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Re: [Gnumed-devel] Using EMRs to assess indicators (maybe quality) of ca

From: Karsten Hilbert
Subject: Re: [Gnumed-devel] Using EMRs to assess indicators (maybe quality) of care - depends on codes, yes?
Date: Tue, 25 Jan 2011 20:27:40 +0100
User-agent: Mutt/1.5.20 (2009-06-14)

On Tue, Jan 25, 2011 at 05:07:24PM -0200, Rogerio Luz wrote:

> I think there is a bit more to coding ...

A lot more, yes.

> For example: patient's right to secrecy, so the codes should not appear to
> those people not ment to see it (say the secretary and the janitor) in
> Brazil the right to secrecy, and thus the disclosures of ICD for example,
> can only be searched in EMR by a PHYSICIAN, even nurses and paramedics ae
> not allowed to see ICD of patients in their normal interactions
> I still would like to see the ICD integrated to the tree view nonetheless :)

Well, we need to cleanly separate these two concerns:

- access rights
- implementation

Of course will be implement codes to be visible within the tree view.

The access rights issue is two-fold

- first it's a an issue with patient rights
- secondly it's an issue with legislation

Access rights are the one legislative issue that GNUmed WILL
do something about.

I seem to remember three types of people accessing an EMR
from the US HIPAA specs. Can we check the wiki whether we've
got the written down somewhere ?

> Maybe a field called (imagine that! ;) ICD with a dropdown list. We could
> also let some configuration so IT could configure to (or not) ask for the
> ICD of the encounter on every exit / change of patient.

Assuming the code to attach codes to things at all existed
that could easily be done by a hook script on patient change.

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