More than half of the Dutch population want a safe online environment where they can review their own medical details. Many patients go a step further and want to manage their own details via a PHR (personal health record). This was revealed in a study by the RVZ (Dutch Council for Public Health and Healthcare), which has highlighted the necessity for a PHR.
Minister Edith Schippers and State Secretary Martin van Rijn from the Ministry of Health, Welfare and Sport made headlines in July 2014 with their eHealth plan ‘Society is changing. Will the healthcare system change with it?’ In that same period, policy makers were set to think about the issue following an urgent appeal from the RVZ. The key message: restructure the dissemination of healthcare information and make the patient the focal point. ‘We take this advice very seriously in our healthcare plans,’ according to a spokesperson on behalf of Minister Schippers.
In an advisory report of more than a hundred pages, the RVZ concludes that patients should have the possibility to access their medical details easily, ideally with just the press of one button, as is the case with the American Blue Button initiative. In the United States people can, with just one click on the Blue Button, access a secure environment containing their medical file details. The RVZ would like to see that Dutch people, through a personal health record, can also review and manage their own details.
Research carried out by the RVZ has indicated that many patients (60 percent) would like an online overview with all their personal registered medical details. The most important reason: curiosity. Patients want to know what is being written about them.
Many patients also feel that it is important to be able to check whether all the registered details are correct. More than half of the proponents of an online accessible medical file would prefer to have the file managed by the healthcare providers (or healthcare institutions). About 20 percent would prefer to personally manage which healthcare providers should have access to their details.
An important condition for many respondents is that their details should only be accessed through a secure login method such as DigiD. The fact that privacy is a crucial theme is also apparent in the arguments of PHR critics. They fear that unauthorized users will have access to their details via internet or that their entire file will fall prey to hackers.
Privacy by design
The RVZ states that it is very important that the privacy of the patients should be safeguarded. The Council proposes to implement a ‘patient’s right to confidentiality’ to protect the details even further than the existing medical confidentiality agreement for healthcare practitioners. The RVZ also stresses the need to include privacy protection measures in the development of the PHR environment (privacy by design) to make it impossible for unauthorized persons to access the information. As far as the RVZ is concerned, no one should be obligated to have a PHR if for whatever reason they do not wish to have one. The point is to make it possible for anyone who does want to be able to manage their own medical details.
The RVZ believes that the Ministry of Health, Welfare and Sport should put its responsibilities into practice and make the (necessary) introduction of the PHR a real possibility. How? By taking the reins and having all the parties involved make binding decisions. A spokesperson on behalf of Mister Schippers has told Mediair that an official response to the PHR advisory report will follow soon. ‘I cannot go into details yet, but I can say that we are undertaking serious steps following the advisory report. It fits in perfectly with our ambitions to focus more on eHealth and patient engagement.’ Purely in terms of technology, the PHR could soon be a reality. ChipSoft has been working for years on developing software which puts patients at the helm, and we have a reliable solution ready to be presented to the market.
PHR: supplementing the EHR
What exactly is a PHR? Simply put, it is a user-friendly tool to collect, manage and share healthcare information and to take control of the healthcare process. The PHR is not an alternative to the existing electronic health records which healthcare providers use, but it supplements those records. It contains (digital) copies of existing (electronic) medical details which are currently often scattered around various healthcare institutions. Patients can add their own information (for example self-measurements) to complete their medical file. In doing so, they decide which healthcare provider has access to which details. It is always clearly visible who has entered the information (the healthcare practitioner or the patient). In short: with a PHR, the patient has complete insight into and complete control over their own medical file.