A fundamental Difference

Nevertheless,electronic patientrecords are fundamentally distinct from paper -based records -a difference that ,as we shall see ,has tremendous ethical implication .howevr, this fundamental  sifference dose not lie in their physical difference from paper -based records,or in the greater technical sophistication that is necessary to generate and use them .instead, it lies in their logical natures as records and the funcation manipu;ation to which they can be subjected .for instance ,electronic patient records can be combined and manipulated in a holostic  fashion to yield an integrated picture of the patient which can directly involved in ,patient as health  care consumers in a way that is not possible for paper -based records .
 
       Thise difference reflects a fundamental difference in the relationship in which the element of electronic patient records as  well as the records as a whole stand  to the patient .to adopt terminology suggested  by wittgenstein  in the tractatus in a somewhat  different context , integrated electronic patient records are made up of representational elements that stand for identifiable aspects of the particular patient in  question.each reperesentational element shares ,so to speak ,alogical form with what it repersentsbecause it mirrorrs, in its combinatorial passibilities with other representational elements,the cobinatoril connection that charecterize the relationsships among the elements for  which  they stand in real  life . in that sense ,and  to that defree , the two may  be  said  to be isomorphic with respect to one another.