Specialty
Psychiatry and Mental Health
A psychiatric note is the one entry in a hospital record where the harm of the wrong person reading it outweighs the cost of the right person waiting. Most hospital software has a single setting for this, and it is the same setting the general ward round uses.
Confidentiality is an access decision taken several thousand times a day, or it is a policy document.
Impact and action
Who may open it.
- A sensitive note sits in the file the whole hospital reads, protected by a convention about who looks rather than by a check that runs.Cirith decides, for every single action in the app, whether this person may take it, and treats the patient consent together with the admission as the gate that opens a record.
- The question of who has already read a record is answered by asking people who were there.An administrator can list who holds access to one patient today, look up everything one staff member can reach, and simulate a permission change before making it. The emergency path exists, and every use of it is logged.
The scale, and the score it produces.
- Rating scales are printed, scored by hand, and filed where the next clinician has to be told they exist.The scale is a form with its own calculator and its own validation, locked when it is finished, versioned, and held on the record.Glyph
The medication that has to continue.
- A depot injection or a mandatory blood count is tracked on a card at the clinic desk.Each is a due task with an owner and a history of given, missed or skipped, and a missed one is a state on the record rather than a gap in it.Quest
What the hospital can answer
A person asking about their own record deserves a specific answer.
Consent is held once and read from one place.
The hospital decides the purposes it holds a record for and records the consent it holds it under. Atlas keeps that consent and the history of who has read the record, and every tool reads the consent from there rather than keeping its own idea of it.
And the access decision is inspectable.
Because authorization is checked on every read and every write, the hospital can answer who saw a note, when, and under what entitlement, without reconstructing it from memory.