Electronic access for the patients
The project group at NST gives patients at the University Hospital of Northern Norway electronic access to their own records.
Project manager Tove Sørensen, systems developer Ragnhild Varmedal and security adviser Eva Skipenes of NST (the National Centre for Integrated Care and Telemedicine) are heading for another important milestone in the Norwegian healthcare system. On assignment for the CEO of UNN (the University Hospital of Northern Norway), they are now developing tools that will give patients at the hospital access to their electronic patient records. The work is being carried out in close cooperation with DIPS ASA, the Northern Norway Regional Health Authority’s ICT department and the Directorate of Health. NST uses international standards, so that the solution for requesting access to the records will be independent of the supplier. Each records supplier must facilitate such communication first, however. ‘The finishing line is in sight now, but it’s been a long process. The first time we worked on this at NST was back in 2000/2001,’ says Sørensen.
A lot has happened since the turn of the millennium. Patients’ right to access their records means that the records are now written with this in mind. A number of security solutions and a national health portal − helsenorge.no − have been developed, so that much of the framework for realising an access solution is now in place. There is still some way to go, however. For example, DIPS shall facilitate access, while also ensuring that health personnel are able to block documents for automatic access by patients. ‘We believe that, technically, patients will be able to see 95 per cent of their records without any problems. In order to be able to implement the solution, however, the therapist must have the option of blocking access to individual documents or whole records,’ says the project manager. Information that patients will not be able to access immediately includes information about third parties or information that may be detrimental to the patient. Information about diagnoses may also be withheld until the doctor has a chance to communicate this directly to the patient.
Security adviser Eva Skipenes, systems developer Ragnhild Varmedal and project manager Tove Sørensen at the National Centre for Integrated Care and Telemedicine (NST)
What are we allowed to see?
Systems developer Ragnhild Varmedal started the job of developing the access solution by ordering her own records − on paper. She thereby found out why access to patients’ own records will be important for both health personnel and patients in future. ‘I was able to revisit a serious incident involving myself. I was able to read what information I had initially received at a meeting with the doctor that Friday at the hospital, but so much information was given at the meeting that I was unable to take in everything that was said. My condition deteriorated over the weekend, and I collapsed and was sent to hospital in an ambulance on the Monday. By then, the situation had become life-threatening and I had to undergo an emergency operation. If I had been able to read the records after speaking to the doctor, I could have acted on symptoms that she had warned me about and prevented the situation from becoming so dramatic.
Varmedal also got some practical ideas for what has to be in place in order for patients to benefit from accessing their records. ‘For example information and guidance about some diagnoses, and a direct link to a medical dictionary on the internet,’ she explains.
They are also considering adding warnings and explanatory text. ‘For example a warning about who you should not share your records with.’
A great deal remains to be done before NST can start testing the solution. ‘We plan to carry out a test in January with fictitious information in DIPS’s test base. By the autumn, we hope to be able to invite patients to take part in realistic tests in relation to UNN by logging on via helsenorge.no and ID-porten, to be able to see their own records.’
But first the partners in the collaboration need to do their bit, and, not least, the whole of UNN HF must start using DIPS Arena in spring as planned. ‘Access will only apply from a certain date, so that doctors will have an opportunity to block documents that are not to be made electronically available to the patient immediately. If older documents shall be made electronically available, the doctors would have to review the whole records first,’ says Sørensen.
The access log is given high priority. Here, patients can see who has accessed their records and ensure that no unauthorised access takes place. The enthusiastic project team enjoy working on a very exciting assignment that will benefit society. ‘Of course, it is great to put something in place that people have waited so long for!’