Re: access to review audits (was Re: [Gnumed-devel] encounter edit before final save)

[Karsten Hilbert]

On Wed, Aug 13, 2008 at 07:38:56AM -0700, James Busser wrote:

>>> trainee doctors... managing a patient under my care...
>>> ... *insisted*... Staph aureus growing in the patient's blood.
>
>> A simple confirmative phone call to the lab
>> would resolve the situation.
>
> Well, now I have had my laugh for the day ;-)

Not sure why, but I hope that's good.

>> I am not sure I quite appreciate how this relates to editing  
>> narrative.
>
> It was an indirect analogy being that a lab result was written into the 
> record, was seen and acted on by a provider.
I see.

> The result was then changed 
> in a way that gave no indication that a change had occurred and to make 
> matters worse there was no way *within the record in question* to 
> identify (audit) that the change had been made. It is not a question of a 
> widget not having been written... the "original" was now "gone". As 
> Rogerio indicated, this should NOT BE (allowed to be) POSSIBLE.
I fully agree that making a previous record GONE without
trace should not easily be possible (it is very hard to be
made entirely impossible).

> The same 
> is true with narrative. I am having trouble understanding that there 
> would be a difference.
There isn't. I wasn't sure whether you intended the example
to simply be an analogy-in-point rather than a concrete
example of how non-visibility of *narrative* changes would
be harmful.

Karsten
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