On 13-09-2002 16:51, "Melvin Reynolds" <MelvinR at AMS-Consulting.co.uk> wrote:
> >>> However, the final statement "... As soon as one >starts thinking >>> about what has to happen to turn messages into EHR >content, it >>> becomes clearer and clearer that the EHR is nothing like a >compendium >>> of messages; for from it - it is a time-based accumulator of >EHR >>> information, some of which is sourced from messages, much of which >is >>> created by human users of GUI applications." seems like a gross >>> oversimplification of the reality. >>> >>> It is true a "readable" EHR is not likely to a compendium of >>> messages. But an EHR for use in a primary care context is not likely >>> require to present the same information (in full) as an acute >>> secondary care EHR; and neither are likely to require to present the >>> full audit trail of all messages, requests and reports that would be >>> required of a medico-legally complete (but clinically unhelpful) EHR. >>> The information a healthcare provider submits to the record is what he/she sees on the screen. This committed information has to be signed. It is not sufficient that the author is recorded but for legal proof it is necessaryb that he/she signes the text with his/her private key. This is the position we (at TNO-PG) take after having studied the legal literature (1500 pages of texts from EU Directives, Dutch laws, FDA documents and ethics documents) So an EHR is a series of signed, authored messages that can be used in court. Without the fulfillment of the requirements, the EHR is nothing but information written in the sand before a wave of the sea washes it away. What an application does with the information on a screen and in its database is much less relevant from a legal perspective. What is signed is relevant. -- <work> -- Gerard Freriks TNO-PG Zernikedreef 9 2333CK Leiden The Netherlands +31 71 5181388 +31 654 792800 - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
