🚀 go-pugleaf

> > I'm developing a patient medical record system for a
> > community-based hospital built around Unix workstations....
> > ....The configuration requires a minimum of 30 nodes; the
> > relational DBMS must support a least 12 different views of the
> > medical database, which will have 68+ relations.

        (I missed this first article, could some kind soul please
mail me a copy? We are doing very similar things, and it would be
nice to see what else is being done. We already have a patient
medical record system up and running, supporting a database of 2.1
million patients. Thanks.)

> This may seem very silly.  It did to me when I was told but...  A
> close friend of mine who does consulting work in the areas of
> communications, networking and UNIX was once working with a
> hospital.  They ruled out use of ethernet because it is expected to
> have failures (i.e.  collisions) and they were afraid that some
> clever lawyers might label this as negligence.  Lawyer to jury:
> "this institution installed a system expected to have periodic
> failures which would delay critical patient information.  Yet they
> tell you they care about their patients".  Yes I know it's
> ridiculous but that was their concern.  You can bet the lawyer
> would carefully pick a technically naive jury.
>
> Anyway the point is, before proceeding with your system you might
> want to check up with the hospital administration and legal people.
> I can refer you to my friend for more information if you like.

        We (Johns Hopkins Hospital) have built and are building
several clinical information systems which are distributed across
several machines (supermini and workstation) connected using
Ethernet. These projects will even include order entry for tests, etc
on patients. But there has been no problem from the legal department
about the use of ethernet. All systems can break. Negligence is
failing to provide a reasonable (electronic or otherwise) backup for
when the system does break.

        Now what we have been talking with the legal department about
is what consitutes an "electronic" signature. Given an environment of
unattended terminals, and users' typical inclinations to write down
passwords, just what is necessary and sufficient proof of identity
when ordering surgery?

-- 

                               eric
                               ...!seismo!umcp-cs!aplvax!osiris!eric