Mcuh of an opinion of this topic depends on what your view of an EHR is.
My view is very specific and focused. The EHR contains the data that is
important for the present and future care of the patient. It is legal in a
sense that the data should be correct, complete for its purpose, and
focused. A clinical warehouse or data repository is where all the data
goes and stays. A clinical data warehouse would serve the purpose you
identify. A physician treats the patient. It would be interesting to note
how such errors are discovered. In my experience, it is frequently the
patient and secondly the provider seeing the patient who discovers those
errors.
If the EHR contains anything and everything without structure and purpose,
it becomes too burdensome to use.
For example, in the clinical laboratory, it is important to note a series
of times - when the specimen was collected, when it arrived at the lab,
when it was processed, and when it was reported. The physician taking care
of the patient is interested only in the time of the specimen and that the
result is reported.
I recognize that many will disagree with this position
Ed
Sam Heard
<sam.heard at oceaninformat To:
openehr-technical at openehr.org
ics.biz> cc:
Sent by: Subject: Re: removal of
data
owner-openehr-technical@
openehr.org
05/04/2006 02:03 AM
Please respond to
openehr-technical
Hi Ed
It is possible that someone acted on this information in the meantime and
even made a key decision - making it unavailable except in a
legal(historical) view of the EHR is easy - built into the spec - it would
only be seen with a historical view which can require further security (and
even patient consent).
Sam
William E Hammond wrote:
Maybe we Americans are the only ones who screw up, but one of the
reasons I
have to remove data from the EHR is when the data manages to get into
the
wrong patient's record. Unfortunately for every right way to do
something,
there are many wrong ways. I have said that if I did not have to
design
for human errors, I could do the work 4 times as fast.
Result, we need to have the ability to remove data physically and
completely from the EHR. To leave the data is a breach of privacy.
Ed Hammond
Mikael Nystr?m
<mikny at imt.liu.se> To:
<openehr-technical at openehr.org>
Sent by: cc:
owner-openehr-technical@ Subject: RE:
removal of data
openehr.org
04/18/2006 04:53 AM
Please respond to
openehr-technical
I know that it is very hard to completely remove (parts of) an
electronic
health record, but the law is still the law and we therefore must
follow
it.
It happens now and then in Sweden that we must remove (parts of) an
electronic health record completely (and not only logically). The
removal
is
mainly done manually and to a high cost. In Sweden we therefore also
need
to
record where we send electronic health record data and where we back
the
data up.
/Mikael Nystr?m
________________________________
From: owner-openehr-technical at openehr.org
[mailto:owner-openehr-technical at openehr.org] On Behalf Of Gerard
Freriks
Sent: den 17 april 2006 08:28
To: openehr-technical at openehr.org
Subject: Re: removal of data
I agree that is very seldom.
For many (technical) reasons it is completely impossible to remove
all
information as if it was never written.
for example:
- The information is communicated with others before it has to be
removed
- the information is part of an archive on CD-ROM
- the information is indexed somewhere
Laws (as far as I know) cannot force healthcare providers to change
the
history of things.
Each healthcare provider has the obligation to document itself.
The law, my personal opinion, most often is written by legal persons.
Therefor what they prescribe is legally correct but many times
impossible
to
execute.
My solution is to translate the legal terms in a requirement to
LOGICALLY
remove the information,
It is there.
But it is not used any longer.
Gerard
--
Dr. Sam Heard
MBBS, FRACGP, MRCGP, DRCOG, FACHI
CEO and Clinical Director
Ocean Informatics Pty. Ltd.
Adjunct Professor, Health Informatics, Central Queensland University
Senior Visiting Research Fellow, CHIME, University College London
Chair, Standards Australia, EHR Working Group (IT14-9-2)
Ph: +61 (0)4 1783 8808
Fx: +61 (0)8 8948 0215
