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
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