In message <[log in to unmask]>, John Farenden
<[log in to unmask]> writes
>On Mon, 25 Nov 1996 23:2 GMT0, Andrew N. Herd wrote in reply to Rob
>Tweed:
>
>>Rob> Not so - if you use the Web browser as a "dumb terminal" to access the
>>> record in situ at a remote site (remember the record fo a patient can
>>> be distributed across many sites/systems), then access control to the
>>> data is the responsibility of the organisation that captured the info
>>> in the first place - via an access control list.
>>
>>Andrew>That's my point - who will hold the material, the GP? Health Web
>services
>>Ltd? Reuters?
>
>Whoever originated it is responsible - and can hold it wherever they
>want.
>
>If it originated in a GP practice, it can stay there - in a hospital,
>then it stays in their system, remembering that some hospitals have
>FM'd (Facilities managed) out their systems which are physically
>located off-site.
>
>Rather than message data around in advance of when it is actually
>wanted, by waiting until someone comes to you (GP) to ask for access
>to the "bit" which you hold, you retain greater control who gets to
>see it (as long as you know who's asking for it, why and have patient
>consent to share)
>
>And IMHO that works both ways - hospital clinician - in conjunction
>with patient - must decide whether to include the GP on the access
>control record for any data created - and kept - at the hospital.
>
At the moment we have what you might call "partial records" in different
sites - and the assumption is that information is sent on a need to know
basis(When I write a referal letter, I include information relevant for
the management of that problem - not the total medical record).
If you have an access control list,would this be for access to the total
record, or could it be taiored to allow access only to the section
needed at the time? - and if so,how?
Is it possible to hack an access control list situation?
Is there a risk to the patient in having partial records (or partial
access to complete records) - missing information on medication or
allergies might lead to medical errors, for instance.
Mary
PS Is there a case for retaining the Lloyd George envelope and doctors'
handwriting? ;->>
>
>
>
>
>
>
>___________________________________________________________________________
>John Farenden - Secta / Health Web Services
>Triton House, Hare Park Lane, Liversedge, West Yorkshire, England, WF15 8HN
>Tel 01274 852160, Fax 01274 852159
>
--
Mary Hawking
Kingsbury Court Surgery
Church Street
Dunstable
Beds LU5 4RS
tel:01582 601289 (home)
01582 663218 (surgery)
fax:01582 476488 (surgery)
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|