Transcript Lysbilde 1

Legal frameworks for
patient information
management –
a Nordic overview
Leif Erik Nohr
Legal advisor
Common Nordic features
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High quality health care services
”Massive” legal frameworks
Patients’ Rights
Extensive and growing use of information
technology in health care
Developed infrastructure – Dedicated Health
Networks
eHealth strategies
Facing the same demographic challenges
Focus on continous provision of health care
Challenges
• Fully utilize the potentials of information
technology in the provision of health care
• Provide a legal framework that considers
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Quality
Patients’ rights
Professional duties
Efficiency
Information security
Etc
Iceland
• National strategy for use of information
technology in all sectors
• Information security and protection of
personal privacy as guiding principles
• eHealth regulated by health care- and
data protection legislation
• No specific eHealth legislation
• The DeCode database…
Finland
• Decentralised health care system
• Principle of citizen-centred seamless
service structures
• National Electronic Health Record by
end of 2007
• Legislation on seamless service chains
• National standards, national EHR
structure, security and safety guidelines
Sweden
• National strategy since 2006.
– Includes social care
• Aim at bringing laws and regulations in
line with extended use of ICT
• Information- and infrastructure
• Bill for a new Patient Data Act
Sweden (cont.)
• The Patient Data Act:
– Cohesive regulation of processing of personal
data in health care
– Framework legislation
– Facilitate both enhanced patient security and
strong privacy protection
– Care providers can – subject to conditions – have
direct access to other’s e-records
– Patient’s get a right to be informed about access
to own medical records.
– Possible for patient’s to have direct access to own
medical records
Denmark
• Government strategy for information
technology in the Health Care systems (2003
– 2007)
• Focus on interoperability and standards (incl.
SnoMed)
• One Patient – one EHR within each region
• Awareness on legal prerequisites
• Issuing of legal guidelines (information
security, consent)
Denmark (cont.)
“A number of initiatives in the strategy will over a very
short period of time challenge some of the regulations
in the Law on Patients’ Legal Status. For instance, it
will be imperative to clarify whether the existing
legislation presents any barriers to displaying
information originating from various registries, with
the purpose of giving the health care professional a
more holistic view of a patient’s state of health.”
National IT Strategy 2003 – 2007 for the Danish Health Care Service
Norway
• National, strategic initiative –
”Te@mwork 2007”
• Continuity of care – on all levels
• Focus on the importance of information
flow
• National health network
• Widespread use of EHR
Norway (cont.)
• Guidelines on telemedicine and responsibility
• Guidelines on access to an sharing of
information in electronic health records
• Telemedicine and ehealth provided under
existing legislation
• Health Register Act
• Limited possibilities to direct access
• Legislation (or interpretation of it) being
discussed
To conlude
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Good national strategies (good intentions)
Strong focus on infrastructure
Changing Health Records
Legal aspects of ehealth is widely
acknowledged
• Differences in the approach to legal issues
• A need to rethink the legal framework to a
new – electronic - reality