On 2002-06-12 03:34, "Thomas Beale" <thomas at deepthought.com.au> 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? > >>>>>> This is the position of the Dutch Smartcard Group. >> 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 >>>>>>> Agreed. But ... "data ownership by the pati?nt" will need some consideration. I know that most laws in most countries are politically correct and give rights to patients. But never ownership. Most often a right to inspect, review, remove, and add information. In my way of thinking, the author is the owner and one responsible. The pati?nt has the right to see his information and under certain conditions is able to remove it or change it. But what is "Information"? I think that there are levels or types of information: "Private Opinions" consisting of personal interpretations of raw data; "Official Statements/opinions" consisting of professional interpretations of raw data; "Raw uninterpreted data" admitted to the EHR; "Raw interpreted data" not admitted to the EHR, (yet) Pati?nt have rights towards the last two, but none with the first. Healthcare providers must have the facility record private unripe thoughts about the pati?nt and its disease process. The author os the information is acting as the proxy of the pati?nt. Patients should have no direct access to all the information. Only to selected portions of the " Official opinions". The preferred way to inspect and change is via the responsible proxy. > - thomas beale > > > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org -- <private> -- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands +31 252 544896 +31 654 792800 - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
