In message <[log in to unmask]>, David Evans
<[log in to unmask]> writes

>I've wondered in the past whether keeping the computer records of old
>pts might breach the data protection act, but I've been told the law
>allows you to keep computer records for as long as they might
>reasonably be needed. This includes keeping them for as long as the pt
>might sue for negligence, which is up to 21 years (I think) for
>maternity cases.

A number of roblems here:-
1. The law allows patients to sue for 3 years (I think) after they have
*discovered* the problem - or three years after the age of maturity
(i.e. 21) in the case of a child. Wasn't there a case recently where it
was decided that in the case of an individual who was mentally
incompetent , there was no time limit?
2. In the case of birth injuries, this information would be , not in the
child's but in the mother's EPR. Should we keep all *women's* records
(on this basis) for the length of time the *child* might sue?
3.Authentication.
Suppose you're a paperless practice. The *only* way of proving that your
record has remained unaltered is the audit trail.
Suppose your patient moves to the opposite end of the country.. and
later has a complaint.
You have either printed out the record - or sent it electronically -
*and in neither case does the audit trail go with it*!
Delete your record, and you *cannot* prove that you made that entry at
that time .. even worse, if the next practice isn't paperless (or only
keys in the major points) and then shreds your printout, there'd be no
record of the consultation ever having occurred!
Think twice.. then thrice.. then..
Mary
PS
</cloak and dagger mode>
suppose I'm a GP in trouble .. I'm paperless and I *need* to lose a few
details "we have done those things we ought not to have done, and we
have left undone those things we ought to have done, and there is no
goodness in us  .. " .. what can I do?
A rather expensive suggestion.
I *change systems*.. and *lose the audit trail*
I make a buisnes case.. not hard to do with anything if you really want
to do it!
The night before the data is transfered, I stay late at the surgery..
and - er- *edit* the relevant records.
Next morning, the data transfer is made.. and *the audit trail lost* ..
incredible how many accidents can happen to backup tapes (said with
feeling.. and we *wanted* to keep the ones we found couldn't be
restored!)
</cloak and dagger mode>
The problem will get worse if and when we're all paperless... unless we
have a transferable audit trail.. and my imagination boggles..

Mary Hawking Kingsbury Court Surgery Church Street Dunstable LU5 4RS
tel:01582 663218 (surgery)fax:01582 476488 (surgery)
Member of British Healthcare Internet Association
Dunstable and Houghton Regis Locality Commisssioning Pilot


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