Summary
Objectives:
As information technology creates opportunities for cooperation which crosses the
boundaries between healthcare institutions, it will become an integral part of the
Dutch healthcare system. Along with manyinvolved organizationsin healthcare the National
IT Institute for Healthcare in the Netherlands (NICTIZ) is working on the realization
of a national IT infrastructure for healthcare and a national electronic patient record
(EPR).
Methods:
An underlying national architecture is designed to enable the Dutch EPR virtually,
not in a national database, nor on a patient’s smartcard. The required secure infrastructure
provides generic functions for healthcare applications: patient identification, authentication
and authorization of healthcare professionals.
Results:
The first national applications in the EPR program using a national index of where
patient data is stored, are the electronic medication record and the electronic record
for after hours GP services. The rollout of the electronic medication record and electronic
record for after hours GP services has been started in 2007.
Conclusions:
To guarantee progress of electronic data exchange in healthcare in the Netherlands
we have primarily opted for two healthcare applications: the electronic medication
record and the electronic record for after hours GP services. The use of a national
switchpoint containing the registry of where to find what information, guarantees
thatthe professional receives the most recent information and omits large databases
to contain downloaded data. Proper authorization, authentication as well as tracing
bythe national switchpoint also ensures a secure environment for the communication
of delicate information.
Keywords
National electronic patient record (EPR) - infrastructure - architecture - national
switchpoint - chain of confidence
