In the context of a patient exercising their GDPR rights (Access, rectification, cancellation, opposition, portability, erasure, limitation), and wanting to remove a diagnosis from his EHR.
Wich is the correct aproach to erase/remove one specific Diagnosis of a persistent list of problems of a patient?
Is this a logical delete aproach?
Wich would be the correct change type?
Wich would be the correct lifecycle_state?
The rest of the problems in the list remain the same.
Any advice based on experience implementing such use case would be welcomed.
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Interesting question. I don’t think there’s a simpel answer. In General I would think the most practical is updating the composition removing the diagnosis. Legally this would probably strictly be a rectification (which removes a diagnosis). Technically this would be a new VERSION of the problem list (in a VERSIONED_) composition, lifecycle state would be untouched (probably still ‘complete’).
This process would keep the diagnosis in the history.
Usually there’s some recognition of the difference of deleting vs destructing. The difference is whether it’s available to recover. Usually it’s accepted that deleting doesn’t require deleting backup of the data. So I would say this process is acceptable as erasure. The alternative is destroying physically the whole composition, this would also include all other diagnoses in the problem list composition. You could over this possibility to the patient.
Practically off course it’s possible to physically delete just one diagnosis in a composition (including from all historical VERSIONs of that composition), but this is explicitly unsupported in openEHR.
Hope this helps. Probably implementers have their own experience, so they might jump in.
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