# Subject of care **Category:** [Technical (archive)](https://discourse.openehr.org/c/technical-archive/156) **Created:** 2002-12-01 22:38 UTC **Views:** 2 **Replies:** 12 **URL:** https://discourse.openehr.org/t/subject-of-care/14447 --- ## Post #1 by @Sam Dear all I have been reviewing the subject of care \- over family history\. It is clear that the following information is potentially useful: 1\. The name of the person so you can refer to them as so\-and\-so 2\. The relationship \(father, mother\) this might or might not include their genetic relationship \(adoptive\) \- at present I have this in the genetic relationship boolean value of the family history problem\. I think this is the most appropriate as it is the only time when it is essential to know it?? 3\. The ID of the person in the demographic server \- allowing contact details etc\. Can others think of other issues with identifying the subject of an entry in the EHR \- \(not the ehr itself\!\) Times when this is likely are around the birth of a child and for family history problems\. Cheers, Sam --- ## Post #2 by @Eric_Browne1 Sam, I'm not sure if you are only considering familial links\. If not, then organ donor/donee relationships might give rise to similar \(and other\) identification requirements\. eric --- ## Post #3 by @Karsten_Hilbert Eric, in some countries it is illegal for the donee to know the donor name so it may not always be convenient/legal to store it\. Just my 2 cents, Karsten --- ## Post #4 by @Sam Eric We have fetus and donor as subjects of care also \- sorry for omitting that\. Cheers, Sam --- ## Post #5 by @Mario_Cortolezzis Dear all, I am joigning the discussion, some of you already know me from GEHR times, so a big hug to them and friendly greetings to all of you\. Re: subject of care, several remarks from my perspective but which may already have been treated as I am not already through all of the documentation\. 1\) I agree with the Donor problematic raised by Eric and Karsten\. The identification of the donor is not everywhere available, but some characteristics of the donor may well be disclosed perhaps\. The same issue applies also for transfusional medecine of course\. 2\) 'Presumed' fatherhood is suspicious, when not clearly tested ;\-\) 3\) Subject of care during pregnancy and foetal treatment 4\) Adoptions are often not diclosed to the childrens until adolescent or even adult age\. 5\) Lab test results samples which are treated anonymous, i\.e\. HIV and other sexually transmitted diseases, Drug use etc\.\.\. Till then Mario --- ## Post #6 by @Mario_Cortolezzis Hi Sam, Is sometimes \(from a specialist view\) a specific System \(liver or heart\) not treated as a subject of care ? Example SIZE related to the organ \(or other subsystem of the body\) rather than applied on the whole individual ? Cheers, Mario --- ## Post #7 by @thomas.beale Sam Heard wrote: > Dear all > > I have been reviewing the subject of care \- over family history\. It is clear > that the following information is potentially useful: > > 1\. The name of the person so you can refer to them as so\-and\-so > but not in the EHR as such \- in some places like Norway, it is not allowed to have patient name or some other kinds of identifying information in the EHR\. So it has to be in the demographic server, ad referenced from the EHR by meaningless ids\. On the screen this will of corse be invisible\. \- thomas beale --- ## Post #8 by @Sam Mario This may be the case but our subject of care is quite specific \- it is the whole person to whom this information relates\. So information about the fetus or donor can be in the person's record\. We have family history problem \- with a specific subject \- that is, the relative\. I have modelled relatives to allow each to be adoptive with zero genetic sharing if required\. It is true that paternity and adoption are not always disclosed \- but we have to go with the patient's belief and test where important\. Cheers, Sam --- ## Post #9 by @system Hi, S\.o\.C can mean many things: One person One mother or foetus Any body part in or outside the body And any grouping of items mentioned above\. A S\.o\.C indicates the participation in activities\. Gerard > Dear all > > I have been reviewing the subject of care \- over family history\. It is clear > that the following information is potentially useful: > > 1\. The name of the person so you can refer to them as so\-and\-so > > 2\. The relationship \(father, mother\) this might or might not include their > genetic relationship \(adoptive\) \- at present I have this in the genetic > relationship boolean value of the family history problem\. I think this is > the most appropriate as it is the only time when it is essential to know > it?? > > 3\. The ID of the person in the demographic server \- allowing contact details > etc\. > > Can others think of other issues with identifying the subject of an entry in > the EHR \- \(not the ehr itself\!