English summaries
The national archive for health care – what is it about?
Julkaistu 09.04.2010 00.01
The information management infrastructure of Finnish health care on the national level will be based on an internationally unique centralized electronic archive. The operative use of electronic patient records will take place on the regional or local level.
The reasons for this choice have to do with practicality and economy. This has resulted in designing the development of health care information systems on the local and regional level, that is to say in and between health care centres and hospitals and is the prerequisite for the forthcoming national system. The electronic patient record is now in comprehensive usage in primary health care centres and in hospitals or other specialized health care. Paper based documents are nowadays only used for the storage of historical data. Information exchange between primary and specialized health care organization takes place principally by electronic means and includes narrative text, laboratory and imaging results.
The core of the national Finnish information and communication technology infrastructure will reside in the national digital archive for patient documents. It is based on legislation and its implementation will be mandatory for all health care providers in the public sector by 4/2011. For private providers of physician services the implementation will be mandatory for those using electronic documentation of patient data.
The overall steering and coordination of the archiving system is under the responsibility of The Ministry of Social Affairs and Health. The eArchive and the national ePrescription database are built and operated by The National Institute of Social Security (Kela). Cards for identification of professionals are provided by the National Supervisory Authority for Welfare and Health (Valvira). Nationally standardized codes and classifications are managed by The National Institute ro Health and Welfare (THL) and delivered via a code server.
The national architecture consists of local EPRs using a common data structure and technical standards, the national eArchive in which all EPRs are made available online subject to patients’ consent. The official patient documents will be stored in the archive, those stored elsewhere will have the status of copies. In addition, the archive will include a national ePrescription database, and an eView for citizens, enabling them to access their own patient data and log data.
There are several challenges to be overcome with the national archiving system. It is a technologically complex system which has to be implemented alongside the everyday service routines of health care. It can therefore only be realized step by step. At present most of the transfer of patient data takes place by operative local and regional systems. In order to work on a nationwide level, the interoperability of the systems is crucial. In addition, volumes of information transfer, for instance in radiology, may be very large and overloading the data networks. For health care employees the system requires the usage of an electronic signature and learning new ways to work, such as documenting patient information in a structured manner.
Ilkka Winblad
M.D., PhD. Adjunct Professor
FinnTelemedicum, University of Oulu, Finland
Päivi Hämäläinen, Jarmo Reponen
Finnish Medical Journal 2010;65:1218–22.
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