|The XrayNotes Event Database
While designing the XrayNotes database great care has been taken to
design a database that captures the medical reality as close as
possible while maintaining security and privacy and robustness. One of
the main innovations in XrayNotes the ability to capture medical
events. A medical event is something that happened to the patient in
the course of patients seeking help or getting treatment. For example,
one of the first events that a patient will encounter is the 'New
Patient' event. The patient then, can receive or register several more
events where his/her basic biometrics are entered, an appointment is
registered or symptoms and complaints are noted. Diagnostic is also an
event. Procedures are also entered as an event. In fact, almost
everything that happened in the course of treating the patient,
may be registered as an event. XrayNotes will allow one to create any
custom event that is suitable for representing what happened in the
course of treating the patient. Naturally, XrayNotes has a full set of
built-in events that is sufficient to describe every aspect of the
treatment process from lab tests to surgeries to insurance claims.
Every patient data entry is tagged with a unique Patient
ID, that unique ID is globally unique and will represent the data that
is connected to that patient. An example of that unique ID is
'Q783-7FGL-730C-4941-F42C-46S2-26R7-DW6Q'. Also every event is tagged
with a unique event ID, again a globally unique, and specific to
that patient and to that event. An example of an event ID would be:
At this point this unique ID is connectable to that
patient only by the doctor or the hospital that generated that ID.
Because only the treating doctor (or entity) can connect the patient ID
to the name, it is safe to share medical detail and every event on an
open global network. Because the patient identity cannot be backtraced
from the unique number, medical data can freely flow and can be freely
accessible for research, education and science.
These set of events contain great power. Particularly, the
events allow real-life actions to be captured as they happen. Because
in reality one cannot undo anything in the past, the events should also
be treated like they cannot be changed. If one needs to correct
something, just like in real life we create the correction event to
undo the error, or rather to correct the error. Because anything that
happened in the past is treated as a read only entity, event queues and
events from different locations can be merged into one master queue,
allowing medical professionals to have a complete overview of a set
of events that happened.
Grouping of events. The same patient may seek help for multiple
unrelated cases at multiple different times. XrayNotes allows an event
to point to a parent event, whereby specifying grouping of events that
belonged to the same case. The root event of one particular case will
have no parent event.
The Patient Resource Locator. This special locator is designed to
allow any qualified medical professional to find a person's emergency
medical information with minimal effort and minimal data input. The
patient resource locator is assembled from the following information:
birth location birth date, birth name. For example the following PRL
was created from a hypothetical patient who was born in Sarasota in
1959 November 20, and was called 'Test Patient':
This combination of birth locale, and birth name also creates a
globally unique ID, whereby it is unrealistic to expect the same name
person to be born at the same location at the same time. Even if the
twins they are named differently.
The Xraynoes event data may be accessed by two main methods: Patient
Resource Locator or patient's unique ID.
1. The patient resource locator only contains emergency related
information, and the doctor and the patient has complete power over
which events to mark as visible under the patient resource locator. If
the doctor/patient does not find suitable events to mark for public
visibility they can create an event specially tailored to be visible by
the patient resource locator.
2. The globally unique ID allows all patient data to be visible. The
only exception whether patient requests complete (or partial) privacy
of his or her events in which case XrayNotes will not publish any of
the event details on the global network.
Ordinarily, the XrayNotes data, accessed by the patient's unique ID
contains all medical event data. Because the patient ID is globally
unique and non-translatable into the original patient's name, the
access to that data needs not be restricted or controlled or encrypted.
However if one suspects that the patient's unique IDs compromised a new
unique ID can be created. When a new unique ID is created, the patient
or doctor or administrator who is creating the new unique ID is
responsible to propagate events onto the new unique ID. This should
happen only in extreme cases, and the XrayNotes program will greatly
assist in the transition.