On 04/11/2017 18:38, Bert Verhees wrote:
But also apart from that. The discussion is if a standard should
facilitate an inactive patient (logical deleted) to still remain in
the active clinical information system with a special flag or that he
should be transferred to an archive system. This is the question which
is important to decide if a standard should define a "deleted" flag.
I think such a flag is a technical flag to organize some way of
archiving data. It has no additional semantic meaning and should not
belong in a standard defining semantic structures.
just to be clear, we are talking about (at least) 3 different things:
* *logical content deletion*, e.g. I want to 'wipe out' my second
homeopathic Care Plan that is no longer relevant because I stopped
believing in homeopathy
* *archival of EHR*: I want to move the EHR to an archive system that
allows access, querying (or at least extraction), but separate from
operational EHRs
* *physical deletion of EHR from entire system*: nuke this EHR
The delete marker in the current model only applies to the first one.
To support archival, we need to know what we think the archival workflow
will be. Let's say we defined that, then I can imagine adding a new
Boolean flag to EHR_STATUS called e.g. archived or ready_for_archival or
similar. THis flag would prevent the system from 'seeing' the EHR even
if it was not yet in the physical archive, and it would enable an
archival admin process to know that it really can archive this EHR. When
you think about it, a flag won't be enough, it needs to be some sort of
signed 'consent for archiving' concept.
For the third scenario, another flag may make sense like
'ready_for_deletion', but again, we need to study the needed workflow in
detail to really know what changes to the models are needed.
- thomas
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