According to the EHR Information Model (ehr_imp.pdf) section 4.4 EHR Creation Semantics, part 4.4.2 Creation, if the modifiable flag is set to false then EHR is not allowed to be written.
what is the exact scenario and who can modify this flag?
The does not clear for me!
thanks in advanced
I'll have a go!!
The typical use for setting modifiable to false would be that the patient has died and we want to 'lock' the EHR (perhaps after a period) so that no further contributions can be made. Or it could be that the patient has withdrawn consent for a further data-sharing.
This might also be needed in the case that a patient wishes to move their EHR to a different CDR provider. In most cases I suspect the data would just be transferred and the the EHR in the original CDR simply hard deleted, but local data governace rules might require that original data to be retained.
I propose we develop a better text for this item and add it to RM Release 1.0.4.
I think Ian's comment math the semantic intention of the modifiable flag. The usage of such a flag might be implemented according local, regional or national policies or laws.
We have seen similar needs for FOLDER and/or DEMOGRAPHIC structures. Like a given part of the EHR shold be locked a number of days after the period of care or episode happened.