Hi Kerry, Historical documents under the American version of English Common Law are admissible after 30 years, and before in some jurisdictions by affidavit from a Custodian. This can change at any time. A potential solution, presuming Custodial Affidavit, is entering the record in a Custodial Record that retains originals. This will provide a Custodial Trail for the records.
Check this out with an appropriate Attorney in practice in your Jurisdiction. Entering a historical document within an EHR poses a different problem. Presuming a secure EHR system, the document must be properly authenticated/certified prior to entry and a Custodial Trail maintained until used. It must be admissible prior to entry into the EHR. This varies by Jurisdiction and one should check this out with an appropriate attorney. A caveat would be: Avoid changing Jurisdictions. Assuming that a historical document in one Jurisdiction would be admissible in another Jurisdiction is tricky. Back to the appropriate Attorney! Migrating a Historical Document to an EHR is a good idea for at least the following reasons: 1)Electronic records are admissible in many Jurisdictions 2)Secure Healthcare Electronic Records can be handled as other Electronic Records (e.g., bank records), e.g., custom in the industry. Again one needs the appropriate Attorney to ensure that Healthcare Electronic Records are treated as other Electronic Records. In your Jurisdiction there may be prior rulings on the admissible of Healthcare records, or similar records. It may be useful to access the rulings to determine prior case law. Unfortunately, Legislative Enactment and prior case law will likely vary somewhat among Jurisdictions within a country; they do between countries especially where to source of law differs, e.g., English Common Law. I usually refer to prior case law on Electronic Records used in Banking (center-weight!). Technology and relevant law evolve with time. Expect and anticipate change. Regards! Thomas Clark Kerry Raymond wrote: > There are undeniably enormous challenges in this area. > > However, right now, we have a health system that operates off bits of > paper augmented with IT here and there. Can we verify the authenticity > of a medical record from the 1970s today? Will a paper health record > created today be authenticated in 2030? If a doctor receives a medical > history on paper and one of the pages has a fold on the corner which > causes two pages to be turned instead of one, can we prove in a court > today if the doctor did or didn't see the information on the second > page? Hey, forensic science isn't that good even on CSI :-) > > Surely the goal of EHR is to do better than the existing systems in > some areas (so there is benefit in choosing EHR), and no worse in > others (so there is no significant detriment)? For example, won't some > patients have better outcomes because their doctors have access to > their past allergic reactions thanks to an EHR, even if we cannot > prove in a court whether the information did or didn't get rendered > correctly on a computer screen? > > If we are serious about proving in court "what the doctor saw", I can > only suggest that we create a head-mounted device with a camera > (positioned at eye level) and microphones positioned at ears and > mouth and record every second of the doctor's working life as evidence > of what they saw, heard and said. Of course, it cannot prove whether > those images and sounds were processed cognitively or not, which is > what you need to establish to go from "what the doctor saw/heard" to > "what the doctor knew". It is easy to overlook something on a page or > on a screen, despite it being in plain view. > > If people or organisations perceive significant benefit from > technology, they will not wait for the technology to be perfected. > They will weigh up the risks and benefits and proceed accordingly. As > an example, many people used analogue mobile phones for years despite > widespread public knowledge that they were not completely secure, but > obviously felt that the benefit outweighed the risk, no doubt figuring > that nobody would be motivated to eavesdrop on their basically boring > conversations. A few people suffered because their conversations were > not secure (e.g Prince Charles!) but most people had no adverse > experience. > > This is not to say that we should not try to solve the problems that > are being identified, but I doubt the lack of immediate solutions will > be a showstopper to many organisations or nations rolling out EHRs if > there are other compelling benefits. > > Kerry, who thinks there is a need for an openehr-societal mailing list > for this kind of discussion > > Dr Kerry Raymond > Distinguished Research Leader > CRC for Enterprise Distributed Systems Technology > University of Queensland 4072 Australia > Ph: +61 7 3365 4310, Fax: +61 7 3365 4311, www.dstc.edu.au > > > > > > > > > - > 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
