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.
The point here is not a big-brother forensic approach - but rather one in which the medic cannot deny that they had the opportunity to consult the entire record document [electronic or paper] that arrived on their [virtual or real] desktop - in the state of completeness that it happened to arrive. In that case the medic can carry our their traditional *responsibility* extracting all the relevant details available in that record document - unmonitored. [Of course they might like to call a colleague to check the facts - as they traditionally have done and surely will want to go on doing] The system designer's *responsibiity* is to not make that opportunity more difficult in the case of an electronic document than it is in the case of a paper record. \Gavin - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
