Patient access to electronic health records: Differences across ten countries

Essén, Anna; Scandurra, Isabella; Gerrits, Reinie G.; Humphrey, Gayl; Johansen, Monika Alise; Kiergegaard, Patrick; Koskinen, Jani; Liaw, Siaw‐Teng; Odeh, Souad; Ross, Peeter; Ancker, Jessica S.

doi:10.1016/j.hlpt.2017.11.003

Cited by 138 publications

(150 citation statements)

References 26 publications

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“…According with Flaumenhaft and Ben-Assuli [110], governments try to balance the need to promote PHRs' use and the need to provide adequate protection of individual's medical information. In this respect, the recent European General Data Protection Regulation' (GDPR 2016/679, Reform 2018, European Union) [111], operating since May 2018, is requiring more strict protection measures regarding the handling of personal data, including sensitive health data among others [33]. For this aim, a strong PC system (e.g., with strong governance, accessibility, and coordination) seems however crucial.…”

Section: Categories Of Ehealth Applicationsmentioning

confidence: 99%

“…Literature also highlights that EHRs have a peculiar relevance to MM given that they allow healthcare providers to access electronic clinical information of patients with MM, which are characterized by multiple care providers, various health conditions and medical diagnoses, and potential drugs interactions [1,25]. Currently, many countries have provided patient access to their EHRs, but legislations and policies regulating this right are greatly variable within nations [33]. Besides EHRs, across Europe, we find also the use of remote monitoring and consultation by means of telehealth services [34,35], independent living solutions (e.g., assistive and ambient intelligence technologies) [36], and support for the family carers, especially of older people [37,38].…”

Section: Introductionmentioning

confidence: 99%

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Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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Introduction. eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics. Materials and Methods. In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country). Results. 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development. Conclusions. Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Section: Categories Of Ehealth Applicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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“…A nationally shared, widely used PAEHR has powerful symbolic meaning [15] and they have been developed, launched and used in many countries, including Finland [4]. However, the PAEHRs are rarely nationwide [16,17,41]. When new functionalities, such as requests to refill prescriptions, are launched in the PAEHR, the use of the PAEHR increases [27].…”

Section: Discussionmentioning

confidence: 99%

“…A person can read the information and give one's consent to view the data so that the people who are treating one can view his/her medical records; this is recorded (consents). One can also give one's refusal to share one's e-prescription or patient record data, which ise recorded (consent restrictions) ** In Will expressions section, a citizen can set up a living will and/or organ donation testament *** In Summary service section, a citizen's current health problems (such as elevated blood pressure) and risks (such as smoking) are displayed bassed on their appearance in the citizen's health records in addtion to (surgical or else) procedures, laboratory test results, vaccinations, imaging reposrts and physiological findings (such as blood pressure measurement results) All Finnish residents with a Finnish personal identity number and an access to electronic identification are able to use the PAEHR [34,41]. With the help of the PAEHR, the users can monitor the retrieval and submission of one's own information, view e-prescriptions and medication purchases, request prescription medication renewal, view personal health data, give consents and consent restrictions (refusals) to share one's e-prescription and patient data, and set up a living will and/or organ donation testament.…”

Section: Introductionmentioning

confidence: 99%

Half of the Finnish population accessed their own data: comprehensive access to personal health information online is a corner-stone of digital revolution in Finnish health and social care

Jormanainen¹,

Parhiala²,

Niemi³

et al. 2019

FinJeHeW

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In Finland, the implementation of the national Kanta services’ second phase was carried out step by step from May 2010 to December 2017. My Kanta Pages, launched in 2010, is an online service where citizens can browse their own health information recorded in the Prescription Centre and the Patient Data Repository regardless of whether the healthcare services they had used were public or private. It is the patient accessible national electronic health records in Finland (PAEHR). The study objective was to investigate the use of the national PAEHR by using indicator data from 2010 to 2018. Cumulatively 2.8 million (M) persons (51% of the Finnish population, and 63% of the adults at least 18 year old) had accessed the PAEHR 23.2M times (49.2M sign-ins) by 31 December 2018. Altogether, 6.0M e-prescription renewal request were sent to healthcare via the PAEHR by 31 December 2018. Patient Data Management Service was implemented as part of the Patient Data Repository. By 31 December 2018, the Patient Data Management Service had records of 6.3M information notices, 3.3M consents and 93,732 refusals (consent restrictions). In addition, the Patient Data Management Service had records of 467,055 organ donation testaments and 93,484 living wills. Half of the Finnish population in general, and two out of three adults had used the national PAEHR by 31 December 2018. Since nine years after its launch, the adults’ use of the Finnish national PAEHR is still increasing and is approaching 50% annual use.

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“…Thus, youth health(care) can differ from adult health(care). Notwithstanding shared experiences between young people and adults – including the rise of chronic health issues and the fragmented ways health services typically address these – young people can develop lifestyle behaviours that shape adult life. Although many are digitally literate, many have limited health literacy, partly because of stigma.…”

Section: Introductionmentioning

confidence: 99%

Understanding practitioner perspectives of youth healthcare using thematic and lexical analyses

Jarrett

2019

Health Expectations

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BackgroundYouth health issues represent a “wicked problem” – they are complex and multifaceted. Furthermore, they are likely to require novel approaches to understand their complexity and develop novel solutions.ObjectiveGiven the importance of youth healthcare, and the need for novel approaches, the aim of this article was to demonstrate the innovative use of two research methods – thematic and lexical analyses – to better understand practitioner perspectives of youth healthcare. It clarifies the factors that shape practitioner ability to support young people and opportunities to improve practice.Design and SettingFocus groups and interviews were conducted with 37 youth health practitioners. They represented government and non‐government services; hospital and community services; and metropolitan and regional services.ResultsThematic analysis highlighted the complexity of participants' work and the judgements made as they negotiated relationships with young people and ancillary services. Lexical analysis revealed two hitherto neglected dimensions of the complexity of youth healthcare – uncertainty and corporeality.DiscussionIn addition to affirming the complexities of youth healthcare, this study revealed how practitioners (can) negotiate these complexities. These findings were only possible because of the innovative use of the two research methods.ConclusionsThis study has important theoretical, methodological and practical implications. Theoretically, it is the first to view the complexities of youth healthcare through the wicked problem lens. Methodologically, it highlights the complementary value of thematic and lexical analyses. Practically, it reinforces the importance of policy support and professional development to enable practitioners to grasp the complexities of their work.

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Patient access to electronic health records: Differences across ten countries

Cited by 138 publications

References 26 publications

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Half of the Finnish population accessed their own data: comprehensive access to personal health information online is a corner-stone of digital revolution in Finnish health and social care

Understanding practitioner perspectives of youth healthcare using thematic and lexical analyses

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