Information Technology Reference
In-Depth Information
23.4
Context-Based Access
In this section we present the contest-based access that is the start point for our
proposal. In next sections, we present the definition of context, and the mechanisms
to work with them in the EHR system. Later we will present how to use them in the
interoperability problem.
23.4.1
Contexts
We call
Context
to a situation in the Doctor-Patient relationship inside an assistance
act, requiring an access to the information previously stored in the EHR.
To contextualize the access to the EHR we first need to establish the set of pos-
sible situations or
contexts
where that access may occurs. Then, to exploit the con-
textualized access system, it is necessary to count on a mechanism to identify the
context in which the medical staff is involved.
Context Definition
The contexts can be defined under three criteria or a combination of them:
•
Pathological process: In this case the contexts are defined based on a diagnosed
pathology that requires monitoring and it is included in the EHR as such process.
Some of these processes are defined by the Regional Health Administration and
others by the hospital services themselves. It must be taken into account that
several medical specialities can be involved in the same process. Some examples
are the pregnancy process, the cataract process, the diabetes process,...
•
Medical specialty: Here the contexts are defined according to the specificity of
each medical specialty (pediatrics, gynecology, nursery, cardiology,...).
•
Kind of assistance: The context definition here is based on the environment
where the assistance process takes places.
The following cases can be
distinguished:
-
Diagnostic study.
-
Surgical intervention.
-
Post-surgical revision.
-
Evolutive revision.
-
Room visit.
-
Treatment revision of outpatient consultation.
-
Analytical control.
-
Urgent assistance situation.
According to these three criteria, we ask to different medical doctors to identify
the contexts on each speciality. The set of contexts obtained has been reviewed by
different groups of medical doctors to validate the results for their corresponding
specialty.
