (this applies to Hospital >>as well), the health care provider can also choose to discuss the patient >>with other health profession on line through the web. >> >>When the patient leave the care provider, it is the responsibility of the >>care provider to upload whatever he has done to the patient back to the >>e-card and the patient goes away. Any subsequent test results etc, it is the >>responsibility of the health care provider to contact the patient to have >>the data put into the patient's e-card. (the patient can choose not to do so >>- but it is of course to the patients benefit to do so) >> >So now there are copies of the EHR a) on the patient's card, and b) >on the system. Over time there will be many copies of the EHR, some >more up to date than the copy on the patient's card. What's the >point of having a copy of the EHR on the patient's card? > >>The benefit of this is at any one time, the patient is the only person that >>has a complete health history of himself and he owns it. (Solve the >> >This won't be true - over time I doubt that anyone will have a >complete history of the patient - they will all have partial >histories, which admittedly is the curret situation, but I don't see >any utility in having yet another copy of part of the EHR on the >card. > >Re: the fear of big brother - I agree this is real; but the >solutions in my opinion lie in: > >- distributed computing systems >- data management by clinical and/or public bodies (non profit >enterprises in other words) >- strict governance of information and enforcement of consent >- data ownership by the patient > >- thomas beale
One attractive option that goes some way to satisfy the above ideals is to have any particular data exist in only one primary location (backed up, of course), and therefore the total record "scattered" potentially around the world. The patient-held e-card (also backed up somewhere?) carries the _index_ to these locations/data, as well as being the physical part of a "key" that allows access to this data, and maybe also carrying some portion of the data (at least a summary of key events and critical information such as serious allergies, medication etc) tony grivell > > >- >If you have any questions about using this list, >please send a message to d.lloyd at openehr.org -- .......................ooOoo........................... - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
