Hi Gerard I have been sitting here in the OpenEHR since February and all of sudden last month someone put through a cyberhighway and the din from traffic has increased enormously. For those who have transferred from other lists I apologise if my ponderings are too facile or have already been covered ad nauseam.
I have never understood the concept of data ownership. I can understand the ownership of things, like hard drives and CD-ROMs, but not data. Data seems to me like a mathematical algorithm or poetry. You can create it, you can interpret it and you can store it. You can also send it on to someone else and these days the electronic copy you send is the same as the original. Medical data is collected from patients by health care professionals. Each of them has specified read / write permissions but, at least in Australia, not deletion rights. If you introduce third parties (HMOs, governments, employers) you also need to define their rights. Having worked under the Australian "open system" since a change to the Privacy Act six months ago, I find that there are hardly any times when you need to withhold information from the patient. I cannot see the point in restricting access to "private" opinions. My letters of referral, which the patient can read in full, contain a copy of my clinic notes. The consultant pyschiatrist soon fathoms out my diagnosis of "voices for investigation" and the patient is painfully aware of the symptom. I do agree that any appendings to the record requested by the patient have to be made by the health professional. After all, it is "your" record. :-) David Gerard Freriks wrote: >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. > > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
