Christopher Feahr wrote: > Tom, > Are your remarks here concerned only about *privacy* laws with respect > to EHR... i.e., patient and provider rights with respect to access and > disclosure? I can't think of any other general aspect of law that > would apply to EHR... at least not one that would benefit from the > "uniform model code" that you describe.
THere are more, mainly to do with the medico-legal area. The original GEHR project developed a lot of them; I don't have them to hand right now, but the basic requirement of an EHR whcih one could imagine being required by law is: * the full informational state of the EHR at any past moment in time must be reconstructable such that it is clear what information was available to the clinician when he/she made he decision in question or took a certain course of action. In short, the EHR should act as the digital proof for all claims or doubts about what happened to patients and what clinicians did - and it works both ways - clinicians can protect themselves by using the EHR to prove that their decisions were reasonable given the evidence available at the time; patients (or their families) can also ask for the EHR to be "exhumed" to find out if this really was the case, if malpractice is suspected. Now...since all this kind of investigation would lead to courts, the quality of proof would presumably have to be of interest to the legislature... > In the US, the conflict and overlap between state laws and HIPAA is > actually part of the motivation for writing the HIPAA Privacy Rule. > It is expected the state laws will be eventually become aligned with > and "modeled" after HIPAA in the privacy area, although there is no > mechanism to ensure that. Incidentally, there are also areas of > state-federal conflict like "prompt pay" laws, with respect to the > HIPAA Transaction Rule... with no help in sight. > > Personally, I don't think legislatures should be making ANY rules that > are specifically about electronic records and information sharing... > at least, not until we have some sort of information authority or > technical review board to pass these proposals by. Well-meaning > politicians have written the Transaction Rule with the intent of > helping patients and providers. But the ill-conceived rule ends up > increasing everyone's cost and helping no one. yes, I agree with this comment - it is easy to imagine farcical laws being enacted - they need to be formulated with the informed advice of relevant IT & clinical informtion management professionals... - thomas beale - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
