Melvin Reynolds wrote:
> Thomas, > > Somewhat to my surprise I find myself agreeing with most of your > points in the discussion below. he he he, that's the kind of reply I like to see;-) > However, the final statement "... As soon as one >starts thinking > about what has to happen to turn messages into EHR >content, it > becomes clearer and clearer that the EHR is nothing like a >compendium > of messages; for from it - it is a time-based accumulator of >EHR > information, some of which is sourced from messages, much of which >is > created by human users of GUI applications." seems like a gross > oversimplification of the reality. > > It is true a "readable" EHR is not likely to a compendium of messages. > But an EHR for use in a primary care context is not likely require to > present the same information (in full) as an acute secondary care EHR; > and neither are likely to require to present the full audit trail of > all messages, requests and reports that would be required of a > medico-legally complete (but clinically unhelpful) EHR. Well, that's probably fair enough (although I am not sure I believe that GPs are any less required to have medico-legal protection than any other clinician), but consider that even in a local GP EHR, modifications to things like Current Medications, Family history, Social History, Vaccination record, Therapeutic precautions , Problem list, will generally not come from messages - there is no other place for this data to come from but the GP application. It will instead come through the application / EHR kernel API, and create EHR data on the fly. Now... try to imagine how useful the GP EHR would be minus the items I mention.... > As well as a clarification of scope, it would seem to be important to > clarify at what level of context/granularity we are seeking to produce > the EHR. do you want to expand on this? > Sorry if I've missed anything - but the recent discussions would seem > to indicate that I'm not alone if I have. just point it out, and I'll try to explain more what I think, if at least that can help... - thomas - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