\) Times when this is likely are around the > birth of a child and for family history problems\. > > Cheers, Sam > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ > Dr Sam Heard > Ocean Informatics, openEHR > Co\-Chair, EHR\-SIG, HL7 > Chair EHR IT\-14\-2, Standards Australia > Hon\. Senior Research Fellow, UCL, London > > 105 Rapid Creek Rd > Rapid Creek NT 0810 > > Ph: \+61 417 838 808 > > sam\.heard@bigpond\.com > > www\.openEHR\.org > www\.HL7\.org > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ > > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ > Dr Sam Heard > Ocean Informatics, openEHR > Co\-Chair, EHR\-SIG, HL7 > Chair EHR IT\-14\-2, Standards Australia > Hon\. Senior Research Fellow, UCL, London > > 105 Rapid Creek Rd > Rapid Creek NT 0810 > > Ph: \+61 417 838 808 > > sam\.heard@bigpond\.com > > www\.openEHR\.org > www\.HL7\.org > \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ > > \- > If you have any questions about using this list, > please send a message to d\.lloyd@openehr\.org \-\- <private> \-\- Gerard Freriks, arts Huigsloterdijk 378 2158 LR Buitenkaag The Netherlands \+31 252 544896 \+31 654 792800 --- ## Post #10 by @thomas.beale Sam Heard wrote: > Mario > > This may be the case but our subject of care is quite specific \- it is the > whole person to whom this information relates\. > yes \- in the openEHR models, there is another 'subject', namely ENTRY\.subject, which is the 'subject of the clinical statement' represented by the ENTRY \- which can be a foetus, organ, stool sample or whatever\. \- thomas beale --- ## Post #11 by @thomas.beale Gerard Freriks wrote: > Hi, > > S\.o\.C can mean many things: > > One person > One mother or foetus > Any body part in or outside the body > > And any grouping of items mentioned above\. > > A S\.o\.C indicates the participation in activities\. > in the openEHR models, we have explicitly made "subject of care" the party being cared for; this is distinct from the "subject of a clinical statement", whcih may be an organ or sample of some kind\. All clinical statements are expressed by ENTRYs of one kind or another, and all must appear inside TRANSACTIONs \(CEN COMPOSITION\)\. There is also an attribute ENTRY\.subject\_relationship, which means the relationship of the subject of the statement to the subject of the record\. \- thomas beale --- ## Post #12 by @thomas.beale Thomas Beale wrote: > Gerard Freriks wrote: > >> Hi, >> >> S\.o\.C can mean many things: >> >> One person >> One mother or foetus >> Any body part in or outside the body >> >> And any grouping of items mentioned above\. >> >> A S\.o\.C indicates the participation in activities\. >> > > in the openEHR models, we have explicitly made "subject of care" the party being cared for; this is distinct from the "subject of a clinical statement", whcih may be an organ or sample of some kind\. All clinical statements are expressed by ENTRYs of one kind or another, and all must appear inside TRANSACTIONs \(CEN COMPOSITION\)\. There is also an attribute ENTRY\.subject\_relationship, which means the relationship of the subject of the statement to the subject of the record\. David Lloyd pointed out that I made a mistake here \(never answer emails during jetlag after 28 hrs flying\!\) \- the ENTRY\.subject is a human being \(includig foetus\); inside the entry is where you say what part of that human being you are talking about\. So Where the subject of an ENTRY is indeed the subject of the record, you might record an observation about their kidney\. But the subject could also be another person \(ENTRY\.subject\_relationship = "donor"\), and the observations could be about their kidney \(in which case they will be the kind of observations that one would make about a donor organ\)\. Sorry for the confusion \- thomas beale --- ## Post #13 by @Sam Tom The names of child or grandmother should not be via demographic as this would also have privacy issues\. Next of kin \- has legal status and should be via demographics\. Sam --- **Canonical:** https://discourse.openehr.org/t/subject-of-care/14447 **Original content:** https://discourse.openehr.org/t/subject-of-care/14447