Op maandag 24 april 2006 01:26, schreef Thomas Beale: > Bert Verhees wrote: > > It is said in > > http://www.openehr.org/getting_started/t_openehr_primer.htm that one > > of the disadvantages of current health-care information systems is the > > costs and difficulties to maintain them. > > Having to delete data manually, and thereby having to regard > > DB-vendor-specifics, OpenEhr-implementor-specifics and > > OpenEhr-version-specifics makes, in my opinion Openehr, regarding this > > issue costly and difficult, and even dangerous to maintian. I think, I > > would never advise some implementor doing this. > > perhaps I am missing something. openEHR simply provides a logical > versioning model that supports many semantics, including logical > deletion. Physical deletion cannot be expressed in that kind of model - > the semantics of physical deletion are by definition at the file system > or some similar level.
Maybe I am missing something too. I don't know if physically deleting has something to do with the filesystem, in my opinion, one could also regard a permanent deletion of a record as a physically deleting. That depends how data are stored, which is something to be done by a persistence-layer, which can be everything, XML, CSV, relational db, post relational db, even smoke signals to an indian on the other side of the canyon, which carves the data in a pieces of wood. Physically deleting would be in this last case: use the pieces of wood for new smoke signals. Maybe I am completely on the wrong track, I don't know the complete documentation, although I am getting further in it everyday, and, as you also said, it is not always up to date. So I cannot take everything for granted, and also I have to consider what people on this mailing list say. I understood that physically deleting (which is, in my view, complete removal of records (leaving no trace at all) is impossible except by bypassing the kernel and doing it manually. The reasons why I understood this are following. - Gerard said it should not be possible to physically delete a record, only logically may be possible. Logically removing in my view is adding a new version which has a deletion mark (like SVN works) - Sam said that for really (untraceable) removal, it would be necessary to hack in the underlying database manually - You said that too, and emphasized it by mentioning that that is not easy because of different DB-Vendors. And also you pointed to Subversion, which at this moment has no way for permantent deleting a record and removing all traces to it, all evidence it ever existed. > > > It is also said on the same webpage that the OpenEhr community is > > growing, and has members of many countries. One can conclude from this > > that OpenEhr has the desire to not be nation-specific, and should have > > features which are needed (f.e. for repairing an errorneous post of > > data), or even in a minority (f.e. to be local law compliant) of the > > community. > > > > So not having a proper "removal of patients-data or even a complete > > patient"-record API is in my opinion opposite against some of the > > OpenEhr goals. > > no, that's not the intention; in fact we already have in the APIs being > used in Australia the possibility to split one EHR into two EHRs due to > wrong patient data going into an EHR, and also to merge two EHRs. > openEHR itself doesn't say anything at all about the semantics of > removing an entire patient, since it doesn't define formally the idea of > "collection of EHRs", only single EHRs. It would be possibe to gather all records (this always confuses me: an EHR is something as one single composition?) belonging to a patient and remove them, without leaving evidence it ever existed? Because, that is what the Dutch law demands to be possible. The context of which is thought about OpenEhr is many times, this for use in regional or even national context. This is not always necessary to be the case. So let me ask again my question, and first explain a situation: It could well be that an OpenEhr-system is used in a private clinic, or a clinic for mental health. For example, there is a famous clinic in London where rich people can get rid of there cocaine and alcohol habits. They work quick, and seem succesful. I can imagine that the really rich people want all there evidence, having stayed in such a clinic to be removed, and I think, they have the power to get this done. Maybe other mental health clinics need some evidence for taxes and insurance administration, but when that is done, no evidence of their stay may be left if the patient demands that. That is what the Dutch law tells us. Is that possible, using an API in OpenEhr? If yes, than I was on the wrong track because of my misunderstanding the remarks made by you, Gerard and Sam. kind regards Bert Verhees
