To some extent, it depends on hopw you define the EHR. If you define the
EHR as only data generated from the patient, then the physician input
shpould not be included. I think that is an error. The purpose of the EHR
is to enable the best healthcare and highest quality of life possible to
the patient. In that scenario, there are many instances in which the
clinician does not want to convery certain data to the patient, or at least
control the timing of the release.
For example, a patinet that obviously heading into kidney failure. The
physician first anticipates the possibility of a kidney transplant vs
dialysis. The physician talks with family members. Since these
conversations take place over a period of time, the physician is likely to
record his/her impression of whether someone in the family is willing to be
a donor. If it turns out to be no, it is critical when and how this
information is released to the patient. It is likely that a better course
of action is to promote dialysis as a solution of kidney failure to the
patient.
To some extent, I also think the diagnoses are the "property of the
physician". Who is responsible if the wrong diagnosis is made or if the
right diagnosis ios made.
In any case, I think we make too much of an issue of ownership. Simply
put, the EHR should contain whatever data enables the best care to the
persons involved in delivering that care.
Ed Hammond
Williamtfgoossen@
cs.com
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Subject
Antw: Re: Antw: Author Information
12/16/2007 01:32 Mandate (Re: Archetype production:
AM Types o...
Please respond to
For openEHR
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<openehr-clinical
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In een bericht met de datum 15-12-2007 23:30:20 West-Europa
(standaardtijd), schrijft jpfreriks at gmail.com:
William and Stef, thank you for your clarifying inputs.
I'm not a clinician and as I said - the cancer situation isn't a good,
ethical or even legal example, as you've (rightfully) pointed out.
But in general: are there situations thinkable where a health professional
doesn't want to disclose her/his comments to the patient? Because if there
are, it will be neccessary to put this in the EHR model. I've got the
intuition that especially when psychology comes in, or when a strategy is
needed to get the patient to act in the most healthful way, this might be
the case. Or isn't this (having private, subjective notes) how medicine
works, or should work, so that there's no need to make private notes
possible?
Kind regards,
Josina
I think the personal notes of a doctor / health professional are not part
of the EHR. It can be stored elsewhere in a computer system.
Sincerely yours,
dr. William TF Goossen
director
Results 4 Care b.v.
De Stinse 15
3823 VM Amersfoort
email: Results4Care at cs.com
phone + 31654614458
fax +3133 2570169
Dutch Chamber of Commerce number: 32121206
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