Now that my health is improving considerably, I’m slowly picking up pieces. Slowly, as I announced previously, so I will occupy myself for the time being with EHRs and the (inter)national problems concerning their development and implementation.
What triggered this first blog post in a long time is the Dutch struggle to get to grips with this issue on a national level. This article (unfortunately, the Google translation here is faulty to say the least) from 16 January 2014 makes some amazing observations. It concerns the implementation that puts the coordination of societal support at the municipal level (”WMO”). First it is assumed that the municipalities (proposed to become responsible for the general database maintenance concerning social and health records) are in the driving seat to indicate which information about a patient can be made visible to specific parties. I would have hoped that by now it would have sunken in that the patient themselves should be in that decision making position, advised, if necessary, by their providers.
The other issue is the next paragraph where it is said that patients themselves are responsible for supervising their data and that a dedicated 3rd party supervisor is not deemed necessary. Although I’m known for advocating giving patients their own responsibility concerning their own information/data, this statement is a pile of delusory hopes. A vast majority of patients, for a plethora of reasons, are not able to exercise that responsibility. Therefore, a new “profession” should be created, a layer between providers and patients, just for monitoring and advisory purposes, maybe an adaptation of the role of nurse practitioners.
It is the more puzzling because in the previous paragraph of the above-mentioned article it is stated that the government “can’t go further than register as detailed as possible for all circumstances which data about a specific person can be processed for which purposes” (my translation, LB). In my view this is contradictory to the above.
Once again, the Dutch health ministry shows a shocking lack of understanding in which direction patient empowerment should and will go.
Lodewijk Bos, ICMCC