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A Framework for Tracking Former Patients in the Electronic Health Record Using an Educational Registry.

Abstract：

:One challenge of contemporary medical education is that shorter lengths of stay and time-limited clerkships often interrupt a student's relationship with a patient before a diagnosis is made or treatment is completed, limiting the learning experience. Medical students sometimes use electronic health records (EHRs) to overcome these limitations. EHRs provide access to patients' future medical records, enabling students to track former patients across care venues to audit their diagnostic impressions and observe outcomes. While this activity has potential to improve clinical training, there is a risk of unintended harm to patients through loss of privacy. Students need guidance on how to perform this activity appropriately. This article describes an ethical framework for tracking using an "educational registry," a list of former patients housed within the EHR that one follows longitudinally for educational purposes. Guiding principles include obtaining permission from patients, having legitimate educational intent, and restricting review of records to those essential for training. This framework could serve as a foundation for institutions seeking to develop a policy on tracking former patients, and may facilitate research on the use of EHRs to improve medical education, such as reducing diagnostic error and promoting self-directed learning.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Brisson GE,Barnard C,Tyler PD,Liebovitz DM,Neely KJ

doi

10.1007/s11606-017-4278-5

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

563-566

issue

4

eissn

0884-8734

issn

1525-1497

pii

10.1007/s11606-017-4278-5

journal_volume

33

pub_type

杂志文章

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