Patient access to electronic health records: Differences across ten countries

被引:114
作者
Essen, Anna [1 ,2 ]
Scandurra, Isabella [3 ]
Gerrits, Reinie [4 ]
Humphrey, Gayl [5 ]
Johansen, Monika Alise [6 ,15 ]
Kiergegaard, Patrick [7 ]
Koskinen, Jani [8 ]
Liaw, Siaw-Teng [9 ,10 ]
Odeh, Souad [11 ]
Ross, Peeter [12 ,13 ]
Ancker, Jessica S. [14 ]
机构
[1] Stockholm Sch Econ, Inst Res, SIR, Saltmatargatan 13-17,4th Floor, S-11383 Stockholm, Sweden
[2] Karolinska Inst, Widerstromskahuset, Learning Informat Management & Eth Med Management, Tomtebodavagen 18 A,Plan 4-5, S-17177 Stockholm, Sweden
[3] Orebro Univ, Sch Business, Informat, SE-70182 Orebro, Sweden
[4] Univ Amsterdam, Acad Med Ctr, Dept Publ Hlth, Amsterdam, Netherlands
[5] Univ Auckland, Natl Inst Hlth Innovat, 261 Morrin Rd, Auckland 1072, New Zealand
[6] Univ Hosp North Norway, Norwegian Ctr E Hlth Res, Tromso, Norway
[7] Univ Michigan, INK, 330 Packard,2325 Perry, Ann Arbor, MI 48104 USA
[8] Univ Turku, Informat Syst Sci, Turku, Finland
[9] UNSW Med Australia, Sydney, NSW 2052, Australia
[10] SW Sydney Local Hlth Dist & Ingham Inst, Acad GP Unit, Sydney, NSW, Australia
[11] Univ Claude Bernad Lyon 1, Dept Informat, Nautibus 8-10,Bd Niel Bohr, F-69100 Villeurbanne, France
[12] TUT, Dept Hlth Technol, Akad Tee 15A,224-228, EE-12618 Tallinn, Estonia
[13] East Tallinn Cent Hosp, Diagnost Clin, Ravi Str 18, EE-10138 Tallinn, Estonia
[14] Weill Cornell Med Coll, Div Hlth Informat, Dept Healthcare Policy & Res, New York, NY USA
[15] Artic Univ Norway UIT, Dept Clin Med, Tromso, Norway
基金
美国医疗保健研究与质量局; 瑞典研究理事会;
关键词
Patient accessible electronic health records; Patient health records; Patient portal; International comparison; PORTALS; INFORMATION;
D O I
10.1016/j.hlpt.2017.11.003
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: Patient-accessible electronic health records (PAEHRs) are being implemented at international scale. Comparing policies and systems could allow countries to learn from each other to address global and nation-specific challenges. We compare national PAEHR policy (hard and soft regulation) and services in 10 countries. Methods: PAEHR policy and system documentation was gathered from Australia, Denmark, Estonia, Finland, France, the Netherlands, New Zealand, Norway, Sweden and the United States. A basic analytic model for policy analysis was used to delimit our focus to policy content, followed by an inductive thematic analysis across countries, in which we clustered initial themes into a set of categories of PAEHR service "approaches" related to three specific content areas. Results: Although all 10 countries ensured some patient rights to access medical records, policies and systems were highly variable, as were the technological processes arising from these. In particular, three policy areas showed great variability. Depending upon country of origin, a patient would encounter differences in: login procedures (security), access to own and other patients' data during adolescence (user rights), and types of medical data made available to the patient (data sets). Conclusions: Individuals encounter very different access rights to their medical data depending on where they live. Countries may be able to develop improved policies by examining how other nations have solved common problems. Harmonizing policies is also an initial step likely to be needed before cross-national PAEHRs could be possible. (C) 2017 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:44 / 56
页数:13
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