[Gnumed-devel] chart accesses (was Storage and and representation (formatting?) of past history items)

[James Busser]

On 13-Jan-08, at 12:50 PM, Karsten Hilbert wrote:

> > It looks that way from the log but I was not paying attention so
> > do not know if the encounter that appears in the log was started...
> The latter.
>
> It doesn't matter whether you enter data or not in any way.
> If you pull up a chart you create an encounter. However,
> empty encounters (in which no data was added) will be
> auto-deleted sometime later.


Is the encounter created when a patient is selected for example from  
the search box?

Might it be desirable / acceptable to not auto-delete empty  
encounters (maybe just filtering them)?

There is a use case that is not edge, but may in fact be core for  
some groups, to be able to audit the accesses of a chart. Even though  
clinical people will be mostly interested about entries in the chart,  
not caring so much about read-only activity, patients (even ignoring  
regulatory demands) want to be able to know, if they should ever be  
concerned, who has been viewing their chart.

There is even a functional advantage to being able to see who  
accessed a chart. For example a patient seems to have failed to show  
for an appointment. They are contacted and warned they should give  
better notification if they will, in future, miss an appointment. But  
they explain that they did in fact phone the practice the day before.  
In the scenario that I describe, the secretary who may have been part- 
time, or away when the dispute arises, might have activated the  
patient during the phone call and intended to make the change to the  
appointment but then got distracted and before they made a change to  
the appointment, handled the next phone call for a different patient.  
This log (or some kind of log if it is desired to record somewhere  
other than in the encounters) can at least show that secretary X  
activated the patient record the afternoon before the missed visit.  
This would support the patient's story and permit any clarification  
to be done with secretary X if it was needed.