Hi Kevin, Agree! The 'precise knowledge of the Patient's identity' is limited by the circumstances and the Healthcare Provider is protected where efforts have been made to completely identify the Patient in the presence of uncertainty. For the duration of treatment 'identity' can be a 'dummy ID' or a 'case number', both of which can be expanded and linked to newly acquired 'identities'.
'anonymous testing' is rooted in Patient Privacy and 'identity' is established as above, e.g., 'dummy ID'. A Lab number can be assigned or another mechanism used to protect privacy. Historical Anonymous Research: The 'anonymous' protected the research but there were still records of the research and the participating Patients. These practices have been addressed in many Jurisdictions and Patient protections are considerably 'wider' today. Someone then knew the Patient's identity; today the reporting/verification requirements are more stringent. 'Anonymous research' is showing up in many areas where the effectives of certain drugs have been shown to be close to if not ZERO and the drugs have been recalled. With time, money, credibility and reputation wasted, along with the fatal and potentially fatal impacts of side effects on Patients, whatever it was that was used to justify this mess should in no way be referred to as 'research'. Full disclosure is necessary prior to certification. Effectiveness is a key component of any such certification. Proof is required. Future: Presuming that Genetics-based medicine has a future it seems that a position that the 'real identity' of the Patient need not be known is untenable. Gene scans are available commercially now and the prospectus of many drug companies include plans for gene-based drugs. It appears that the trend is moving in the direction of knowing the 'real identity' of the Patient. Situations where the Patient's 'identity' is limited to 'current knowledge' will be restricted dependent upon the extent of that knowledge. Emergency Medicine will always be a special case and will require in some cases a 'chain-of-identity' for particular Patients. The chain may takes considerable time to complete and it may never be completed. For an EHR system the capability of handing every EM Patient is a requirement. Regards! -Thomas Clark Kevin Coonan, MD wrote: >This is a routine occurrence in Emergency Medicine. Often patients have >multiple identities or are in a state where their identity can only be >approximated (e.g. middle aged male) due to patient condition. > >Also, if someone presents in acute distress/trauma many systems use a dummy >ID, which is used for orders, labs, etc. and when the patient is stabilized, >family arrives, etc. their dummy registration is linked to, and subsumed by, >their real identity. > >Finally, anonymous testing doesn't have knowledge of the patients identity, >beyond that of system assigned code. > >Kevin > >_______________________________________________________ >Kevin M. Coonan, M.D. >kevin.coonan at utah.edu >Adjunct Assistant Professor, Division of Emergency Medicine >NLM Fellow, Department of Medical Informatics >University of Utah School of Medicine > > > >>-----Original Message----- >>From: owner-openehr-technical at openehr.org >>[mailto:owner-openehr-technical at openehr.org] On Behalf Of Tim Cook >>Sent: Sunday, March 13, 2005 2:51 PM >>To: OpenEHR Technical >>Subject: Re: EntityNameParts >> >>On Sun, 2005-03-13 at 07:57, lakewood at copper.net wrote: >> >> >> >>>What 'use case' in Healthcare does not require precise knowledge of >>>the Patient's real identity? >>> >>> >>Research; among others. >> >>-- >>Tim Cook >>Key ID 9ACDB673 @ http://www.keyserver.net/en/ >> >> >> >> > > >- >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
