Compositions involving multiple patients

Clinical
1

Hi,
There are multiple use cases when multiple patients are involved in some clinical event. For example many mental health therapies are conducted in a group. What is the recommended approach to handle such compositions that are linked to multiple patients(EHRs)?

The requirements in this situation are

  1. The composition should appear in al the EHRs
  2. Need for authorized users to know all the patients that were involved in a particular session
  3. Maintain privacy of the people involved

regards

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2

Here is my attempt.

Composition for each patient. Somehow labelled as a group event with , of course names of prpofessionals (composer + participants). Giver the composition some sort of ‘session identifier’.

If you ever need to know all of the participants, that can be retrieved via that identifier but makes me a little uneasy TBH.
Alternatively, do not carry the identifier but rely on other indicators to ‘find the group’ - start_time/ composer name/facility/ composition name

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3

I can see where a clinician may need to keep a record about an event or activity, including who attended a group session and what happened as part of the broader group dynamic and interactions, especially from a medicolegal perspective. But that’s a record for the clinician’s purposes, not part of an EHR for a patient.

On the other hand, in the patient record, I would expect the same clinician to record only pertinent information about the session as it relates to the subject of care only. But record nothing about the other participants to preserve privacy.

You may need to relate the event/activity record to the EHR record using some sort of ID or URL as per Ian’s suggestion. But I’d caution against conflating the event record and the patient record into some kind of shared group record.

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4

Thanks Heather & Ian,
Just to rephrase my understanding, the information about all the participants who were part of a joint session does not belong to the EHR.

An external service such as task management/appointment service could be used to manage this information. Separate compositions are to be created for all the participants separately in their EHRs.

Alternatively the participation information can be extracted through a cross EHR query on the CDR, using some common metadata.

regards

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