On 22 Oct 2004, at 7:13 PM, Thomas Beale wrote:

David Forslund wrote:

I disagree. Your medical record can be created over a variety of locations
each of which may have its own id. This can occur even within a single hospital
system. Thus an MPI of some sort is required to "stitch" the medical record together.


but then the EHR that is on your stick is just a copy of something else - then all the points about security of thumbprint-activated memory sticks and emulator-loaded Linuxes becomes redundant. Then it's main use is not personal privacy, but _availability_ when you are unconscious, i.e. in an A&E situation. Or did I miss something here?

be definition a portable, detachable patient record device is not on line in real time (at least not the current generation of devices) therefore it cannot be primary, it can only be a copy of records that are primary at an originating source, and can only be as current as its most recent sync


on the plus side a portable, detachable patient record device can host

- for the patient, discharge summary or referral details current to the last sync with one of the many primary ehr source systems distributed about the health care system

- for the site, summary patient identity details linked to specific patients at specific primary ehr source systems, acting as an identity key

in practice i suspect the patient safety angle of the latter is the more compelling systemic purpose, like dog tags for soldiers, issued not by a central authority but rather inferred by the presence of identities at distributed nodes on a federated mpi, like a cookie file in your browser...

[wr]

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will ross
phoenixpm.org project manager
[voice]  707.272.7255
http://www.phoenixpm.org

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