English summaries
The forthcoming national archive for health care – challenges perceived in different sectors
Julkaistu 09.04.2010 00.01
Background
The forthcoming national archive for health care is a centralized system unique even by international standards. The archive includes storage of the official patient records and a data base for electronic prescriptions. Implementation of the archive is mandatory by 4/2011 for all public health care providers and for private service providers using electronic documentation. Our overview of the basic elements of the system can be read in this journal. In the article we present the challenges foreseen by different sectors of the health care system.
Methods
The data for this report were collected as part of the study: ”eHealth of Finland, Check point 2008”, published in 2009. An electronic web-based questionnaire was distributed by e-mail to all hospital districts and health care centres and to a sample of private health care providers. Health care providers were asked to state in which year they expected to be ready for implementation, while an open questions asked what kind of challenges they anticipated. The answers to the open question were analyzed by qualitative methods.
Results
All but one of the 20 hospital districts for which the implementation is compulsory, 168 (73%) of all 229 health care centres, and 24 of the sample of 45 private sector providers answered the questions. A total of 18 of the hospital districts, 126 (55%) of the health care centres, and 14 providers from the private sector were able to specify the year in which they will be ready for implementation. Most of them gave the year 2010 or 2011.
The challenges most frequently reported by the hospital districts concerned the preparedness of the providers of the information systems with regard to issues such as integration and timetable. The challenges for the health care centres were inadequacy of their own resources, such as funds and know-how, and the implementation of the PARAS reform (Reform of Municipal and Service Structures). The predominant challenges for the private providers were the lack of directions from the authorities and of economic resources.
Conclusions
The health care organizations, especially the health care centres, appear to be insufficiently prepared for implementing the national archive. Most of the organizations gave the year 2010 or 2011 as the year of implementation, but almost half of the health care centres and the sample of private service providers could not specify the year at all.
The hospital districts, in contrast to most of the health care centres, have the necessary know-how and resources for- information management. This is reflected by the reported challenges. The answers given by the hospital districts indicated that the challenges anticipated most frequently concerned the lack of preparedness elsewhere, e.g. among the system providers. The challenges most frequently anticipated by the health care centres concerned their own resources such as funds and know-how.
The aim of the national archive is to develop a cost-effective and data secure system, which promotes patient safety and continuity of care, and enables the implementation of new ways of working in health care. The coverage of electronic patient records in Finland is extensive, and most of the information exchange between health care organizations already takes place electronically. Consequently, the basic prerequisites for the national archive exist. However, a lot of work still has to be done before the archive becomes fully operational. The primary health care sector appears to be especially in need of support.
Ilkka Winblad
M.D., Ph.D., Adjunct Professor
FinnTelemedicum, University of Oulu, Finland
Jarmo Reponen, Päivi Hämäläinen
Finnish Medical Journal 2010;65:1223–9.
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