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SPD lobby wants patient records voted out in 2011 back

Interest groups in healthcare are lobbying for the reintroduction of the Electronic Patient Record as it was unanimously rejected by the Senate in 2011. Just when a law is on the way to solve the "file with a thousand back doors" problem. Their stance harms both patient privacy and healthcare communication, Privacy First said.

The issue of digital healthcare communication has been a headache since the rejection of the National Electronic Patient File in 2011. Since then, several attempts have been made to create new legislation for a digital healthcare exchange system. All the while, this remained without a workable solution: the new healthcare communication law now in place is the third attempt in 11 years.

Eleven years of persistent tunnel vision

The main reason for the lack of progress is that even after the EPD was rejected in 2011, parties such as health insurers, healthcare umbrella organisations and patient organisations continued to cling to the system devised for it: the National Switch Point (LSP). The way the LSP is set up leads to several problems that stand in the way of an effective and safe exchange of medical data.

For example, it is not possible in the LSP for a healthcare provider to send targeted information to another healthcare provider, while this type of message is the main part of healthcare communication. Sharing data with other healthcare providers is only possible in the LSP by making it widely accessible to entire categories of healthcare providers in advance. In the vast majority of healthcare communications, this method of working is not in line with practice and violates medical confidentiality.

New law finally offers relief

Meanwhile, there are new systems specifically designed to share treatment information one-to-one between healthcare providers, such as in the case of a referral from a GP to a specialist. The new healthcare communication law, the Electronic Data Interchange in Healthcare Act (WEGIZ), allows these different systems to function side by side. For instance, for urgent situations, it would be useful - via a system such as the LSP - to make emergency data on allergies, medication use and contraindications available in advance. In addition, for referrals, systems built to send specific treatment information to another healthcare provider could be used.

Interest groups balk

However, major healthcare stakeholders such as healthcare umbrella organisations, insurers and the Patients Federation are not open to the new possibilities offered by the WEGIZ. The so-called Healthcare Information Council, where healthcare umbrella organisations and insurers have been meeting to discuss new solutions since 2014, has only contributed solutions that used the LSP since its existence. The recently leaked Integral Care Agreement, which sets out the lines of future healthcare policy, contains an extensive annex on data exchange that talks exclusively about exchanges as they are conducted according to the LSP setup.

The recent development of the consent portal Mitz is presented as something new, but does not change this situation, because in the background the LSP is still being used, with all its limitations and shortcomings.

"It seems by all accounts that the parties who drafted this healthcare agreement do not intend to keep the WEGIZ as the legal framework," Privacy First stated in a topical letter to the House of Representatives. Therefore, Minister Kuipers should take control and stop putting it in the hands of the parties that have been providing the same non-working solutions for 11 years.

Riddle attitude

The parties now pushing for the introduction of a single national system are all involved in the association VZVZ, which was formed after the EPD was voted down to push the system through privately. Funded by many millions in annual premium money from health insurers, the parties involved kept pushing the SPD, now called LSP, for the past 11 years. Even now, they continue to do so while a law is on the table that can overcome the problems that led to rejection of the SPD.

Marc Smits, director at Privacy First:

"Stakeholder organisations dogmatically cling to the idea of a national system for all healthcare communications of every patient, while patients, doctors and healthcare as a whole benefit most from technology that fits the healthcare process, rather than the other way around. Minister Kuipers, in implementing the WEGIZ, should not invest exclusively in central solutions such as the LSP, but equally encourage and scale up decentralised solutions."

Read here the letter (pdf) which Privacy First sent to the House of Representatives on this matter. The Parliamentary debate on the WEGIZ will take place on 14 September next.