You speak much sense!! "The Legal environment in particular requires reconstruction."
Oh that was the best one I heard today - it's in the order of when the warp drive emerges. Need to think more on your wise thoughts though. David -----Original Message----- From: [email protected] [mailto:owner-openehr-technical at openehr.org] On Behalf Of lakewood at copper.net Sent: Saturday, 5 March 2005 3:36 AM To: openehr-technical at openehr.org Subject: Re: Demographics service Hi David, Significant problem! However, software configuration management has solved this before. In the Legal or secure OS environments the contributions of individuals are in fact part of the record even through the 'end-game' is an update that merges the contributions of all, e.g., a composite record. It is critical that 'information' is not lost nor corrupted. Efforts to 'crunch' multiple records into a satisfactory record usually fail this requirement at some point. A reasonable objective is to permit multiple Practitioners to enter information simultaneously, maintain original context and content, build a composite record that is compatible with the target record-handling system, and support 100% re-assembly of all sources of information. A 'build-and-submit' or 'interactive-entry' architecture can yield multiple 'composite' records that may also be linked by one or more events, e.g., surgery and lab work. It may also be necessary to declare a higher-order event (in a record) to which subsequent events can be linked (extra-record, meaning the event can transcend a collection of records, e.g., multiple contacts-same cause). Information organization is a virtue; lack of it may well impact information retrieval. Try coordinating the activities and results of 20+ Software Engineers working on a release. Things happen in parallel. The Legal environment in particular requires reconstruction. Regards! -Thomas Clark Bigpond wrote: >The EHR is rather a unique document and a layered approach is necessary as >old data must never be altered - may not necessarily be accessible but must >never be altered. Errors can be corrected but the error must remain totally >accessible in the manner it was presented to the clinician when it was >relied upon - eg clinical results, medications. >The concept of layering new information on old is important. >There does have to be lock outs or transaction controls when new data is >being entered in but there is no need for old material (old may be seconds >of course)to be locked out cause it can't or shouldn't be changed. >If two doctors are entering elements of say a discharge summary then one >cannot edit while another is adding - it needs a message indicating someone >else is working on the current document and wait. It is more complex than >that but the basic principle applies old data never changes even old >addresses must stay. >Legally it is important to be able to reproduce exactly the circumstances >that the computer presented to the clinician at any point in time for >inquests, litigation etc. >We are dealing with these issues today with our CIS and it is a challenge. > >David Evans >Brisbane Australia > > > >- >If you have any questions about using this list, >please send a message to d.lloyd at openehr.org > > > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
