Patient accessible electronic health records: Connecting policy and provider action in the Netherlands

Objectives: The study provides a conceptual model for analyzing the connections and gaps between national policy and care provider processes aimed at patient accessible electronic health records. We illustrate the model using empirical data from the Netherlands as an explorative case study. Methods: The conceptual model integrates governance and organizational theory of routines. Empirical material was gathered in 2015 in the Netherlands comprising documents and interviews with policymakers and healthcare providers (N=14). The integrated conceptual model guided the data analysis. Results: The findings reveal a common aim of patient participation and improving patents' self-management at both policy and care provider level, while both sides lack comprehensive strategies to translate this shared goal into regulatory frameworks, guidelines, technological solutions and daily performances. Furthermore, initiatives on the levels of policymaking and service providers are poorly connected, thereby constraining the vision of improved patient participation and innovation more generally. Conclusions: The research highlights the need for developing standards at various levels for the implementation of patient accessible electronic health records in order to improve equal access and interoperable technological solutions. The conceptual model illustrates the benefits of linking governance and organization theories to bring existing gaps between policy and healthcare provider perspectives into view, which may block more efficient implementation of e-Health policies. (C) 2017 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.