Nomercy Hospital has both an outpatient clinic and inpatient services
(for patients who need to be admitted overnight). While most nurses
are assigned to either the outpatient or inpatient department, they
may shift to the other department as needed to cover staffing needs.
Nomercy has contracted you to build a new medical records system,
which will include electronic health records for patients. They have
gathered the following requirements for the new records system.
Every patient has an electronic health record. This record contains
a patient's basic medical facts (blood type, allergies, etc),
immunization records, prescription records, and histories of visits
Doctors may attach notes (as separate files) to a patient's record.
Patients can login to view their records online at any time.
Doctors can view or edit health records from either work or home.
If a patient is admitted as an inpatient, the staff attending to the
patient gain view and update access to the patient's health record.
Doctors can mark some notes or comments as sensitive, to be seen
only by hospital personnel (not patients).
Patients may add comments to a doctor's notes (such as adding
explanation of an observed medical condition), but may not delete
any of the doctor's remarks.
A patient may designate other individuals (such as a spouse) to have
access to their health record.
Patients may request that their health records be sent to other
medical establishments (for second opinions or alternative
Access to medical records must comply with HIPAA and Massachusetts
laws on medical data privacy. In particular
- Patients may challenge any portion of the record they deem inaccurate
- Mental health data need not be shared with insurance companies
- Only a patient's doctor may view genetic data (such as DNA
profiles) unless the patient gives explicit written permission
While a patient is a member of a gym affiliated with Nomercy, the
gym trainers may enter comments in the patient's record, including
current weight, prescribed exercise plans, and fitness progress
reports. The web interface to health records should contain a
section of fitness recommendations as maintained by the gym.