Eric Browne wrote:
>Sam, > >I take Tom's position. The issue is whether there is a one to one >mapping between subject of care and an EHR. > >>From a health perspective, a foetus can be considered as a subject of >care in its own right. > and I think it can certainly be considered a "subject of clinical Statements" even if one feels that making observations on a foetus is not "care"... > >A foetus is tightly coupled to a mother, but is sufficiently >distinct for there to be a need for a separate EHR under certain >circumstances. The question is when do we spawn a new record? >Under normal circumstances, this would probably occur at birth, partly >since the foetus becomes a person under law, partly because it becomes >an entity predominantly independent of the mother, partly because prior >to birth there is rarely a need for information specifically regarding >the foetus. > which is what I used to think, based on Sam's thinking, but having had this discussion, I have changed my mind. As soon as the first observation is made of the foetus it should have its own EHR. >However, when the foetus does become a subject of care, i.e. measurements >and interventions are undertaken specifically for the benefit of the >foetus, there are good grounds for spawning a separate EHR. > >Either approach requires a more complex EHR model. > I'm not sure what these are yet, but I guess I can see a few things that need to be sorted out: - connection between mother and child (can be done in the demogarphic server) - when there are twins - when things go wrong, e.g. ectopic pregnancies > But surely the >raison d'etre of an EHR is to promote the care of a subject? Or is it >being proposed for some other reason of which I am unaware? > not as far as I know! - thomas - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
