Dutch EPR rollout on track

The Dutch national electronic patient record project is progressing slowly, but steadily. Sixty five doctors have been connected to the infrastructure so far. By the end of the year, this number will increase to 200.

“We are confident that we can stick to our goal and have all 8,000 GPs using the national electronic patient record by the end of 2009,” said Reina Kloosterman, head of health and social issues at the Dutch embassy in Berlin. She gave an update on the project at a regional eHealth event organised by the industry association IHK in Berlin.

Kloosterman said two factors were critical for the success of the project. First of all, doctors would have to be connected to the infrastructure efficiently and without putting too much financial burden on them. And second, the public would need to be informed about the EPR and privacy issues would need to be addressed.

The EPR in the Netherlands will be a virtual EPR. The medical data will remain physically where it originates: it is not stored on a central server. This means that the IT systems of the doctors involved have to be brought online in a way that makes EPR-relevant data accessible 24/7.

“We acknowledge that updating the software solutions of the GPs to fulfil this requirement is not for free,” said Kloosterman when talking to E-Health Europe. This is why a total of 45m Euros will be paid to roughly 10,000 Dutch GPs and pharmacists for the necessary updates and the installation of the interconnectivity services.

In addition, another 45m Euros will be needed to set up the first two modules of the Dutch national EPR; an electronic medication record and a record that is called “deputy GP record.” The latter will allow access to patient data for GPs on duty during holiday time, for example.

Doctors who want to access EPR-data have to authenticate themselves using an electronic health professional card. Every access will be logged, so that patients will be able to reconstruct which doctors have accessed their data and when. Patients do not need a smartcard or even a PIN; they are identified via a citizen service number.

This means that – like in Denmark, for example – any doctor can, in principle, access patient data. But they will only be allowed to do so if the patient has consented or in a medical emergency. “There will also be a supervisory agency for privacy issues. Citizens can contact this agency in case of a possible violation of privacy rules,” Kloosterman said.

Working with the Dutch EPR will be mandatory for all doctors and pharmacists, but voluntary for citizens. If a citizen decides not to use the national EPR, he can actively opt out. If he doesn’t do so, consent is assumed.

“Everybody will be informed about this procedure in due course. There will be a letter to all citizens,” said Kloosterman.