< With the existence of the LR there are relatively few reasons for the
forced declaration of an LR where one does not exist (say if a patient
has collapsed). Without it, even if all accesses were documented, there
would be an open season on records with a potentially large number of
claims along the lines of "I did not know this was improper access". >
John:
<< It raises the question of what is improper access. If I as a practice
manager dive in to a patient's records to find out why the hell they are
not logged as having a diabetic foot check will that be improper? >>
No. Your organisation and your role will be agreed (locally probably by
the PCT) and programmed into your smart card which will then then
determine your access permissions. You will swipe your card through the
reader on your keyboard when you log on and the theory is that you
should then be able to seamlessly access records which are deemed
appropriate to the role of PM in your surgery.
<< Will I have to fill out a requisition in triplicate and gain the
patient's consent before doing so? >>
No. The issue of consent becomes more complex in the event of the
patient requesting some of her information to be held in a "sealed
envelope" which would effectively hide the contents (not the presence of
the envelope) from agreed groups, or roles, or possibly allow access to
only named people. This would probably be done at the time that the data
was entered by the clinician. It could also be done retrospectively. The
issues (and there are many of them) are being thrashed out as we speak.
Laurie
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