Dear All Sorry, I have been out of touch over the Xmas - great surf on the east coast! This may be old ground?
This conversation is sounding a little like a technical solution rather than a pragmatic solution. My response is that both solutions are required - a fetal record (rare) and fetal recordings in the maternal record. The fetal heart rate is an example of a measurement that is NOT the mother that is appropriate for the maternal record - and I do not think that anyone is going to start a fetal record for this value. Philippe is right - fetal scans will sometimes (rarely) have implications for the future child and will need to be copied to that record in the future. I do not think that linking between records will be an acceptable approach - although it is attractive technically - as it will pose a lot of privacy issues that the public are not ready for at this stage - neither am I frankly! Applications can clearly link the records as they wish with the appropriate access controls. The scenario of not having family history records but rather a set of links to all relatives records is not tenable in the current environment and should not be proposed as a solution at this stage. The fact that openEHR would allow this technically is not a problem. I will read on in this thread....Sam > -----Original Message----- > From: owner-openehr-technical at openehr.org > [mailto:owner-openehr-technical at openehr.org]On Behalf Of Philippe > AMELINE > Sent: Thursday, 19 December 2002 7:57 PM > To: openehr-technical at openehr.org > Subject: Re: [Fwd: RE: Subject of 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. > > What do you call "certain circumstances" ; anyway, the follow up > echographies during pregnancy belong to the future baby. > > >> 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. > > I agree with that. > > A solution coul be to open an EHR immediately (first echography > ?) and have > this EHR usable as a "time delimited window" inside the mother EHR. > > The other solution (more pragmatic) would be to have the mother's > pregnancy > "Problem" (just POMR way of labelling things) being opened as a "before > birth window" inside the baby record. > It is more pragmatic since the "system" you work on during > pregnancy is the > mother (with extra "organs"). > > I can't guess the legal issues. > > Philippe > > - > If you have any questions about using this list, > please send a message to d.lloyd at openehr.org > - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
