--- David Forslund <[EMAIL PROTECTED]> wrote:
> There is a joint effort between HL7 and the OMG to
> standardize such an
> RLS. I urge participation by those involved
> in these standards efforts. There was a lot of
> work done on a RLS a number of years ago by the OMG
and we need to ensure that this RLS
> service be interoperable as it develops. I couldn't
find any significant specification for the RLS in the
references you
> gave.
>
Hi,
On the proposed RLS
from
http://www.connectingforhealth.org/resources/collaborative_response/hie_model/3.php
The system supports
1. Linking of records via a registry of information
about where records are located and sharing among
users participating in the system, but it also allows
2. Linking without sharing, or sharing pursuant
only to higher authorization, as well as
3. The ability to choose not to link information in
certain sensitive treatment situations determined by
users.
Should the last of these be determined by patients or
professionals? If patients determine what is linked
and not, much of the data collected by the doctor will
become unavailable to the doctor.
Will we need a type of Informed Consent from patients
as to
1. If they are willing to have an EMR
2. That they understand the risks (however good
security looks)ad that the clinician cannot be
responsible for the loss or leak of records.
3. That if they decide not to link parts of the EMR,
they will first discuss with the doctor before
delinking? That they may be harmed if this information
is not available in an emergency situation to the
clinician.
What about responsibility of problems due to errors in
data entry by the patient to his record, or by the
health care workers? If a clinician finds an error in
the patients own additions, can he correct it? Is he
responsible to that records accuracy as well?
Nandalal
> Dave
> Will Ross wrote:
>
> > On 23 Apr 2005, at 3:25 AM, Adrian Midgley wrote:
> >
> >> I am not convinced we always address the
> collection of problems and
> >> opportunities from the right aspect.
> >>
> >> I prefer to think about _automation_ rather than
> just an EMR, and about
> >> tools for tasks rather than a whole system. I
> know that re-usable code
> >> and integration of different pieces is harder in
> practice than in
> >> theory, but ...
> >>
> >> I also believe we have not considered the use of
> the computer and
> >> network as a Knowledge Source for
> medical/healthcare practice
> >> sufficiently, and some distance remains, in
> England although it is
> >> decreasing, to the establishment of an ecology of
> people making a
> >> living, and technical resources aligned to FLOSS.
> >>
> >> Looking at the opinions published by the US
> Leapfrog Consortium, and
> >> reviewing my memories of the development of UK
> General Practice software
> >> over some decades, the prescribing system seems
> to be the first clinical
> >> tool to be of obvious value.
> >>
> >> This implies the presence of a register - a list
> of who is a patient/was
> >> a patient (but does not absolutely _require_ it,
> or require it to be
> >> complete).
> >
> >
> > The Connecting for Health group (a fellow
> traveller to the Leapfrog
> > group) is working as we speak to deliver just this
> type of index. They
> > call it the "Record Locator Service". Their most
> recent technical
> > overview ("Linking Healthcare Information"
> published in February) is
> > available in pdf on the project home page at:
> >
> > http://www.connectingforhealth.org/
> >
> > The RLS observes a distinction between "knowing
> where a record is
> > located" and "knowing what is in the record".
> >
> > The OpenHRE project is following the RLS
> specification.
> >
> > [wr]
> >
> > - - - - - - - -
> >
> > will ross
> > technology project management
> > 216 west perkins street, suite 206
> > ukiah, california 95482 usa
> > 707.272.7255 [voice]
> > 707.462.5015 [fax]
> >
> > - - - - - - - -
> >
>
> > begin:vcard
> fn:David Forslund
> n:Forslund;David
> org:Los Alamos National Laboratory;CCS-DO
> adr;dom:;;MS B265;Los Alamos;NM;87545
> email;internet:[EMAIL PROTECTED]
> title:Laboratory Fellow
> tel;work:505-665-2633
> version:2.1
> end:vcard
>
>
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