On Dec 17, 2007 9:01 AM, Gerard Freriks <gfrer at luna.nl> wrote: > I know for sure that in many occasions I want to document a private > thought in the context of my note about a patient. > I know for sure that when the patient demands access to these notes I must > give them, when I have them. > Agreed
> I know for sure that the EHR is the official play ground where others will > read and interact with each other. So this is not the place for private > notes. > but there are other types of notes that are accessible to clinicians but legally concealable to the patient which may exist within the EHR. > I know for sure that part of the privacy is dealt with at the system > levels. (Desktop, Networks, Applications, Services) > I know for sure that at the end of the line the EMR or EHR will play a > role as well because here the patient mandate is stored and exchanged. (part > 4 of EN1606) > Agreed but privacy rules are bound to Archetyped information as part of the OpenEHR reference model, although the rules themselves are not defined. > So > I know for sure that openEHR will have to deal with all this and the > OpenEHR tooling must be able to produce Templates/Archetypes to deal with > the Patient Mandate. > There is no problem in doing the modelling of the Patient Mandate using archetypes and templates but within OpenEHR, this class of data is seen as being separate, like metadata, to the main content of each archetype. Think of it like the Contributor,composition dates etc. which are elements automatically attached to the contribution to the EHR by the reference model. The main difficulty is not modelling the requirements but in establishing the 'maximal dataset' of all possible approaches to patient confidentiality and security. An archetype approach would have to be as inclusive as possible a number of potential overlapping ideas. Could become very tricky!! If anyone is interested in this area, I have a contact via my Msc Informatics course who was looking at varying privacy legislation as part of her final year project in the context of mutli-national occupational health records. She currently works for Shell and is/was based in the Netherlands. Ian -------------- next part -------------- An HTML attachment was scrubbed... URL: <http://lists.openehr.org/mailman/private/openehr-clinical_lists.openehr.org/attachments/20071217/6073ef3b/attachment.html>
