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· Would the patients benefit from instant access to their own medical
record?
· How would the doctors react to such a scenario?
Those were two of the questions asked when the County Council of Uppsala
set off to explore the effects of giving the patients access to their
own medical record via the Internet. Other questions asked were; what
are the security and integrity implications? Is sufficient technology
available?
One of the most important objectives was to encourage patient involvement.
A basic condition for patient involvement is to have access to that same
information as the providers.
The project, founded by the EC and the Swedish Knowledge Foundation, launched
a system that deals with all the technical, security and integrity matters.
Patient benefits
The basic idea of Sustains could best be under- stood using the concept
of Internet banking as a role model. Before Internet banking became a
wide spread service, it was available only to the staff of the bank. In
the same way bank customers today have access to their own bank accounts,
patients can access their own medical record over the Internet
Whenever the patient wants to read the doctors notes at home or need the
same information at another doctor when traveling, Sustains can be a useful
tool. Being able to access the information in the medical record the patient
is likely to have better knowledge of his own condition and there- fore
having better chances to participate in the planning and treatment of
the condition. It also makes it easier for relatives of the patient to
participate in the care without having to be present at every encounter
with the health care.
Security and integrity
The solution is formed with several tiers of hardware and software. The
patient authenticates himself using his civic registration number, a personal
PIN and a One Time Password. The authentication server generates a new
password every time the patient logs on and is distributed to the patient's
mobile phone as an SMS. Moreover advanced proxy firewall technology is
used to keep the communication and information safe.
Conclusions
The comparison with the Internet banking can be used to understand the
impact that this will have on the health care industry. Just as the banks
e-services alone can't increase the economic wealth of their customers
in any obvious way, will of course the e-health services not increase
the health of the patients. But availability of efficient e-services will
help individuals to make decisions when such can be made. The more you
are involved in the case, the easier it is to se relations between your
way of living and your physical condition. It's also easier as a patient
to express wishes, preferences and other information to professionals
dealing with their health care. In other words, professionals making decisions
on your behalf must of course act on known information about patient preferences.
E-services can substantial improve quality of such decisions. But there
is a necessity to improve systems as Sustains III with structured ways
of getting such information from citizens.
Contact person for this submission
Name: Ingrid Joustra-Enquist or Benny Eklund
Organization: County Council of Uppsala
Telephone: +46703536072 or +46 705101306
e-Mail: Ingrid.Joustra-Enquist@it.cklul.se
or Benny.Eklund@it cklul.
se
Address: Slottsgriind 2A, Box 602
Post Code: 751 25
City: Uppsala
Country: Sweden
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